Six generic drug companies have signed voluntary licensing deals to make the HIV prevention injection lenacapavir, royalty free, for 120 low-income countries where the burden is high.
(Photo by Justin Sullivan/Getty Images)
This week, we heard that six generic drug companies have signed voluntary licensing deals to make the HIV prevention injection lenacapavir, royalty free, for 120 low-income countries where the burden is high.
For this we must commend the drug’s originator Gilead Sciences. The injection, taken just twice a year, eradicated HIV infection risk for the straight women who were part of the trial.
But the company’s supposed generosity belies a betrayal.
Some of the countries that are excluded from the deal — Mexico, Argentina, Brazil and Peru — are home to the very people who participated in the clinical trials that gave Gilead the blockbuster new medicine whose trial results boosted the company’s stock price by 8,5%.
The HIV epidemic is growing quickly in these nations, especially among groups who are intentionally ignored and underserved such as sex workers, the queer community and people who use drugs.
Plus, these governments will be forced to cough up whatever Gilead charges them to get the drug to their people because the six licensing deals include an anti-diversion clause. This bans generics companies from selling their cheaper versions to countries not on Gilead’s list of 120.
It’s an old Gilead trick that only confirms the company has little interest in saving lives at scale.
Gilead’s latest agreements also block any other routes governments might take to buy the medicine cheaply.
The six companies may not sell to excluded countries even if there’s no other patent registered there or even if the nation’s government issues a compulsory licence. A compulsory licence is a tool (backed by the World Trade Organisation) that allows governments to pay to use patented information without explicit permission from the owner.
Once again, the message communities and trial participants are getting from Big Pharma is a big middle finger. They might as well be direct and say: “Thanks for your bodies, we’re off now to make money, good luck.”
What’s even more tragic is that communities that Big Pharma exploits (in complicity with national research institutions) are the same communities we so desperately need to be confident in clinical research.
People who put their bodies on the line for science should be assured access to the fruits of that research. Anything else is exploitative.
If government-backed research institutes do not secure deals that ensure participants get post-trial access, they reduce themselves to mere Big Pharma lap dogs.
Much of our work at the African Alliance is about pushing for the rights and protection of those who participate in clinical research. We believe (because we’ve seen it first hand) that engaging with communities in a meaningful way is the best way to boost trust in the medicine that they’re helping to bring to the world.
Gilead has made a grave error in excluding these communities.
The snub will only deepen the distrust that already exists between Big Pharma and the people whose lives depend on interventions such as lenacapvir and an end to HIV. Distrust in important advances has implications for the entire HIV response.
There are lots of familiar deceptions at play here but our work as global activists is clear. We will remain at the mercy of the pharmaceutical industry until the day our governments, research councils and scientists find the courage to put in place agreements to secure post-trial access before the study gets underway.
We must continue to demand a new level of consciousness in clinical research.
We must pay attention to the agreements our research institutes sign in our name.
Scientists and researchers must do right by those who make their awards, accolades, funding and historical headlines possible.
Tian Johnson is the founder and strategist of the pan-African health advocacy nonprofit, African Alliance.