By Bunmi Yekini
Doctors Without Borders, known by its French acronym MSF, launched a global campaign on Wednesday urging U.S. drugmaker Gilead Sciences to make its breakthrough HIV prevention medicine lenacapavir more widely available, warning that millions of people could be denied access because of high prices and limited supply.
The medical charity also called on governments to use legal measures, including compulsory licensing, to challenge Gilead’s monopoly over the drug if the company continues to restrict production and maintain prices that put the treatment out of reach for many low- and middle-income countries.
Lenacapavir, a long-acting injectable form of pre-exposure prophylaxis (PrEP), is administered only twice a year and has shown near-complete effectiveness in preventing HIV infection. Health advocates have described the drug as a potential game-changer in efforts to curb the global HIV epidemic.
According to MSF, about 1.2 million people acquired HIV worldwide in 2025, with vulnerable populations including sex workers, transgender people, people who inject drugs, and men who have sex with men among those who could benefit most from the medicine.
“Millions of people need lenacapavir right now,” said Dr. Tom Ellman, director of MSF’s Southern Africa Medical Unit.
“In the early days of HIV/AIDS, we were left empty-handed in places like South Africa as pharmaceutical corporations sold their antiretrovirals to the highest bidders. We can’t let history repeat itself with this transformative prevention medicine,” he said.
MSF said Gilead has repeatedly refused requests over the past year to sell lenacapavir directly to the organisation for use in its medical programmes, regardless of price.
The company has instead directed MSF to obtain supplies through the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has received a limited allocation of doses for low- and middle-income countries. MSF said those supplies are already running low in countries such as Eswatini and Kenya, while some countries where it operates are not eligible to receive them.
Meanwhile, lenacapavir is available in the United States at a list price exceeding $28,000 per patient annually, according to MSF.
The organisation also criticised Gilead’s licensing strategy, arguing that agreements with selected generic manufacturers exclude several middle-income countries, including Brazil, Argentina, Mexico and Peru, despite some of them hosting clinical trials for the drug.
MSF said generic versions are not expected to become available until at least 2027 and noted that countries excluded from existing licensing agreements account for roughly a quarter of new HIV infections globally.
“Governments must step in if Gilead continues to put profits over people’s health,” Ellman said, urging countries to use provisions under the World Trade Organization’s Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) to override patents where necessary.
The campaign was launched ahead of next week’s United Nations General Assembly High-Level Meeting on HIV/AIDS in New York, where governments, health agencies and civil society groups are expected to discuss strategies for ending the epidemic and expanding access to prevention and treatment tools.
MSF is encouraging supporters to join the campaign and press for broader access to lenacapavir, arguing that equitable availability of the drug could play a critical role in reducing new HIV infections worldwide.