Gilead urges community-led design for medicine access

Gilead Sciences is pushing for a radical shift in how pharmaceutical companies and health systems design access to medicines: putting community voices at the centre of decision-making. The argument is straightforward—innovation only matters if it reaches people in ways that reflect their lives, not just clinical data. For Peter Wickersham, vice president and general manager of Gilead Sciences in the UK and Ireland, the gap between what science can deliver and what patients actually access isn’t a technical problem. It’s a failure of listening.

The issue is most visible in England’s fight to eliminate hepatitis C. The goal, eliminating the virus by 2030, required more than new treatments. It demanded rethinking how care is delivered. Instead of waiting for patients to handle a fragmented system, services were brought to them. Drug treatment centres, prisons, and community charities became partners in designing the programme from the start. The result? Over 17,500 people treated across 79 centres, with testing and treatment now available in settings where trust already exists.

This approach isn’t just about hepatitis C. It’s a model for how health systems could work, where the people closest to a problem help shape the solution. Take Martha’s Rule, for example. It began after one family’s desperate plea for their daughter’s worsening condition went unheeded. Now, the rule, named for Martha Mizen, operates in every acute hospital in England and has been extended to maternity services. Hundreds of interventions later, it’s a reminder that systemic change often starts with a single voice demanding to be heard.

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The problem, though, is that community insight is still often treated as an afterthought. Policymakers gather feedback after decisions are made, not before. The NHS’s 10-Year Health Plan acknowledges the need for neighbourhood-level care and patient voices, but the mechanisms to make that real remain vague. Digital feedback channels aren’t enough when the system still expects patients to adapt to its structure rather than the other way around.

Wickersham points to three practical steps to fix this. First, involve under-represented communities early in strategy development, and be transparent about how their input shapes outcomes. Second, treat community organisations as long-term partners, not just consultation boxes to tick. Third, build care pathways around how people actually live, not around the rigid schedules of GPs and hospitals.

The data backs up the urgency. In the UK, one in three people living with HIV are women, yet they’re still more likely to be diagnosed later than men. Black women face higher risks of late-stage breast cancer diagnoses compared to white women, a disparity tied to systemic gaps in care. These aren’t isolated cases. They’re symptoms of a system that too often fails to reflect the diversity of patient needs.