Melissa Barber @mbarber.bsky.social · 28/07/2026If you're here and want to chat drug economics and access, please say hi! 000
Melissa Barber @mbarber.bsky.social · 28/07/2026MSF is here continuing to call for Two shots, $40, Everywhere. If you want to learn more about the sorry state of access to long-acting PrEP, please attend our session “Where's my lenacapavir? How to break monopolies and end the HIV epidemic” on Thursday, 12:00-13:00 in room 202. 140
Melissa Barber @mbarber.bsky.social · 28/07/2026In Rio for #AIDS2026. Gilead has put up more promo banners than it has allowed people in Brazil to access lenacapavir. It's a grim echo of past AIDS conferences: we celebrate scientific breakthroughs inside a conference center while people outside still can't access the medicines being discussed. 31610
Melissa Barber @mbarber.bsky.social · 22/07/2026The peculiar situation of Gilead not selling HIV drugs to MSF has been hard to explain: "Wait, the drug company doesn't want cash money, what am I missing?" is the constant q I get from journalists. Thanks to #tbfighters who are finding ways to explain in sharp (& very funny) ways what's happening. 195
Reposted by Melissa BarberCeleste Moss @celestevmoss.bsky.social · 17/07/2026YEZTUGO (lenacapavir) is a new injectable form of long-acting PrEP that only requires 2 doses per year to prevent HIV infection, and 3 million people are expected to get access to the drug by 2028 via The Global Fund. Sounds great, right? (1/5) 418259
Melissa Barber @mbarber.bsky.social · 22/07/2026And your semi-regular update: this podcast is being released 113 days after MSF went public with Gilead's refusal to sell lenacapavir to us, at any price. We have clinics ready to use this drug today but can't, because Gilead has said no and currently has complete control over global supply. 010
Melissa Barber @mbarber.bsky.social · 22/07/2026We dig into market segmentation beyond patents, a worrying trend toward draconian supply chain controls, post-trial access, and why the credible threat of being able to manufacture or purchase non-originator supply is ultimately what gives countries leverage to negotiate prices and licensing terms. 130
Melissa Barber @mbarber.bsky.social · 22/07/2026Some folks (including me) spoke w/Tracy Swan and the Make Medicines Affordable pod abt lenacapavir. Come for a deep dive into Gilead’s VL. Stay for a broader (occasionally 🌶️) convo abt how VLs don't just determine access today, but shape generic markets tomorrow. open.spotify.com/episode/5Klc...open.spotify.comExploring Access Barriers to Lenacapavir Created by Gilead's Voluntary LicneseMake Medicines Affordable · Episode 141
Reposted by Melissa BarberThiru Balasubramaniam @thirugeneva.bsky.social · 21/07/2026The minutes of the TRIPS Council meeting in April 2026 documented heated exchanges on the triplets: biodiversity, traditional knowledge and patenting of life forms. For more background on the 719 document, please see: www.keionline.org/40837 @wto.org 022
Melissa Barber @mbarber.bsky.social · 20/07/2026I'm not saying revoking strict patentability criteria is bad for your odds of winning the World Cup, and mandating drug price transparency is good for them. But I'm not *not* saying it. 070
Melissa Barber @mbarber.bsky.social · 28/06/2026Doctors Without Borders is at NYC Pridefest (4th Ave & 13th St) talking abt our campaign demanding global access to lenacapavir: Two Shots, $40, Everywhere. If you’re at pride, stop by! So far 100 folks have written postcards to Gilead abt why they believe in global access. Let’s get to 1000! 0134
Melissa Barber @mbarber.bsky.social · 24/06/2026MSF technical brief on diagnostics for Bundibugyo Ebola disease: msfaccess.org/The-diagnost...msfaccess.orgThe diagnostic blind spot in the 2026 Bundibugyo Ebola disease outbreak: access gaps and priority actionsA technical briefer sharing gaps and access priorities to ensure access to right diagnostics for Bundibugyo Ebola virus outbreak in DRC and Uganda. 002
Melissa Barber @mbarber.bsky.social · 24/06/2026Hoping someone across my network (or yours - please share!) knows an ingenious diabetes campaigner looking for a 12-month contract with MSF, with the possibility of extension. JD is defined more broadly, but campaigning on insulin will be central. July 3 deadline. www.msf.org/internationa... 011
Reposted by Melissa BarberAdam R Houston @healthlawadamh.bsky.social · 08/06/2026👀"Drugs for Neglected Diseases initiative (DNDi), the GARDP Foundation, and Medicines for Malaria Venture (MMV) join forces to accelerate drug development for patients in greatest need" 🔬🧪💊💉🤝 dndi.org/press-releas... 175
Reposted by Melissa BarberThiru Balasubramaniam @thirugeneva.bsky.social · 06/05/2026Voluntary contributions to the General Fund of WHO in 2025. Gates Foundation - $321,652,415 European Commission - $250,754,314 Gavi, the Vaccine Alliance - $295,771,914 Germany - $140,992,167 United Kingdom - $76,328,886 Canada - $58,089,144 India - $47,325,703 China - $2,960,515 #WHA79 @who.int 342
Reposted by Melissa BarberAdam R Houston @healthlawadamh.bsky.social · 29/04/2026👀 "Canada becomes the first G7 country to approve a generic version of #semaglutide" www.canada.ca/en/health-ca... 062
Reposted by Melissa BarberBK. Titanji @boghuma.bsky.social · 29/04/2026A major serogroup C meningitis outbreak is unfolding in Chad, amid mass displacement driven by war in Sudan. It deserves far more attention than it is getting. Since Jan more than 1,500 patients have been admitted to isolation units amid meningitis C & measles. www.msf.fr/communiques-...msf.frTchad : MSF alerte sur une double épidémie de rougeole et de méningite dans l’est du paysAlors que des milliers de personnes fuyant la guerre au Soudan se réfugient dans l’est du Tchad, les équipes de Médecins Sans Frontières (MSF) font face à une double épidémie de rougeole et de méningi... 15029
Reposted by Melissa BarberJudy Stone @drjudystone.bsky.social · 17/04/2026Gilead's battle with Médecins Sans Frontières (MSF) and plans for limited access to #Lenacapavir raise disturbing questions about #ResearchEthics and who a corporation is responsible to. My latest: www.forbes.com/sites/judyst... #ClinicalResearch #AccessToMedicines #Bioethicsforbes.comBreakthrough HIV Drug Is Out Of Reach For Many Who Need It MostLenacapavir, almost 100% effective at preventing HIV, is priced by Gilead at $28,200 and inaccessible to many in low-income countries plagued by the disease. 11110
Melissa Barber @mbarber.bsky.social · 16/04/2026@gregggonsalves.bsky.social: "The policy by Gilead is delay and deflect—it’s disingenuous, manipulative and will cost lives..In the end Gilead sees one audience for what it is doing, its shareholders, & maximizing share prices is more important to them than the lives of people around the world.” 4/4 1145
Melissa Barber @mbarber.bsky.social · 16/04/2026@gregggonsalves.bsky.social: “This drip-drop, slow-walking approach to LEN access is again evident in Gilead’s refusal to sell LEN to Doctors Without Borders, telling them to go ask the Global Fund, when the supply availability through the Fund is limited and way below need in LMICs." 3/4 1102
Melissa Barber @mbarber.bsky.social · 16/04/2026Forbes: "If corporations’ sole responsibility is to shareholders, that leads us to the question Ugandan researcher Peter Mugyenyi asked at the 2000 AIDS Conference, “Where are the drugs? The drugs are where the disease is not. And where is the disease? The disease is where the drugs are not.”2/4 1265
Melissa Barber @mbarber.bsky.social · 16/04/2026As a pharma company, you know your position is morally indefensible when even business publications like Forbes are scathing about your refusal to supply HIV drugs to MSF and much of the world, while charging the few you do sell to exorbitant prices. 1/4 www.forbes.com/sites/judyst...forbes.comBreakthrough HIV Drug Is Out Of Reach For Many Who Need It MostLenacapavir, almost 100% effective at preventing HIV, is priced by Gilead at $28,200 and inaccessible to many in low-income countries plagued by the disease. 15427
Melissa Barber @mbarber.bsky.social · 13/04/2026Do I know anyone who has recently done a MSc Politics and International Relations at SOAS? Asking for a friend who is looking into the program and has some questions. thank you! 030
Melissa Barber @mbarber.bsky.social · 08/04/2026I'll be speaking on goods in transit issues at the Fordham University School of Law IP and Policy Conference this week. Glad to connect with others working on all things pharmaceutical - feel free to reach out. 010
Melissa Barber @mbarber.bsky.social · 07/04/2026"Companies sought...to reduce budgets for scientific & policy activities carried out by WHO, to pit other UN agencies against WHO, to convince developing countries that WHO’s tobacco control program was a “First World” agenda...to distort the results of important scientific studies on tobacco." 5/5publichealthlawcenter.org 000
Melissa Barber @mbarber.bsky.social · 07/04/2026Some excerpts: "In their campaign against WHO, the documents show that tobacco companies hid behind a variety of ostensibly independent quasi-academic, public policy, and business organizations whose tobacco industry funding was not disclosed." 4/5 www.publichealthlawcenter.org/sites/defaul...publichealthlawcenter.org 100
Melissa Barber @mbarber.bsky.social · 07/04/2026Also recommend a banger of a report - "Tobacco Company Strategies to Undermine Tobacco Control Activities at WHO." There are multiple chapters on scientific misdeeds alone, not to mention surveillance. 3/5 www.publichealthlawcenter.org/sites/defaul... 100
Melissa Barber @mbarber.bsky.social · 07/04/2026"Efforts to deny & distort the scientific evidence of smoking's harms are demonstrated by not only decades of press releases, reports...& scientific symposia & publications, but also by evidence of their concerted efforts to attack & undermine the studies in mainstream scientific publications." 2/5 100
Melissa Barber @mbarber.bsky.social · 07/04/2026Is the Philip Morris currently on an advertising blitz to 'free the science' the same one that DOJ described as having "suppressed research, destroyed documents... distorted the truth, and abused the legal system"? 🤔❓😠 See DOJ summary of U.S. v. Philip Morris www.justice.gov/osg/brief/ph... 1/5 110
Melissa Barber @mbarber.bsky.social · 03/04/2026This is concerning but the impact is hard to gauge without detailed guidance defining how 'ingredients' and 'onshore' will be implemented in practice. www.whitehouse.gov/fact-sheets/...whitehouse.govFact Sheet: President Donald J. Trump Bolsters National Security and Strengthens U.S. Supply Chains by Imposing Tariffs on Patented Pharmaceutical ProductsBOLSTERING NATIONAL SECURITY: Today, President Donald J. Trump imposed tariffs on patented pharmaceuticals and their ingredients under Section 232 of the 000
Reposted by Melissa BarberAsia Russell @asia-ilse.bsky.social · 31/03/2026Gilead spends millions on PR to make 2 million doses sound like something other than the pittance it is. 2 million will have virtually no impact, see the green line below >> 151
Reposted by Melissa BarberAsia Russell @asia-ilse.bsky.social · 31/03/202620 million people need PrEP, and of those many would prefer lenacapavir to oral options. Unless Gilead makes more doses available, access will just remain cruel hype. Already in Eswatini, where HIV prevalence is 25%, clinics are stocked out of lenacapavir because demand is so great >> 162
Reposted by Melissa Barberpharmalot.bsky.social @pharmalot.bsky.social · 30/03/2026Doctors Without Borders calls Gilead ‘unconscionable’ for refusing to sell HIV prevention drug to organization.. statnews.com/pharmalot/20... #pharma #HIV #AIDS #pharma #Gileadstatnews.comDoctors Without Borders calls Gilead 'unconscionable' for refusing to sell HIV prevention drug to organizationThe move came after months of talks in which Doctors Without Borders asked Gilead Sciences for a “limited” supply of lenacapavir. 0188
Reposted by Melissa BarberMelissa Barber @mbarber.bsky.social · 30/03/2026I've walked thru the economic logic here, but Gilead obviously does not say this out loud. They don't really have a good reason not to sell to MSF, which is why they landed on negotiating supply contracts is "a lot of work" (actual thing they said). 13/ www.doctorswithoutborders.org/latest/preve...doctorswithoutborders.orgOpen letter to Gilead: Prevention should not be a privilegeMSF calls on Gilead for direct access to lenacapavir, as the current rollout falls far short of the needs. 522928
Melissa Barber @mbarber.bsky.social · 30/03/2026I've walked thru the economic logic here, but Gilead obviously does not say this out loud. They don't really have a good reason not to sell to MSF, which is why they landed on negotiating supply contracts is "a lot of work" (actual thing they said). 13/ www.doctorswithoutborders.org/latest/preve...doctorswithoutborders.orgOpen letter to Gilead: Prevention should not be a privilegeMSF calls on Gilead for direct access to lenacapavir, as the current rollout falls far short of the needs. 522928
Melissa Barber @mbarber.bsky.social · 30/03/2026Theoretically yes, there are a few pathways. But they require nat'l authorities (not MSF) actioning CLs, which takes time (as well as time to develop the drug). In territories where Gilead has granted a VL, generics are preparing to launch, but this isn't expected until at least next year. 170
Melissa Barber @mbarber.bsky.social · 30/03/2026Even if Gilead would likely make at least a 100% profit selling to a LIC for $80, it becomes politically incredibly difficult to justify your $28,000 price tag in the US. Here's a clip of the BIO lobby saying just this in a USITC hearing. 12/ 324234
Melissa Barber @mbarber.bsky.social · 30/03/2026You also have to think about price pressure: HIV is Gilead's core business, and despite the HIV burden not being heaviest in the US, 81% of Gilead's revenue comes from the US alone (bc prices are so high, even if volumes are low.) 11/ 424819
Melissa Barber @mbarber.bsky.social · 30/03/2026But you have to think abt a potential sale in terms of their portfolio: a 10,000% markup sounds good, unless your other drugs that are vying for time and space on production lines yield you a 70,000% markup. This is why drug companies outsource manufacturing, engage in licensing deals, etc. 10/ 224113
Melissa Barber @mbarber.bsky.social · 30/03/2026To understand this, you have to think about opportunity costs. Gilead told us in meetings that they expect prices to fall below the $40/year price generics have offered - this isn't an expensive drug to manufacture. 9/ 124116
Melissa Barber @mbarber.bsky.social · 30/03/2026At this point, I'm taking of my MSF hat and putting on my academic economist hat to step back and try to make sense of this for folks. (Again, to be clear - this is speculation about markets and I do not speak for MSF). Why would a pharma company like Gilead forego a profitable sale? 🤔8/ 128516
Melissa Barber @mbarber.bsky.social · 30/03/2026The focus of critiques about pharmaceutical monopolies is generally on PRICE. But this case is a compelling example for problems of SUPPLY: it's not a great world when one company controls global supply of a drug and can just refuse to sell it to people who need it. 7/ 139059
Melissa Barber @mbarber.bsky.social · 30/03/2026This situation is extra bad because it's not that Gilead isn't interested in markets in the rest of the world - they have filed for patents and signed licenses blocking dozens of countries from accessing future generic supply. 6/ 130535
Melissa Barber @mbarber.bsky.social · 30/03/2026I expect at this point you are muttering to yourself, "there must be some rational explanation." We thought so too. Which is why we tried & tried again before going public, in the hope that shame still exists and Gilead can be persuaded to do what pharma companies are supposed to do: sell drugs. 5/ 334622
Melissa Barber @mbarber.bsky.social · 30/03/2026Here's where things get weird: Gilead is refusing to sell lenacapavir to MSF. In a series of meetings, Gilead communicated that they're just not really interested in selling lenacapavir in most of the world beyond the cap. Depending on estimates, this cap = between 0.5% and 10% of global demand. 4/ 129939
Melissa Barber @mbarber.bsky.social · 30/03/2026Here's where MSF comes in. We have a long history of offering HIV treatment and prevention services. We have a long history of buying drugs from Gilead. We were not expecting this to be complicated: they have a drug, we want to buy it, thanks to our donors we have money to pay, etc etc. 3/ 131725
Melissa Barber @mbarber.bsky.social · 30/03/2026Lenacapavir is a twice-yearly, long-acting HIV prevention tool, and represents one of the most promising advances towards ending AIDS. In the rich world, Gilead charges $28k/year for the drug. In the rest of the world, Gilead has capped supply at just 2 million ppl over 3 years. 2/ 133143
Melissa Barber @mbarber.bsky.social · 30/03/2026Today, MSF is going public with something we've been fighting behind closed doors for months: Gilead will not sell us their new HIV drug, lenacapavir. The sticking point isn't even price, they just refuse to sell. Open letter linked + explainer 🧵1/ www.doctorswithoutborders.org/latest/gilea...doctorswithoutborders.orgGilead refuses to sell groundbreaking HIV prevention drug to MSFBlocking humanitarian organizations from accessing a medical breakthrough puts vulnerable people across the world in danger. 2217121360