Commentary: This pharma company makes a miracle HIV drug, but is blocking access for millions of low-income people

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By most accounts, the HIV drug lenacapavir is so effective in preventing infection and treating HIV-positive patients that it could revolutionize the fight against AIDS.“Lenacapavir could be transformative,” says Peter Maybarduk, director of the access to medicines program at the nonprofit organization Public Citizen, “if people can get it.”What’s the main obstacle? It’s the drug company that developed and owns lenacapavir, Foster City, Cal.-based Gilead Sciences.Gilead has so tightly limited access to the drug that millions of people at risk from HIV might not get it, according to Public Citizen.

Lenacapavir could be transformative, if people can get it.— Public Citizen drug access expert Peter Maybarduk“We have a technology that could end AIDS, and collectively we’re wasting it,” Maybarduk told me.Gilead’s action became public at the end of March, when the international health organization Médicins Sans Frontières, or MSF, published an open letter detailing its fruitless yearlong effort to purchase a supply of lenacapavir from the company.Commentary on economics and more from a Pulitzer Prize winner.

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MSF, or Doctors Without Borders, says Gilead advised it to obtain the drug from the Global Fund to Fight AIDS, Tuberculosis and Malaria, which will acquire 2 million doses over three years.That’s a small fraction of what’s needed, MSF said in its letter, given that “this allocation is capped, demand far exceeds supply, and every dose directed to MSF is a dose unavailable to another program.”The last meeting bet...