Gilead Sciences CEO Daniel O'Day at Semafor World Economy

Yeah.

Well, thank you Alexis for having me here. It's extraordinary. It's important to put this into context. I mean, HIV is a disease where we still have 1.3 million new people every year diagnosed with HIV. Extraordinary. Many people don't know that two-thirds of the people living with HIV actually are in sub-Saharan Africa, and two-thirds of those are actually women and adolescent girls. This is an extraordinary global health need. And so our scientists have been working on treatments and preventive medicines for 20 years. In fact, Lenacapavir, which was hailed last year in the scientific community when the results came out, was 17 years in the making actually. But it's quite extraordinary because while we have daily pills that prevent HIV, the adherence is quite low. This is a medicine that is given just twice a year, and it was really nearly 100% effective at preventing HIV. So even before we saw those results, we anticipated those results, and it was extremely important for us to get it to the people that could use it most. In fact, we all know with infectious diseases, you can't prevent it anywhere if you don't prevent it everywhere. So it was really important for us, and therefore we built it into our programs. And so I'm really pleased to say, but for the first time, we were able to have the medicine approved in the United States and available five months later in the first sub-Saharan African country. I was in Eswatini when it was delivered. We have a lot of work to do to scale that up. But it's extraordinary, and with a lot of partners to get there. But it took a lot of innovation on the access side as much as it did on the scientific side to bring that and to make that happen.

Absolutely. So look, this is part of our responsibility at Gilead. We immediately voluntarily licensed the medicine to generic manufacturers when we saw this data. No royalties. This is not a part of our business model. It's a part of our responsibility to society. And then, while it will take two or three years for generic manufacturers to have really supplies at scale, we've also, we are also producing Lenacapavir at no profit to Gilead and working with the Global Fund and PEPFAR to distribute it to 120 low and low-middle income countries throughout sub-Saharan Africa, other parts of the world. And we started, as I said, with Eswatini, but we're actually up to nine countries now, including South Africa, which has the largest incidence of HIV. We expect to be, collectively with our partners, at around 24 countries, and then as generics come on board next year, we expect to get to, you know, hundreds of countries in the coming years and tens of millions of people. But yesterday, we announced with the Global Fund and PEPFAR that this interim bridging commitment has gone from reaching two million people in the next three years to three million people. So it's extremely important that we move with speed, because we need to bend the arc of the 1.3 million. That's the only way we're going to end HIV for everyone, everywhere, is by bending that arc. And the way to do that is, of course, to treat people that have the disease because if they're treated, they can't pass it along. But then make sure that 1.3 number drastically comes down. And you know, frankly, in my lifetime, I believe we will be able to talk about HIV in the past tense, not in the current tense.

So when I came into Gilead about seven years ago, it's an extraordinary company. They cured a disease in hepatitis C. They had amazing work in HIV. We wanted to take that science and apply it also to other therapeutic areas. So that's when we established our strategy around taking some of the same aspects of impacting the immune system and applying them to cancer and autoimmune disorders. Fast forward seven years, we've got really the strongest pipeline in our history in all three of those areas. And these acquisitions that you speak about, Arcellx, Tubulis, oral medicines, that all occurred over the past couple of months, are an ability to actually supplement that pipeline and to make it even stronger. And you mentioned cell therapy. I think it's extraordinary to think about we're living in a revolution of science that's only being enabled faster and scaled higher with artificial intelligence being applied. But it's really quite futuristic to think cell therapy is an ability to take your immune cells, if you were to have cancer, we take them to a lab, engineer them to be able to identify the type of cancer you have, reinfuse them back in your body, and we're seeing actually curative responses in diseases like large B-cell lymphoma that in the past had maybe a six-month prognosis for life. So there are extraordinary technologies that are occurring right now in healthcare that will transform diseases like cancer, autoimmune diseases, and certainly ongoing work in virology.