➤ Gilead is harnessing data to target its HIV initiatives at regions with the greatest patient need.

➤ The drugmaker sees its model of local partners engaging marginalized communities as a potential template for Big Pharma to adopt.

➤ The social impact of increasing access to medicines is the most prominent strand of the company's environmental, social and governance strategy.

Gilead Sciences Inc. — which produces the HIV drugs Truvada and Descovy, among others — launched its Compass initiative in 2017 to address the epidemic in the southern U.S. Through the $100 million, 10-year program, the Foster City, Calif.-based drugmaker partnered with three coordinating centers that identify and provide funding to local organizations committed to combating the spread of HIV.

S&P Global Market Intelligence spoke to Gilead's senior vice president of public affairs, Korab Zuka, about the pharmaceutical company's medicines access strategy, as well as wider ESG lessons for the sector. The following is an edited transcript of the conversation.

S&P Global Market Intelligence: How has Gilead's approach to HIV prevention and treatment among marginalized groups changed over the years?

Korab Zuka: We have a deep bench of knowledge and expertise to pull from in terms of the impact that we want to create in communities that are disproportionately affected by HIV. There is so much data that shows that HIV sits at the intersection of a lot of issues that individuals face — the compounding effect of rurality, sexual orientation, race, gender and health literacy. For us, it has always been really important to partner with organizations who have access to marginalized communities so that they're actually able to reach them.

In terms of what has changed, in the beginning of the HIV epidemic it was very much concentrated in metropolitan areas. Now, data shows that the southern U.S. is disproportionately impacted. When we do a deeper dive into it, we see that marginalized communities are disproportionately affected by HIV, particularly Black men and the transgender community. So it's been really important to reengineer a lot of what we did in the early 1980s.

You mentioned data. What role does that play?

There is this wonderful website led by Emory [University] in partnership with Gilead that looks at HIV diagnosis by ZIP code. It's become a tool for many of us who work in HIV to see the caseload and disease burden in [each] region.

It's a similar approach that the U.S. government has taken. When they declared that we want to end the epidemic by 2030, so much of that is driven by the data to see where the new diagnoses are, how we make sure that people have access to comprehensive HIV prevention, and all of those really important aspects as we think about HIV and the continuum of care.

Has Gilead made efforts to better represent these populations in clinical trials?

Yes, we have. For us, clinical diversification has always been really important. We've always taken this approach and making sure that the [contract research organizations] we're partnering with are located in diverse geographic locations. We wanted to make sure that they have the right training in terms of how we think about inclusion and diversity.

We've also developed materials that are more sensitive when it comes to translating information and making it more accessible for underrepresented communities. We're starting to make some more progress [but] we still have a long way to go as an industry.

Medicine costs can be a barrier to access, especially in the case of HIV drugs. How is Gilead approaching this issue?

For us, access has always been at the core. We have a lot of programs in place that address access holistically. In the U.S., we offer free drugs to qualifying patients who don't have insurance and meet the income criteria across all of our disease categories. We also support patients with out-of-pocket costs.

There have been concerns raised that changes to Gilead's Advancing Access scheme in January could potentially reduce the availability of HIV drugs. Is that something that you monitor or are worried about?

The access program, which was initially designed to provide free drugs for qualifying patients — nothing has changed. If you're a patient, you don't have insurance, you're struggling to get your medicine, [then] you meet the income criteria, you will receive a free drug from Gilead. It's more in the back-end that changes were made in terms of reimbursement, [but] this was never set up to provide reimbursement to begin with.

Do you have any advice to your Big Pharma peers who are also trying to reach marginalized communities?

I would say, "Partnership, partnership, partnership." It's really important to put the patients at the center, but also making sure that we're able to connect to the ecosystem of that individual.

It's not about individual companies being able to do something and receive credit for it. It's about the joint impact that you create through partnerships. Pharmaceutical companies have such an incredible role they can play as a facilitator and a connector, but also a leader, so that we're able to amplify that social impact.

Does Gilead have specific ESG targets when it comes to HIV or working with diverse communities?

This is definitely part of our ESG [strategy]. We talk about the environmental aspect of biopharma, but really social is the piece that's most significant for our company because on the social side you have both innovation, but also making sure that the innovation reaches patients.

In HIV, we have used both peer pricing and generic licensing to make our medicines available in over 100 countries. So it's very much integrated as a part of who we are and how we make our decisions.

What's next for Gilead in this area? Do you have other ambitions or programs beyond Compass in the works?

We launched a lot of programs in the last four years, so it's not necessarily launching new programs, it's tweaking things along the way so that we're able to respond to what the community tells us.

It's also really important to capture the learnings so that we can share them more widely because this could be applied in other areas, not just HIV. How do you make sure that you can get four or five organizations that represent a unique dimension of an issue that we're trying to solve collectively? That's the piece that we're most excited by: how we can potentially apply this model in other areas and not necessarily have it be disease-specific, but still create an impact for individuals.