After 43 years, the world’s worst modern health crisis could finally be coming to an end. Since 1981, over 40M people have died of HIV/AIDS worldwide. But thankfully, modern diagnoses are no longer a death sentence — and diagnosis rates are falling thanks to the increasing popularity of preventative drugs. With preventative treatment on the rise, some pharma leaders have made billion-dollar franchises out of ending the pandemic.

• Gilead’sGILD
  once-daily Truvada and Descovy PrEP pills have generated peak annual sales of $3B and $2B, respectively — and now, Gilead hopes to bring a lucrative injectable PrEP to market.
• GSKGSK
  and ViiV Healthcare have jointly launched injectable versions of PrEP — Cabenuva and Apretude — generating $338M in the latest quarter, a 77% increase year-over-year.

Adoption curve: The CDC says that 1.2M high-risk people in the US could benefit from preventative meds — but only 36% of those patients are currently enrolled in treatment. That’s up from 23% in 2019, but there’s still a lot of room for improvement. To close the gap, the US has been giving away HIV drugs for free to uninsured Americans through its “Ready, Set, PrEP” campaign — and new laws will mandate insurers to cover injectable HIV prevention drugs by 2025. However, reaching 100% enrollment will require making drugs cheaper — and facing conservative lawsuits against widening care. Both could impact profits and the efforts against the disease.