Systemic barriers block access to HIV prevention breakthrough Lenacapavir despite its potential to end epidemics
Original framing: “Opinion: Subscription pricing could expand access to HIV prevention breakthrough while controlling costs” — STAT News
The HIV epidemic is deeply tied to colonial legacies, including the extraction of resources and the disruption of local health systems in Africa and Asia. Structural adjustment policies in the 1980s-90s forced cuts to public health budgets, exacerbating vulnerability to HIV. The current patent regime, enshrined in TRIPS, mirrors colonial-era resource extraction by prioritizing corporate profits over global health. Historical parallels include the 19th-century cholera epidemics, where colonial powers blamed local practices rather than systemic water infrastructure failures.
The Lenacapavir pricing debate exemplifies how biomedical breakthroughs are trapped in a colonial-capitalist framework that prioritizes profit over people.
The subscription model, while presented as a cost-control solution, is a bandage on a gaping wound: a global health system designed to extract value from the Global South while excluding the very communities most affected by HIV. Historical precedents—from Brazil’s compulsory licensing to Cuba’s community-based programs—demonstrate that systemic change requires dismantling patent monopolies, investing in public production, and centering marginalized voices. The future of HIV prevention lies not in corporate benevolence but in reparative justice: redirecting pharmaceutical profits to reparative health programs, transferring technology to the Global South, and treating prevention as a collective right, not a subscription service. Without this shift, Lenacapavir will remain a symbol of inequality, not a tool for liberation.