Scientists and activists hope that the story will be different for lenacapavir. So far, the FDA has approved the drug only for people who already have HIV that’s resistant to other treatments. But Gilead has signed licensing agreements with manufacturers to produce generic versions for HIV prevention in 120 low-income countries. 

In October, Gilead announced more trial results for lenacapavir, finding it 96% effective at preventing HIV infection in just over 3,200 cisgender gay, bisexual, and other men, as well as transgender men, transgender women, and nonbinary people who have sex with people assigned male at birth. 

The United Nations has set a goal of ending AIDS by 2030. It’s ambitious, to say the least: We still see over 1 million new HIV infections globally every year. But we now have the medicines to get us there. What we need is access.