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By Fred Deya
Nairobi, Kenya: This weekend, the 26th International AIDS Conference kicks off in Rio de Janeiro, where Doctors Without Borders (MSF) is ramping up pressure on Gilead Sciences.
The organization is calling on the US pharmaceutical giant to expand access to the HIV prevention drug lenacapavir across low- and middle-income countries, including Brazil.
“We’re here at AIDS 2026 with one main ask: lenacapavir must be available for no more than $40 per person per year in all low- and middle-income countries,” said Renata Reis, executive director of MSF-Brazil.
“We have been running HIV prevention programs and treating people with HIV/AIDS across the globe for decades. We’ve seen firsthand what happens when medical tools like antiretroviral treatments are priced out of reach or are simply unavailable: People die needlessly, and communities suffer. We can’t let history repeat with this critical HIV prevention medicine.”
MSF recently launched a campaign against Gilead and is encouraging people to sign up to join and voice their support for increased access to lenacapavir. MSF will also be hosting a satellite session on July 30 during AIDS 2026 on improving access to lenacapavir.
MSF calls on Gilead to drop its price, ensure the supply of lenacpavir meets the actual demand, and to sell to MSF directly so that MSF can supply this game-changing HIV prevention tool to those who are most in need and who are not currently covered by the Global Fund agreement.
“HIV isn’t waiting, so why is Gilead?” Flores said. “Millions of people who need this medicine can’t currently access it. The pharmaceutical corporation must immediately lower its prices and expand access to lenacapavir — or governments like Brazil must take action. There are international legal tools in place for a reason: to protect public health. Brazil has used them in the past, and they must use them again now.”
Gilead currently completely controls who can receive lenacapavir, where it’s available, and on what terms. The pharmaceutical corporation sells it for $28,000 a year per patient in the US even though it could be produced for less than $40. Some more affordable generic versions are set to become available as early as next year, but only select manufacturers will be allowed to make them, and their sale will be restricted to certain countries. Many countries — including Brazil, Argentina, Mexico, and Peru — that hosted the lenacapavir clinical trials are excluded from that deal altogether.
“It is unacceptable that communities in Brazil contributed to the clinical trials that paved the way for lenacapavir’s approval and sale in countries across the world, yet people here still struggle to access this game-changing medicine,” said Antonio Flores, senior HIV and tuberculosis (TB) advisor with MSF’s Southern Africa Medical Unit. “Gilead alone should not decide who gets lenacapavir and who doesn’t.”
If Gilead continues to charge high prices for this medicine and restrict its production, governments, including Brazil’s, should take any and all necessary steps to make it easier to override Gilead’s monopoly on this product. Governments are afforded a broad range of flexibilities under the World Trade Organization’s Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). For example, countries may grant compulsory licenses on otherwise patented products, allowing their use without the authorization of the patent holder. Actions like this can remove intellectual property barriers and may facilitate broader generic production.
Lenacapavir is a long-acting injectable form of pre-exposure prophylaxis (PrEP) that is administered just twice a year and has demonstrated near-complete effectiveness in preventing HIV infection, making it a potentially transformative option for HIV prevention.
By providing extended protection through only two injections annually, it offers greater convenience and choice, particularly for populations that experience stigma and significant barriers to healthcare access, including men who have sex with men, transgender people, sex workers, and individuals living in conflict or humanitarian settings.
Nonetheless, despite its promise, access remains highly limited due to Gilead’s high pricing, restricted distribution to selected countries such as Brazil, and its refusal to supply the medicine directly to Médecins Sans Frontières (MSF) for use in its medical programmes.
Brazil hosted clinical trials that paved the way for lenacapavir’s approval and sale, but the medicine remains widely inaccessible for people there.
