Brazilian LGBTQIA+ organizations participating in the Pride Parade, led by the São Paulo LGBT Pride Association (APOLGBT-SP), have called for universal access to lenacapavir. The twice yearly long-acting injectable medication is considered one of the most significant innovations in HIV prevention and treatment. Lenacapavir has demonstrated nearly 100% efficacy in preventing HIV. 

These organizations are stressing that the anticipated high cost of the antiretroviral drug could prevent its incorporation into Brazil’s Unified Health System (SUS), potentially deepening inequalities and undermining the country’s response to the HIV epidemic.  

“One of our priorities is to foster discussion around crucial scientific innovations such as Lenacapavir, ensuring that it reaches those who need it most,” said Nelson Matias Pereira, President of APOLGBT-SP. 

The public manifesto emphasizes that access to health, science, and prevention technologies is a fundamental human right. It also warns about the disproportionate impact of the epidemic on historically marginalized populations, including gay men and other men who have sex with men (MSM), transgender people, , sex workers, and other key populations that have long faced social vulnerability.  

According to data from Brazil’s Ministry of Health, published in the 2025 HIV and AIDS Epidemiological Bulletin, Brazil recorded a 21.9% increase in new HIV infections between 2014 and 2024. According to UNAIDS, in Latin America, new HIV infections increased by 13% between 2010 and 2024, with approximately 120,000 new HIV infections reported in 2025 alone. An estimated 66% of these cases occurred among key populations and their sexual partners.  

The signatories of the manifesto also note that Brazil was one of the countries that participated in the lenacapavir clinical trials, yet the country was excluded from voluntary licensing agreements that would allow the production of more affordable generic versions of the product.  

“It is unacceptable that Brazil, which directly contributed to the clinical trials of this medication through Brazilian individuals and communities, has been excluded from voluntary licensing agreements and remains hostage to prices that make its incorporation into the SUS unfeasible.  We cannot accept commercial barriers and patent restrictions that hinder access to HIV prevention and treatment,” said Mr Pereira.  

For Federal Congresswoman Duda Salabert reason more to advocate for full Lenacapavir access through the health system.  “Patents play an important role in science, but there are moments in history when they must be weighed against a greater collective good through the public interest. The issue, of course, is the price,” she said. “I reject the idea that someone should be unable to live because they cannot afford treatment. That is why our office has taken up this cause and will continue fighting for access through the SUS,” added Ms Salabert. 

The manifesto is calling for urgent action from Gilead Sciences and Brazil’s Ministry of Health. Their demands include:  

• Continued access to lenacapavir for Brazilian participants in clinical studies; 
• Immediate inclusion of Brazil in voluntary licensing agreements; 
• Transparency in pricing negotiations; 
• Pricing that is compatible with the long-term sustainability of the SUS; 
• Meaningful participation of the most affected communities in decision-making processes; and 
• Consideration of compulsory licensing should patent-related barriers and excessive pricing persist.  

They also want the Ministry of Health to commission studies by the Oswaldo Cruz Foundation (Fiocruz) on the feasibility of public production of lenacapavir and other long-acting technologies for HIV prevention and treatment.