Five years ago, Eldred Tellis heard about a “wonder drug” that could give a fighting chance to people at high risk of contracting AIDS.

Tellis’s work involves one such group – drug users in Mumbai, many of them unlettered.

“They share needles often and do not understand the consequences,” said Tellis, who founded the Sankalp Rehabilitation Foundation to advocate for the healthcare of addicts.

“Several end up contracting HIV.” The human immunodeficiency virus, or HIV, spreads through unprotected sex and the sharing of needles.

The virus attacks the immune system and, if not treated, develops into the deadly acquired immunodeficiency syndrome or AIDS.

But the new drug, Lenacapavir, holds out hope.

If injected once every six months, it can prevent the onset of AIDS even in people at high risk.

“When we heard about it, we realised we could save many with Lenacapavir,” he told Scroll.

“Not just drug users.

Even sex workers who have no choice when their customer refuses to use a condom” stand to benefit.

Lenacapavir has shown a 96% reduction in HIV incidence, and is 89% more effective than current oral medications.

Last year, the World Health Organisation recommended Lenacapavir as a pre-exposure prophylaxis.

The drug is yet to get permission for use in India.

But when it does, it may be unaffordable for most Indians.

In the last few years, Gilead Sciences, the American pharmaceutical giant that made the drug, put in several applications to patent the drug in India.

If granted, the patents would make the drug prohibitively expensive, Tellis said.

In the United States, Gilead has priced the drug at $28,218 per patient per year – an unaffordable Rs 25.8 lakh per year for an Indian patient.

To make sure that HIV patients in India have a chance at affording the drug, Tellis registered four pre-grant oppositions with the Indian Patent Office in 2021.

“This drug is the best possible tool to prevent HIV and it must be made accessible to those at risk,” Tellis said, explaining his reason for filing an opposition on behalf of Sankalp Rehabilitation.

UNAIDS agrees.

“It is beyond comprehension how Gilead can justify a price of $28,218 [for a game-changing medicine],” said Winnie Byanyima, executive director of UNAIDS, in a statement issued last year.

“I urge Gilead to do the right thing.

Drop the price, expand production, and ensure the world has a shot at ending AIDS.” Between 2021 and 2025, nine pre-grant oppositions were filed in India against Gilead’s patent applications on Lenacapavir, including the one by Sankalp Rehabilitation Foundation.

Last year, while adjudicating one of the applications, the patent office heard both sides, the manufacturer and Tellis.

Its decision is pending.

What Gilead proposes: ‘Sustainable access’ A patent gives a pharmaceutical company a legal right to prevent others from producing, using or commercialising a drug formulation for a certain period.

“Often to seek more profits, pharma companies attempt to increase their patent duration by making minor tweaks in their drug,” said Tellis.

This could include a minor change in dosage, or formulation, or the method of administering the drug, he said.

This is called patent evergreening.

Several attempts have been made to extend patents to crucial drugs in India.

In some cases, the court has stepped in.

In 2013, Swiss pharma company Novartis’s plea to extend the patent of cancer drug Imatinib was rejected by the Supreme Court.

More recently, the Indian Patent office rejected Johnson and Johnson’s application for bedaquiline, a popular life-saving medication for drug-resistant tuberculosis patients.

So far, objections to Gilead’s pre-grant applications on Lenacapavir have been filed in India, Thailand, Vietnam and Argentina.

In 2025, Argentina rejected one such application, which could allow generic drugs to enter the market.

This may set a global precedent, activists hope.