HIV has been the sword dangling over the head of the LGBTQ community for decades. Survivors of the AIDS crisis will often recount how they were abandoned by their governments and left to die en masse. Over the years the threat of that specter has somewhat lessened; HIV drugs were eventually developed, and while many people developed drug resistances and needed complex cocktails of pills to stay alive, life expectancy with HIV grew. 

Today, an HIV diagnosis is no longer considered a death sentence. This has all culminated in the development of a miracle drug: Lenacapavir, which is as close as we’ve ever been to an HIV vaccine. But hardly anyone can afford to take it. 

Lenacapavir represents a massive breakthrough in HIV treatment and prevention. Given by injection every six months, the drug can not only suppress HIV in people who are already infected, but can also prevent infections. In an initial trial, the drug offered a 100% protection rate to more than 5,000 women in South Africa and Uganda, according to results published by Gilead in June 2024. 

Even more significant, the drug is impossibly cheap to produce; if the company sold a year-long course of the medication for $40, they would still make a 30% profit, even if only 10 million of the 60 million people globally who likely need it were to buy it. 

In an utterly disgusting and indefensible act of price-gouging on a commodity that means life and death for millions of people across the world, Gilead is currently selling Lenacapavir for over $42,000 a year. This drug was made on the back of scientific workers, many of whom are paid wages that fall significantly below the cost of living, all while people worldwide are getting sick and dying. 

According to the WHO there are nearly 40 million people worldwide living with HIV today, and in 2023 over 630,000 people died of HIV-related illness. This affects the neocolonial world to an even greater degree; African HIV patients account for two-thirds of all the HIV patients worldwide, amounting to over 3% of the population of the region living with the infection. 

Getting Sick Shouldn’t Bankrupt You

The human need for this medication is obvious, but for corporations like Gilead, meeting human need seems to have little to do with their goals for their medical research. Many HIV patients eventually develop a resistance to the drugs that they use to suppress their viral load, which results in the need for different, stronger, (and more costly) drugs. Simply put: these pharmaceutical giants realized a long time ago that when you have a life-saving product, especially when few other products will do as a replacement, you can essentially name your price. 

This leaves many working-class people with the grim choice of either bankrupting their family by saddling them with medical debt, or just waiting around to die.The prices set by Gilead and other pharma giants mean that many people don’t even get to make that choice, or that they try to ration their care and end up amassing debt and dying anyways. 

The vaccines for Covid-19 are still among the most profitable commodities ever produced by humanity—Pfizer alone generated $35 billion net profits on its Covid-19 related products during 2021 and 2022, while the world’s poorest countries remained unvaccinated. From Covid vaccines to Lenacapavir and so many other drugs, the evidence becomes clear: until the profit motive is taken completely out of the healthcare system, the capitalists who own these drug companies will never stop holding sick and dying people upside down by their ankles to shake out every last penny. 

Any working-class person who has come into contact with the prices of pharmaceuticals and healthcare in general comes away with the stark impression that our capitalist society is sicker than they will ever be. 

We’ve all seen stories of people coming together to support fundraising for those with massive medical bills; these stories are often presented by corporate news outlets as touching stories of solidarity and communities coming together. But the real takeaway is that our healthcare system is so utterly broken that the only way many can get the help they need is relying on other poor and working people passing the hat. 

What’s The Solution?

While a “Medicare for All” single payer healthcare system that is free at the point of use would be a massive step forward, but ultimately we need even more than that. We need a fully nationalized healthcare system run by the working class, not for the sake of profit, but for the sake of meeting the needs of humanity. 

Some activists are calling for Gilead to make Lenacapavir cheaper. But the truth is that in the absence of working people holding Gilead accountable through strikes or protests, the company is likely to make big promises about delivering cheap, or even free, doses to the neocolonial world that they have no intention of living up to. 

This is exactly what happened with Covid-19 vaccines: companies like Moderna made big promises of vaccinating the neocolonial world, and then instead diverted huge sections of the vaccines they produced to countries with the money to buy them. 

A year and a half into the Covid-19 pandemic, Moderna had only delivered 0.2% of their vaccine supplies to low-income countries, while Pfizer/BioNTech also delivered less than 1%, which was a contributing factor in both the mass deaths caused by the pandemic as well as the formation of new strains. 

The for-profit healthcare system, just like the rest of the capitalist system, utterly failed in its response to Covid-19, and is utterly failing in its response to HIV now, even at a moment when the closest thing we have ever had to a cure for the disease has just been brought to market. 

Over the last ten years, demands around winning Medicare for All drove an entire generation of young people and workers towards becoming activists, and played an important role in increasing the openness many have towards socialism. 

Bernie Sanders and the Squad, formerly the champions of Medicare for All and other demands, have now fallen in line with the Democratic Party establishment. We just had the first presidential election in a decade where no one in the Democratic Party mentioned Medicare for All. The chief reason for this is that the biggest political threats to the Democratic Party establishment, Bernie Sanders and the Squad, have been fully neutralized. 

We need to abandon the Democratic Party; we can’t pull it to the left, and if we attempt to partner with it, it will pull our movements to the right. Today, the best avenue to fight for demands like Medicare for All is within the labor movement, which urgently needs to take up the demand and use its tremendous power to deal body-blows to the wallets of the ruling class until they meet our demands. 

We should demand that the top pharmaceutical companies be taken into democratic public ownership, run by and for working people. These corporations’ billions in profits, instead of going into the pockets of a few millionaires and billionaires, should be put toward researching and producing desperately-needed treatments and making them widely available at low cost.

The labor movement and the working class, if it becomes politically independent of the bosses and their political servants, have the power to win more than just badly needed reforms. An organized and politically independent working class could transform society by democratically planning our economy around meeting human need, instead of generating massive profits for a small few.

The time has come to do away with a gangrenous and decaying system that has shown itself incapable of meeting human need and preventing wars and famine. We need a new system, and that’s what Socialist Alternative members are fighting for. Join us!