Gilead's Lenacapavir Dilemma: A HIV Breakthrough Hindered by Access Rules

Lenacapavir could be a game-changer in HIV, but Gilead’s practice of not selling directly to Doctors Without Borders (MSF), limiting supply via the Global Fund to just 2 million doses over three years, and its licensing that excludes 26 middle-income countries has sparked criticism that profits trump public health. Gilead argues it is expanding access through generic licenses and deals with Global Fund and PEPFAR to deliver low- or no-profit supply, with a broader rollout planned in 2027 via generics in 120 countries, but concrete expansion remains uncertain.