Gilead Sciences, the pharmaceutical that makes Truvada, the only FDA-approved drug for PrEP, is having a great week in the public relations department. First, Gilead announced they were surrendering their patent for Truvada a year early, and now Federal officials have announced that Gilead will donate enough Truvada for 200,000 people in the United States.

Don’t fall for this. Gilead is engaged in a brilliantly self-serving marketing ploy and dressing it up like charity. Their deeply entrenched ownership of our governmental and community HIV response is as clear as ever. This ownership isn’t absolute; there are activists and national community leaders who see this ploy for what it is. #PrEP4All has met the news with great skepticism, and national non-profit leaders, who depend upon Gilead funding, have damned the announcement with faint praise or silence.

Here are five reasons why Gilead is simply building profits and ignoring pleas to do some real good.

  1. Gilead is offering no-cost Truvada for 200,000 when they could make it affordable for everyone.

It costs Gilead pennies to make Truvada. They charge $20,000 a year for it. If Gilead really wanted to end this epidemic – and make no mistake, they have the ability to fundamentally alter the trajectory of HIV in the United States – then they would lower the price of Truvada across the board, for everyone. And by lower, I mean by a lot.

And the math is way off. We don’t need 200,000 more people on PrEP. In the United States alone, we need a million more people on PrEP.

Did I mention that Gilead will claim many, many millions of dollars in lost revenue on their corporate taxes as a result of their generosity?

  1. Gilead is only providing Truvada for non-insured persons. People with insurance need it just as much.

There are people with health insurance who still face barriers to PrEP. They have high deductibles and co-pays, for instance, or they take one look at the bureaucracy of prior authorizations and co-pay assistance cards and just give up.

We all want PrEP to reach everyone who needs it. There are and will be roadblocks, including basic needs like transportation that affect populations that need PrEP most.  This is a case where white, gay, cis men who think getting and maintaining PrEP is easy might want to check their privilege.

  1. Gilead’s big donation creates new customers for their new PrEP drug, Descovy.

This might be Gilead at their most vile. By offering free Truvada to 200,000 people, they are creating a customer base for the arrival of their new drug, Descovy, which awaits FDA approval for use as PrEP.

Descovy reportedly does not cause the side effects that some Truvada patients have had. Gilead knew about the Truvada side effects years ago, but they waited all this time to introduce Descovy because they wanted to run out the clock on Truvada’s patent, yes, even while knowing Truvada was causing side effects in some people along the way. This is just another chapter in the rich, sick history of Gilead’s corporate profiteering.

  1. Gilead is fading out one PrEP drug and charging full price for their new one.

Once Descovy is FDA-approved next year for PrEP, Gilead will have an additional 200,000 new Truvada customers that they can try and talk into taking their new, improved version. Everyone else on Descovy will be paying the full price of $20,000 per year. This may be a sum gain in terms of HIV prevention, but it ain’t charity.

And don’t look too closely at Gilead’s deal to allow generic Trubvada in 2020. Because only Teva Pharmaceuticals will be allowed to make it, pricing is unclear and may not offer the savings we expect. (Teva was paid off by Gilead not to fight Gilead’s schedule for generic Truvada, known as “pay to delay.”)

  1. The Truvada-as-PrEP patent belongs to U.S. taxpayers. Where are the royalties we deserve?

Which brings us to the topic Gilead really, really wants everyone to stop talking about. The patents for Truvada-as PrEP belong to the United States taxpayers because the research was done by the CDC, not Gilead. Considering Gilead makes $3 billion a year on the sale of Truvada, those royalties could fund our national HIV prevention response. The CDC will not discuss this.

Oh, and the CDC owns patents to Descovy-as-PrEP, too. Don’t expect all the #PrEP4All activism to fade when Truvada goes generic. It won’t.

Gilead is hoping that their one-day headline about their Truvada donation will appease critics of their profiteering.  It does not. And from what I am hearing, there are more interesting headlines to come in the days ahead.

Stay tuned.