Semua Kabar

The thirty-three-year-old democratic socialist has created a movement. Can it overcome Andrew Cuomo’s power?

Zohran Mamdani, the young democratic-socialist state assemblyman who has waged a surprisingly strong campaign for mayor of New York City, hasn’t just frustrated his opponents. He’s made them jealous. “I regret not running for mayor in 2021,” State Senator Jessica Ramos said this month, during a televised Democratic primary debate, when asked if she had any regrets in her political career. “I thought I needed more experience,” she explained. “But turns out you just need to make good videos.” Someone in the audience broke out in applause. It was obvious to everyone that this was a jab at Mamdani. Standing a few feet away from Ramos, Mamdani took in the dig with—what else?—a winning, dimpled smile.

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In 2025, the idea of dismissing a political candidate for “just” being good at social media is almost a joke in itself. We have known for many years now that a candidate who can tell their story creatively on the internet is at an electoral advantage, in New York City and pretty much anywhere in the world. Social media is where many voters decide if a politician is what the Tammany Hall bosses a hundred years ago used to call “regular”—whether they can be counted on. It’s an authenticity test. A mayoral campaign today that doesn’t have a plan for “good videos”—ones in which the candidate can make their case and an implicit compact with their audience—is likely doomed. It’s not difficult to understand Mamdani’s opponents’ frustration. Most have spent years carefully plotting their mayoral runs, building their résumés, political connections, and fund-raising networks. Now the kid with the nice eyebrows is running circles around them.

When I had coffee with Mamdani a few months ago, he proudly told me that his thousands of campaign volunteers—the people he’d converted to his side, partly with “good videos”—would, before primary day, knock on a million doors on his behalf. I was skeptical. Which million, I asked. Mamdani flashed me another one of those damned smiles. At the time, I had been thinking of recent debates over the effectiveness of political canvassing and other ground-game techniques. I was reminded particularly of the former congressmanBeto O’Rourke, who excited his supporters around the country with a pledge to knock on more than a million doors in Texas in his run for Senate, in 2018, only to come up short against Ted Cruz. Texas is big—two hundred and sixty-nine thousand square miles—and has resisted canvassing efforts for decades. But New York City’s four hundred and sixty-nine square miles might present an even harder challenge to door knocking: Who in this town answers the door to a stranger with an open mind? Who even opens the door?

What I hadn’t considered is that, even if knocking on a million doors isn’t the most efficient use of campaign resources in New York City, it makes for great content. The story of Mamdani’s door-knocking campaign and other old-fashioned efforts reached millions of people online, gave the campaign shape, and helped it become a movement.Ding-dongand TikTok. In politics today, one can feed off the other.

Mamdani has a movement behind him, but he has spent the closing days of the primary race struggling to build a coalition. Even in the polls that look best for him, Mamdani comes up short to Andrew Cuomo, the disgraced former governor who has led every ranked-choice poll since he entered the race. In one poll, conducted on behalf of a superPACthat supports Mamdani (in 2025, even socialists have superPACs), he comes out just two points behind Cuomo in the final round of ranked-choice voting. The cross tabs of that poll showed why. Among Black voters, Mamdani lost by more than forty points. Among Hispanic voters, he lost by nearly ten. Mamdani’s voters trended younger than Cuomo’s—no big surprise there—but also whiter, better educated, and more male. That he has aspired to speak for the city’s downtrodden but has done best drawing out the work-from-home creative class is a contradiction that he wasn’t able to resolve before primary day.

That same poll showed Mamdani leading among Asian voters. There are 1.5 million residents of Asian descent in the city, but that’s still less than twenty per cent of the city’s population. Mamdani, the son of Mahmood Mamdani, a Ugandan Indian political scientist, and Mira Nair, an Indian American filmmaker, has also made a representation pitch to the city’s more than seven hundred thousand Muslims. But forming a coalition requires reaching voters beyond what might be considered a politician’s natural base, stitching together unlikely factions, communities, and blocs. In the race’s closing days, Mamdani’s campaign became fixated on “momentum,” reaching for the figurative in lieu of the numerical. (E-mail subject line, June 17th: “AS MOMENTUM REACHES A FEVER PITCH, BERNIE SANDERS ENDORSES ZOHRAN MAMDANI FOR MAYOR.”) When the votes get counted, though, coalitions trump momentum every time.

Mamdani has been stymied for several reasons that were apparent before primary day. For one thing, he is undeniably young, and he never found a way to reassure voters that he was truly up for the job of managing the city’s agencies, its hundred-billion-dollar budget, and its three-hundred-thousand-person workforce. In trying to become the youngest mayor since John Purroy Mitchel—the idealistic “Boy Mayor” who was elected at thirty-four, in 1914, and got crushed by Tammany’s man John Francis (Red Mike) Hylan three years later—Mamdani never explained how he might avoid Mitchel’s fate. The new program of public spending he has proposed is predicated on increasing taxes on the wealthy and corporations, taxes that would have to be approved in Albany. If the big shots in Albany—never a good bet for anything, politically—refuse him, what would become of Mayor Mamdani? No one can say.

Some voters are turned off by the socialist label, though most of Mamdani’s policies are hardly revolutionary. He’s calling for free buses (they have some free bus lines in Boston) and freezing the rent on rent-regulated apartments (which Bill de Blasio did three times in his eight years as mayor—and rents still kept rising in the city over all). Mamdani has backed off some of the language that he’d espoused during his activist days in college and the years after—“I will not defund the police,” he said, at the final Democratic primary debate—but he has not fully explained what changed his mind, besides the fact that he is running for mayor.

Mamdani’s critics and opponents have cornered him for his views on Israel—a line of questioning that his supporters say is unfair. They’re right that outlets like the New YorkPostand theFree Presshave tried to make him a bogeyman, and that attack ads funded by Cuomo and his allies have relied on Islamophobic tropes and racism. (“Less Safe. Too Radical,” read one mailer that arrived in my mailbox, next to what must be one of the only unflattering photographs of Mamdani in existence.) But part of the reason that reporters have kept asking Mamdani about Israel is because his answer isn’t very convincing. “I believe Israel has the right to exist as a state with equal rights,” he says. For a guy who exudes authenticity, that sounds suspiciously like a line he arrived at not personally but after a series of increasingly frustrating meetings. There are nearly a million Jews living in New York City, many of them ardently Zionist, and the next mayor is going to have to speak on this issue. (Think of the protests at Columbia, and of the ongoing federal response to them.) This was a challenge for Mamdani, and not one he has yet met.

In the primary campaign’s closing days, Mamdani has shown signs of casting about for ways to win—he’s shown signs, in other words, of being a normal politician. He’s reached for the strains of liberalism and radicalism that have expressed themselves in the city in recent years, sometimes reaching for more than one at once. “Government must deliver an agenda of abundance that puts the ninety-nine per cent over the one per cent,” he told a huge rally crowd at the Manhattan music venue Terminal 5, serving up Occupy-tinged red meat with a side of centrist-slogan salad. He made a surprising overture to the city’s Orthodox Jewish communities, which were stung a few years ago by aTimesinvestigation that revealed neglect and academic underperformance in Hasidic yeshivas. “The issue of your education is something I will listen to your leaders [about],” Mamdani told a Hasidic newspaper a few weeks ago. Were these the shrewd moves of a wunderkind on the doorstep of a historic election upset? Or were they compromises made by a precocious political talent seeing the numbers close in around him?

No one has ever accused Andrew Cuomo of being “regular.” For more than a decade, he has loomed over New York politics like the Prince of Darkness. The son of a legendary former New York governor, Mario Cuomo, he is the closest thing in living memory that the state has to political royalty. Cuomo, who legalized same-sex marriage in New York and spearheaded major infrastructure projects such as the bridge across the Hudson River named for his father, is among the handful of paternalistic local leaders in history—like Peter Stuyvesant, who told the residents of New Amsterdam that he would rule over them “like a father,” Nelson Rockefeller, and Michael Bloomberg—whose legacies, good and bad, will endure for centuries.

The question is: what is he doing running for mayor? Four years out from a sexual-harassment and abuse-of-power scandal that forced him from office as governor, Cuomo is clearly running to redeem himself, if only in his own eyes. He has plodded through the race, parking his Dodge Chargerwhereverhe pleases and apologizing for nothing and no one, making no promises to avoid the bullying, recalcitrance, handsiness, and tolerance of corruption that he was known for in the governor’s office. In fact, he’s avoided promises of any kind about what he’d do as mayor. Instead of focussing on policy pledges, Cuomo has made the campaign a demonstration of political might, garnering endorsements from elected officials—including many who called for him to resign four years ago—from labor union leaders (though DC 37, which represents most city workers, backed Mamdani over him), and from religious leaders in Black and Jewish communities. The power plays have at times been breathtaking. In June, a group of Orthodox leaders in South Brooklyn announced their support for Adrienne Adams, the speaker of the City Council. A few days later, they announced that they had changed their minds and had decided to back Cuomo instead.

Cuomo doesn’t make good videos, but he knows that he doesn’t need to. Say what you will about the cynical old operator, he has spent the campaign stitching together a coalition. In 2013, Bill de Blasio won the mayoral election with a potent mix of Black votes plus liberals of various creeds and colors. In 2021,Eric Adamssucceeded de Blasio with a potent mix of Black votes plus moderates of various creeds and colors. Cuomo is now attempting to re-create Adams’s formula. Sunday after Sunday, he has sat in the pews at Black churches. He has called the rise in antisemitism the “most important” issue in the election, and, though this is transparent pandering (most voters say affordability and public safety are top of mind for them), it has not blunted its political effectiveness. When Mamdani has wobbled on provocative slogans like “Globalize the intifada,” he has played right into Cuomo’s hands. The former governor’s chances of being a disaster as mayor are at least as high as Mamdani’s, but many rich and powerful New Yorkers appear willing to ignore that risk. (Bloomberg contributed more than eight million dollars to a superPACbacking Cuomo.) He simply might have the votes.

Since Mamdani gained on Cuomo in the last weeks of the spring, the Democratic primary has mostly looked like a two-man contest. But there was a moment last week when everyone was talking about Brad Lander, the city’s comptroller, who has spent much of the race polling at a distant third place. Within a matter of days, Lander was sort of endorsed by theTimesand got himselfdetainedby Immigration and Customs Enforcement officers while trying to escort a man out of immigration court. “I’m going to be just fine,” Lander told reporters after his release. “I lost a button.” The real issue, he said, was what happened to the man he was trying to help, who was now trapped somewhere in the country’s immigration-detention gulag. It was a good performance from a veteran of local government who hopes to lead a city of immigrants through a period of anti-immigrant terror. And, though the sight of masked plainclothes officers manhandling the city’s second-highest-ranking elected official was a terrifying omen for Trump’s encroachment on New York, it also made, not incidentally, for good videos.

Lander is a candidate who might have once hoped for an endorsement from theTimes’ editorial board, and who was dismayed last year when the paper announced it would stop endorsing in local races. Everyone remembers the primary in 2021, when aTimesendorsement helped propel Kathryn Garcia, the camera-shy former sanitation commissioner, within a few thousand votes of the front-runner, Eric Adams. This month, the paper’s opinion section relented in its determination to stay out of the mayoral race, sort of, and released asurveyof fifteen notable New Yorkers, seven of whom picked Lander as their first-choice candidate. (No other candidates received the support of more than two respondents.)

Then, a few days later, the paper published an unsignededitorialthat admonished New Yorkers not to vote for Mamdani; described Lander as competent but uninspiring; and reluctantly supported Cuomo, despite “serious objections to his ethics and conduct.” The piece was bizarre. It glossed de Blasio’s eight years as mayor as the source of the city’s current decline, while making almost no mention of the pandemic’s devastation, the shoddy scandals of the Adams administration, or the hostility that the current President displays for the politics and people of his home town. But in its weird, jumpy antagonism, the editorial captured a mix of sentiments that a certain swath of New Yorkers, particularly the wealthy and the powerful, do feel: that the city is less nice and less safe than it was not so long ago, that they’d rather go with a disgraced establishment politician like Cuomo than risk it with more progressive alternatives, and that the thirty-three-year-old socialist upstart with the good videos is a joke. The punch line is he’s still making them nervous. ♦

Just hours after the U.S. bombed three nuclear sites in Iran on Sunday, President Masoud Pezeshkian joined thousands of anti-American protesters in Tehran’s Enghelab Square. Enghelab means “revolution” in Farsi. The angry crowd waved placards vowing that they were “ready for the big battle” and calling for “revenge, revenge.” One poster depicted President Donald Trump as a snarling vampire. The Iranian regime has long been able to mobilize its base for propaganda purposes and social-media imagery. But, after ten days of barrages by the American and Israeli militaries, the more telling banners made plaintive and prideful statements. “Iran is our homeland,” one declared. “Its soil is our honor. And its flag is our shroud.”

Late on Monday, President Trump said on Truth Social that Iran and Israel had “fully agreed” to a “Complete and Total CEASEFIRE.” But the outcome of this war may be shaped more by Iran’s culture and politics than by the military prowess of its opponents. Iran’s controversial nuclear program is only part of a larger conundrum. Can the U.S. and Israel coexist with the Islamic Republic at all after forty-six years of fraught enmity? And will the Supreme Leader, Ayatollah Ali Khamenei, and the Islamic theocracy survive politically after the military onslaughts?

Trump had already called for an end to hostilities, and renewed negotiations with Tehran, following the unprecedented deployment ofU.S. stealth aircraft and bunker-busting bombsover the weekend. “Iran, the bully of the Middle East, must now make peace,” he said, in a televised address. In a subsequent briefing at the Pentagon, his Defense Secretary, Pete Hegseth, told reporters that Operation Midnight Hammer, which lasted a mere twenty-five minutes, “has not been about regime change.” But, by Sunday afternoon, Trump posted, on Truth Social, “It’s not politically correct to use the term, ‘Regime Change,’ but if the current Iranian Regime is unable to MAKE IRAN GREAT AGAIN, why wouldn’t there be a Regime change??? MIGA!!!”

Israel has been even more explicit. Its Defense Minister, Israel Katz, said that Khamenei is a “modern Hitler” and “cannot continue to exist.” On Monday, Israel struck two of the biggest symbols of Iranian repression: the entryway of the infamous Evin Prison, where thousands of dissidents have been held, and the headquarters of the Basij, the paramilitary wing of the Revolutionary Guard, which is used to crack down on opposition. It also hit other internal security sites. In a statement, the Israeli Defense Forces said that the facilities have been responsible “for homeland defense, suppressing threats, and maintaining regime stability.”

Trump’s ceasefire announcement followed Iran’s anticipated response to the U.S. strikes: short- and medium-range missile barrages on Al Udeid Air Base, in Qatar, the largest American military installation in the region. The Supreme National Security Council, the chief decision-making body in Tehran, which includes political and military leaders, said in a statement that it had fired the same number of missiles that the U.S. used over the weekend. The response mirrored Iran’s retaliation, in 2020, after the U.S. killed General Qassem Suleimani, the leader of the Revolutionary Guard’s Quds Force. It fired missiles on U.S. forces at the Ain al-Asad base in Iraq. Hostilities de-escalated after that. This time, Tehran reportedly sent warning of its strike in advance. Several American warplanes and ships had already been moved last week.

I suspect that millions of Iranians would not miss Khamenei, an accidental leader who stepped into top jobs only after others died unexpectedly. He was a mid-level cleric when he became President, in 1981; a terror attack had killed his predecessor. Six years later, I had breakfast with him, in an ornate room at the Waldorf-Astoria, in New York. It was during his only trip to the West, when he spoke at the opening session of the U.N. General Assembly. In our meeting, he lacked charisma, worldliness, and intellectual depth. He mumbled his way through inflammatory rhetoric as a member of his Revolutionary Guard team bent over to cut up his breakfast meat. (He lost the use of his right arm in 1981, after a bomb hidden in a tape recorder went off as he spoke at a mosque in Tehran. His hand dangles at his side.) In 1989, he stepped in after the revolutionary leader, Ayatollah Ruhollah Khomeini, died suddenly, with no heir apparent. Khamenei had a limited independent political base, so he tapped into the Iranian military. They have empowered each other ever since.

The fate of the Islamic Republic is not necessarily dependent on the fate of its ruling Ayatollah. “Khamenei as a leader may not survive this war—either because he is literally taken out of the scene through an assassination or because the war ends with such a disastrous outcome for the country that he will be forced to step down,” Ellie Geranmayeh, a senior fellow at the European Council on Foreign Relations, told me. Khamenei now faces only bad options. He will, however, avoid unconditional surrender at all costs. He would “likely prefer being taken down as a martyr rather than going down in history as the Iranian leader who capitulated with a gun to his head,” Geranmayeh said.

The majority of Iranians are Shiite. The sect emerged in the seventh century, after the Prophet Muhammad died, during a political dispute over leadership with mainstream Sunnis. Shiism preaches that it is better to die fighting for justice than to live with injustice. Imam Hussein, an early Shiite leader, fought Sunnis in the Umayyad dynasty, even though he had only a few dozen fighters and knew they were grossly outnumbered and bound to die. Martyrdom remains central to devout Shia. I’ve travelled in Iran for decades, and I think it is among the most secular countries in the Middle East. Yet the history of the faith and its traditions still define the culture and the mind-sets of many. Iranians are also religious and ethnic minorities in the wider world, and that has bred existential fears of foreign conquest.

“Shiism is a culture of resistance,” Fatemeh Haghighatjoo, a former member of Iran’s parliament, told me. Elected in 2000 at the age of thirty-two, she was the youngest female lawmaker in the revolution’s history. She was barred from running a second time, in 2004, after accusing the regime of torturing political prisoners and manipulating elections. She left Tehran a year later and now lives in Massachusetts. Iranians “are basically against authoritarianism, and they don’t like what’s going on in the country,” she told me. But Haghighatjoo doesn’t see the regime abruptly collapsing. Khamenei could easily be replaced, she said. Article 111 of Iran’s constitution, which is modelled on French and Belgian law, calls for a troika—made up of the President, the judiciary chief, and a cleric from the Guardian Council—to assume the duties of the leader if he is incapacitated or dismissed. An eighty-eight-man Assembly of Experts, which is democratically elected every eight years, would then select a new one.

After almost half a century, the Islamic Republic has deeply entrenched institutions—and intense rivalries among its executive, legislative, judicial, military, and intelligence branches. But they all crave survival despite their bickering, John Limbert, one of fifty-two diplomats held hostage after the U.S. Embassy was seized, in 1979, told me. “They love power. They’ve kept it. They’ve kept other people out of it,” he said. “For better or worse, they’ve built a system that is resilient. There’s a cadre, a men’s club” that includes the first generation of revolutionaries or their acolytes. For most of the past twenty-five hundred years, Limbert noted, Iran has been led by dictators—“some bad, some terrible. Some with crowns, some with turbans, some with military uniforms.” And, if regime change does happen, he cautioned, “Why should we assume it’s for the better? People assumed that in 1979. ‘Let’s get rid of the shah and everything will be better.’ ”

Since the Revolution, the Islamic Republic has managed to endure punishing blows by enemies, both foreign and domestic. In 1981, the young regime survived two massive bombings by the Mujahideen-e Khalq, or Warriors of the People, which killed a President, a Prime Minister, a judiciary chief, twenty-seven members of parliament, and dozens of other officials. After Iraq’s then President, Saddam Hussein, invaded in 1980, Iran held out for eight years, even as the Reagan Administration fed Baghdad intelligence that it used to kill tens of thousands of Iranian troops with chemical weapons. Iran reluctantly agreed to a U.N. ceasefire, in 1988, but the regime got its revenge by supporting and arming Shiite opposition groups that are now major players in post-Saddam Iraq. Iran has survived, albeit with growing difficulty, more than fifteen hundred U.S. sanctions, which have reportedly cost hundreds of billions of dollars in lost revenue. And it has managed to suppress sporadic nationwide protests—the student uprising in 1999, the Green Movement after the Presidential election in 2009, economic protests over price hikes since 2017, and the“woman, life, freedom” movementin 2022. “Death to the dictator” has been a common chant in all of them.

In the past, Iran’s upheavals have been presaged by visible indicators, Shaul Bakhash, a Harvard-educated former editor in Iran, and the author of“The Reign of the Ayatollahs: Iran and the Islamic Revolution,” told me. They have included huge ongoing street protests. Bazaars have closed down “not because of disorder but as a protest,” Bakhash said. Critical sectors, notably the oil industry and the civil service, have gone on strike. “We don’t see any of these elements right now,” he said. And even in the current dire circumstances, Bakhash added, “The individuals who might lead an opposition have not spoken up.”

And yet, long term, the status quo may not be acceptable, either, Geranmayeh said. If the regime emerges from the war with a diplomatic off-ramp, it will have to overhaul the social contract, which for two decades after the U.S. invasions of Iraq and Afghanistan has provided Iranians with security, in exchange for restricted political, social, and economic rights. The stunning scope of the U.S. and Israeli airstrikes over the past ten days proves that the theocracy can no longer deliver the protection it promises.

Utopian, religious, and ideological revolutions have only so much staying power if they fail to meet their absolutist goals and their publics’ lofty expectations. The Soviet Union could not sustain Communist rule in a world rapidly becoming politically and economically globalized. South Africa could not endure the isolation or the costs of apartheid, which required separate and segregated housing, schooling, health care, and infrastructure for three different races.

All aspects of life in Iran are now growing worse, Mohammad Taghi Karroubi, a lawyer and the son of the former speaker of parliament Mehdi Karroubi, told me. In 2009, his father, a cleric, ran for the Presidency, as did the former Prime Minister Mir-Hossein Mousavi, to defeat the hard-line incumbent, Mahmoud Ahmadinejad. The two opposition candidates lost in a vote widely viewed as fraudulent. Wearing green sashes, the two men led the Green Movement, when millions protested for some six months. Both men were placed under house arrest for almost fifteen years. “People will go to the streets again in the future,” Karroubi said, during a WhatsApp conversation from London. For now, though, they “prefer to be silent” because of the U.S. and Israeli aggression. “The day after the aggression,” he said, “they will start to talk. They will start to criticize the system.” ♦

This article has been updated to include news developments.

Progress against H.I.V. marks one of the greatest accomplishments of biomedical research in history. Four decades ago, an H.I.V. infection meant an early, painful death. Scientists went on to develop powerful antiretroviral treatments that staved offAIDSand curbed H.I.V.’s spread. Yet, in 2023, 1.3 million people around the world became infected—more than thirty-five hundred per day, nearly a hundred and fifty every hour. Treatments only work if you take them, and many people do not know that they have H.I.V. Even for those who are aware of their status and can access the drugs, the virus integrates with human chromosomes and never clears, meaning that people living with H.I.V. must take medication for the rest of their lives. In 2023, almost forty million people were living with H.I.V., and six hundred and thirty thousand died fromAIDS.

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Then, in June, 2024, Moupali Das, the head of H.I.V. prevention for the pharmaceutical company Gilead Sciences, received an e-mail about lenacapavir, a drug being tested by the company to prevent the spread of H.I.V. The message authorized Das to see the results from an ongoing clinical trial in South Africa and Uganda. When she reviewed the data, at her company’s sprawling campus in Foster City, California, she had to move closer to her computer’s screen to confirm that she was reading the numbers correctly. She was dumbstruck: What she thought was a zero reallywasa zero. More than two thousand teen girls and young women had been injected with the drug, which stays in the body for an astonishing six months. In the first year of the trial, each received two shots, and none of them became infected with H.I.V. “It was phenomenal,” Das told me. “We thought it was going to work, but none of us thought it was going to be one hundred per cent.” Three months later, the drug demonstrated ninety-six-per-cent efficacy in a similar trial that had enrolled more than three thousand men, transgender men and women, and nonbinary people who have sex with men.

For nearly twelve years, Gilead had been selling a pill named Truvada as a preventive treatment called pre-exposure prophylaxis, or PrEP. The drug worked remarkably well in clinical trials, but many healthy people had difficulty taking a daily pill, and others faced stigma and discrimination from sexual partners. Another company, ViiV Healthcare, brought a PrEP injection to market in 2021, but it only lasts two months, and remains little used. If two shots a year offered the same protection, Das knew, it could revolutionize H.I.V. prevention. On June 18th, the F.D.A. approved lenacapavir for PrEP. A stunning new era is upon us. But, as world leaders dismantle global health programs and cut back foreign aid, will this extraordinary new technology be able to change the world?

When scientists first started talking about using drugs to prevent the spread of H.I.V., few expected that Gilead would be the company to develop them. In the early nineteen-nineties, the top anti-H.I.V. drugs on the market had at most a modest impact: they were reserved for people with severely damaged immune systems and, at best, only extended life by a few years. Side effects included diarrhea, nausea, headaches, and anemia. As the death toll approached a million per year, big pharmaceutical companies competed to create better treatments. Gilead, a small corporation that had a few hundred employees, was an underdog in the race. But it licensed a promising compound, tenofovir, from academics in Europe.

During that bleak era, Che-Chung Tsai, a researcher at the University of Washington, contacted several companies, seeking experimental drugs for use in an animal study. Gilead sent him an early form of tenofovir, which produced remarkable results. When a group of monkeys were given the compound before being exposed to H.I.V.’s simian cousin, S.I.V., not a single one was infected. What’s more, the drug had no significant adverse effects.

H.I.V. is made up of single-stranded RNA rather than double-stranded DNA. To infect its host, it enters white blood cells, uses a viral enzyme called reverse transcriptase to convert its RNA into DNA, and hijacks the cell’s machinery to make more copies of itself. Tenofovir works by crippling this enzyme. In a person with H.I.V., tenofovir prevents the virus from making new copies of itself.

Yet tenofovir also showed promise for people who did not have H.I.V. The monkey study found that, when a healthy animal received tenofovir, the virus was like a bullet that fell to the ground before striking its target: the RNA virus couldn’t convert itself into DNA, so it couldn’t splice itself into the DNA of the host.

Despite the drug’s potential as PrEP, Gilead made little effort to support the research: preventive drugs had unique risks. In uninfected people, it’s harder to prove that the benefits of a drug will outweigh potential risks, raising liability concerns. Some feared that widespread use of PrEP might breed resistant strains of the virus itself. And although millions of H.I.V.-positive people were desperate for effective drugs, it wasn’t clear that people at the highest risk of infection—gay men, sex workers, people who injected drugs, sexually active heterosexuals in sub-Saharan African countries—would want PrEP or be able to access it. And so Gilead focussed instead on the lucrative and stable market of H.I.V. treatments. In 2001, tenofovir won F.D.A. approval for treating H.I.V. infections. The next year, the drug accounted for about half of the company’s sales.

Gilead’s disinterest in PrEP deeply frustrated academic researchers. In 2003, to confirm that tenofovir would work as well in humans as it had in monkeys, researchers announced plans to recruit sex workers for a clinical trial in Cambodia. Gilead kept itself at a distance from the study; the National Institutes of Health (N.I.H.) and the Bill and Melinda Gates Foundation offered to fund the research. But someAIDSactivists were enraged by the trial’s design. They argued that researchers were introducing risk of infection to people in a country with limited treatment resources. In July, 2004, at an internationalAIDSconference in Bangkok, a group descended on a Gilead Sciences booth and plastered it with posters: “Sex Workers Infected by Gilead,” “Tenofovir Makes Me Vomit,” and “Gilead Prefers us HIV+.” As news cameras from around the world gathered around the scene, the activists covered signs in fake blood. Soon after, the trials in Cambodia were abandoned. Though Gilead provided academic researchers use of the compound for PrEP studies, they declined to pursue further preventive testing on their own.

A month after the Bangkok conference, the F.D.A. approved a new H.I.V. treatment, produced by Gilead, called Truvada, which combined tenofovir with a second drug. At the time, regimens typically required three drugs, several times a day. The new compound, a pill taken once a day, could be combined with just one other drug, simplifying treatment. By 2006, Truvada was the best-selling anti-H.I.V. drug on the market.

Flush with cash, Gilead launched an ambitious project to create a new drug targeting an H.I.V. protein called capsid. Many scientists saw Gilead’s project as folly: viral proteins have no obvious weaknesses, making them far less druggable than viral enzymes. Researchers had long thought that capsid proteins—which link together to form a protective shell, known as a cone, around the RNA—simply fell apart after infecting a cell. But a series of stunning discoveries found that the capsid cone not only survives infection but plays a far more complex role in the production of new viruses. With this insight, Gilead tested thousands of compounds, leading to the discovery, in 2012, of what would become lenacapavir.

That same year, Gilead finally sought F.D.A. approval for Truvada as PrEP. It was approved in July. A drug for prevention was a major turning point, yet it was met with ambivalence by some of the communities most affected by the virus. Even the primary market for the drug, gay men in the United States, had strong reservations about taking the pills to protect themselves. Critics feared it created incentives for uninfected men to abandon condoms and increase their number of sexual partners, undermining years of hard-won progress in prevention. Worries ran so high that some gay men for a time slagged people who used PrEP as “Truvada whores.”

Truvada PrEP steadily gained popularity, and as it grew cheaper it became more widespread in poorer countries. In March, 2019, Gilead reported that lenacapavir had performed well in early human studies. Gilead’s risky investment was showing signs of paying off—and this time, the company was eager to get ahead of its critics.

In December, 2019, Das flew to Kigali, Rwanda, to meet with community advocates and public-health leaders from across the continent. Lenacapavir was going to be tested as a prevention tool; the company wanted input on the design of the trials. How could the company’s researchers avoid the community opposition that had dogged the Cambodia trial? Should they include pregnant people? What about adolescents as young as sixteen? Earlier research had been roundly criticized for excluding both groups, as well as for cutting out trans people and anyone taking hormones. Yvette Raphael, a human-rights activist who chairs the African Women Prevention Community Accountability Board, left the meeting reluctantly impressed. “It was tough because, obviously, they are a pharmaceutical company, and we are advocates,” Raphael said recently. “We’d like to see more transparency from them—but they really have tried.”

The company has also made efforts to increase access to preventive lenacapavir. After a drug is approved, years often pass before generic manufacturers are allowed to sell it at a discount. But in October, 2024, Gilead—still months away from even seeking F.D.A. approval—announced that it had cut a deal with six generic manufacturers to provide low-cost versions of lenacapavir PrEP to a hundred and twenty poorer countries. While those producers are getting up and running, a process that may take an estimated two years, Gilead will sell lenacapavir to the same countries at cost. “They learned from their mistakes,” Mitchell Warren, the executive director ofAVAC, an advocacy group for PrEP and other H.I.V.-prevention interventions, told me. “At least conceptually, this is one of the most transformational moments in H.I.V. prevention ever.”

Two months later, near the end of the Biden Administration, a major partnership set out to make injectable preventive lenacapavir available to at least two million people during its first three years on the market. It would bring together the President’s Emergency Plan forAIDSRelief, orPEPFAR; the deep-pocketed Global Fund to FightAIDS, Tuberculosis, and Malaria; the Gates Foundation; and the Children’s Investment Fund Foundation.

Then came another seismic shift in the H.I.V./AIDSworld. On the day President Donald Trump took office, his Administration began dismantlingPEPFAR, which has spent more than a hundred and twenty billion dollars in more than fifty countries over the past two decades—not only to support the treatment of twenty million people but also to purchase and deliver more than ninety per cent of PrEP drugs used globally. A State Department memo in February stated that, during this pause of U.S. Foreign Assistance or until further notice,PEPFARcould only support PrEP for pregnant and breast-feeding women.

The fate of the rollout of lenacapavir PrEP remains murky. Although neither the Gates Foundation nor the Global Fund has committed to honoring their original pledge, both have indicated that they still plan to support “equitable access” to lenacapavir PrEP. (What this means, in practice, is difficult to say.) The White House, earlier this month, released its Congressional Budget Justification for fiscal year 2026 that calls for continued support forPEPFAR, with a budget cut of thirty per cent and a desire to speed its elimination; it specifically mentions funding for “high cost-efficiency biomedical tools, such as a twice-a-year HIV prevention injection.”

Injectable lenacapavir, despite its clear benefits, faces several other financial, political, and cultural challenges that have dogged PrEP from the outset. Will insurance companies reimburse for it in full? How aggressively will health officials promote its use? Will communities embrace it? “We have not seen evidence of the bigger resources being devoted and the political will to do what needs to be done to get any of these PrEP options into the populations that need it the most,” says Raphael Landovitz, an H.I.V./AIDSresearcher at the University of California, Los Angeles, who has helped run other PrEP studies. “Everything we have seen is incremental. And so I fear that this is going to be yet another incremental improvement.”

Then again, Landovitz speaks for many when he describes the results from the two lenacapavir clinical trials as “stunning.” And he notes that a near-hundred-per-cent protection from infection “is better than I think we could ever have hoped for from a prophylactic vaccine.”

Eleven years ago, the Joint United Nations Programme on H.I.V./AIDSannounced a “fast-track” strategy to “end the AIDS epidemic.” Thanks to testing, treatment, and prevention tools like PrEP, infection rates were dropping year after year.UNAIDScontended that if the number of new infections were to drop as low as two hundred thousand a year by 2030, theAIDSpandemic would, effectively, end.

The world, of course, is way off target.

In March, at a large H.I.V./AIDSconference held in San Francisco, Gilead scientists reported new data from a small human study suggesting that higher doses of lenacapavir allow the drug to protect the body for more than a year. At the same meeting, however, researchers were reeling; the Trump Administration had just laid off thousands of scientists at the N.I.H. and the Centers for Disease Control and Prevention, and cut funding to their universities, their research grants, and clinical-trial networks that test new medicines.

It was another blow: the cutbacks to research joined slashes to global health programs, threatening to slow down decades of progress.

Scientists and researchers continue to warn that such disturbances will hobble future innovations. More immediately, lenacapavir PrEP may be able to reach only a small percentage of the people who stand to benefit. Even if Gilead and its supporters are able to insure equitable access, the U.S government’s retreat from the fight against H.I.V. andAIDSwill present new challenges and new infections. Will this powerful new medicine counteract the damage? Or will lenacapavir PrEP, which could change the world, only maintain the status quo?

In wealthy countries where insurance companies or governments cover most of the price of drugs, the new medicine will likely build a market. But most people who are at high risk of H.I.V. infection live in countries that have long relied on governments such as the U.S. to prop up their limited investments in health care. Even with discounted pricing and market competition driving costs down further in time, testing for infection and delivering drugs is expensive, too. It’s hard to see how lenacapavir PrEP will live up to its promise without new infusions of financial assistance.

Some H.I.V./AIDSadvocates have criticized Gilead for not yet cutting a deal to offer discounted lenacapavir to middle-income countries. Then, there’s South Africa, which has more people living with H.I.V. than any other nation and funds the bulk of its own response to its epidemic. The country pays a mere forty-one dollars to provide a person with an annual supply of PrEP pills; will they pay more for two long-acting injections?

Injectable lenacapavir cannot, on its own, end the H.I.V./AIDSepidemic. The world still needs a cure for the tens of millions now living with H.I.V. and a prophylactic vaccine that can outlast a year. Other prevention tools exist, and more are being developed. But, even in the wake of dramatic setbacks, companies such as Gilead, in concert with nonprofits, clinicians, advocates, philanthropists, and foreign governments, could collectively insure that this remarkable drug is accessible to all. Then its success will depend on the medicine itself—and on the interest of those who have the option to use it. ♦

Being a liberal justice on a Supreme Court with a six-Justice conservative super-majority can be a miserable job. The opportunities for victory are scant; frustration is the baseline. There are two different models for dealing with this reality, approaches that can broadly be described as strategic and rhetorical. A strategic Justice can try to lure a conservative vote here and there, to cobble together an elusive majority and at least limit the damage. A rhetorical Justice can call out the conservatives for the sake of educating the current public and planting a flag for history. Or she—and the three liberals are all women—can tailor her response to the specific case.

Elena Kagan exemplifies this last, hybrid model. She is more than willing to let the majority have it when that is warranted; she also forges compromises with individual conservatives when it is possible to pick up their votes. The newest member of the Court, Ketanji Brown Jackson, is the epitome of the rhetorical Justice. Last week, as the Court prepared to finish its work for the year, Jackson issued a pair of dissents that signalled her despair over the Court’s trajectory, her refusal to sugarcoat its behavior, and her willingness to break with her liberal colleagues, Kagan and Sonia Sotomayor.

New Justices tend to hang back; Jackson, now in her third term, spoke up from the start. In her first eight oral arguments, she spoke eleven thousand words, twice as many as the next most loquacious Justice, Sotomayor. That tendency has persisted—TheHillfound that Jackson spoke seventy-five thousand words this term, fifty per cent more than Sotomayor—and it isn’t the only measure of Jackson’s assertiveness. As theTimesSupreme Court correspondent Adam Liptak noted at the conclusion of Jackson’s first term on the Court, Chief Justice John Roberts “did not write his first solo dissent in an argued case until 16 years into his tenure. Justice Jackson issued three such dissents in her first term.” Jackson’s conduct this term—in her work on the Court and her comments outside it—is not different so much as it ismore so: more alarmed at the direction the Court and the country are heading, and more willing than ever to go it alone in expressing that distress.

Jackson’s independence from her liberal colleagues was on display in April, when the majority ruled that a challenge to President Trump’s use of the Alien Enemies Act to remove Venezuelan migrants to a Salvadoran prison had been brought in the wrong court. Sotomayor’s dissent, joined by Kagan, Jackson, and, in part, by the conservative Justice Amy Coney Barrett, was unsparing. She described the Trump Administration’s effort to “hustle” the Venezuelans out of the country before they could obtain due process as “an extraordinary threat to the rule of law.” The Court’s seeming indulgence of that behavior, she added, was “indefensible.” Jackson went further, in her own dissent. She assailed the majority’s “fly-by-night approach” of deciding cases on an emergency basis, without full briefing or oral argument—and compared the opinion withKorematsu v. United States, the discredited 1944 ruling upholding the internment of Japanese Americans. “At least when the Court went off base in the past, it left a record so posterity could see how it went wrong,” Jackson wrote. “With more and more of our most significant rulings taking place in the shadows of our emergency docket, today’s Court leaves less and less of a trace. But make no mistake: We are just as wrong now as we have been in the past, with similarly devastating consequences. It just seems we are now less willing to face it.”

Speaking last month at a judicial conference, Jackson seized the opportunity to call out “the elephant in the room, which is the relentless attacks and disregard and disparagement that judges around the country, and perhaps many of you, are now facing on a daily basis.” Two of her colleagues had already taken oblique aim at President Trump. In March, after Trump called for the impeachment of the district-court judge who handled the Alien Enemies Act case, the Chief Justice departed from his usual Olympian silence to note that “impeachment is not an appropriate response to disagreement concerning a judicial decision.” Later that month, Sotomayor went a bit further. “One of the things that is troubling so many right now is many of the standards being changed right now were norms that governed officials into what was right and wrong,” Sotomayor cautioned in an appearance at Georgetown University Law Center. “Once norms are broken, then you are shaking some of the foundation of the rule of law.” Jackson, for her part, let it rip. “Across the nation, judges are facing increased threats of not only physical violence but also professional retaliation, just for doing our jobs,” she warned. “And the attacks are not random; they seem designed to intimidate those of us who serve in this critical capacity. The attacks are also not isolated incidents; that is, they impact more than just the individual judges who are being targeted. Rather, the threats and the harassment are attacks on our democracy—on our system of government. And they ultimately risk undermining our Constitution and the rule of law.”

The ferocity of Jackson’s dissents last week was remarkable in part because the opinions came in two relatively low-profile cases, not the kind of hot-button disputes that tend to bring out the adjectives. It was even more remarkable because, in both cases, one of her liberal colleagues was on the opposing side: Kagan, who tends to be more moderate than Jackson and Sotomayor, joined the majority. One case involved the important but technical question of whether the federal disability-rights law covers discrimination against retired workers in the benefits they receive. The majority opinion and the dissent each accused the other side of being driven by the desire to reach the outcome they wanted rather than by an interest in interpreting the law correctly—a charge that is about as nasty as things get at the high court. Gorsuch, writing for the majority, asserted that Jackson had resorted to examining the purpose and legislative history of the disability law because she found the method of “pure textualism”—looking only at the precise language of a statute—“insufficiently pliable to secure the result” she wanted. Jackson returned fire. “Too often, this Court closes its eyes to context, enactment history, and the legislature’s goals when assessing statutory meaning,” she wrote. “I cannot abide that narrow-minded approach. If a statute’s text does not provide a clear answer to a question, it is not our role to keep twisting and turning those words until self-confirmatory observations solidify our ‘first blush’ assumptions.”

Sotomayor joined that part of Jackson’s dissent, but she pointedly did not sign on to a lengthy footnote in which Jackson accused the majority of “an unfortunate misunderstanding of the judicial role,” arguing that the insistence on “pure textualism”—its refusal to consider Congress’s goals in enacting a statute—turns the interpretive task into a potent weapon for advancing judicial policy preferences.” Far from “being ‘insufficiently pliable,’ ” Jackson added, “pure textualism is incessantly malleable—that’s its primary problem—and, indeed, it is certainly somehow always flexible enough to secure the majority’s desired outcome.”

If that exchange wasn’t heated enough, in the second case—which concerned whether gasoline companies, not just automakers, have standing to challenge California’s auto-emissions standards—Jackson all but accused the majority of being in the pocket of big business. The Justices allowed the case to proceed even though the Trump Administration had signalled that it will repeal the waiver letting California set its own emissions standards. The Court “does not explain why it is so eager to resolve this highly factbound, soon-to-be-moot dispute,” Jackson wrote. “For some, this silence will only harden their sense that the Court softens its certiorari standards”—how it decides whether to hear a case—“when evaluating petitions from moneyed interests.” She added, “This Court’s simultaneous aversion to hearing cases involving the potential vindication of the rights of less powerful litigants—workers, criminal defendants, and the condemned, among others—will further fortify that impression.” Jackson made a similar point about the Court’s finding: that gasoline companies had the right to sue. The majority’s “demonstrated concern for ensuring that the fuel industry’s ability to sue is recognized on these facts highlights a potential gap in the manner in which the Court treats the claims of plaintiffs pursuing profits versus those seeking to advance other objectives,” she wrote. Sotomayor, notably, dissented separately.

The end of a Supreme Court term is inevitably a moment for frayed tempers and jangled nerves. And Jackson is not the first Justice to sound such a bitter note. “The current Court is textualist only when being so suits it,” Kagan wrote three years ago, when the Court essentially invented a new rule to limit regulatory agencies. “When that method would frustrate broader goals, special canons like the ‘major questions doctrine’ magically appear as get-out-of-text-free cards.” Dissenting in the Presidential-immunity case last year, Sotomayor lamented that the majority “invents an atextual, ahistorical, and unjustifiable immunity that puts the President above the law,” concluding, “With fear for our democracy, I dissent.” (Jackson took some of the oomph out of Sotomayor’s opinion, which she and Kagan joined, by penning one of her own.)

Even so, the Jackson dissents—and there could be more to come before the summer recess—offer an unnerving window into a Court where Justices’ patience with one another is wearing thin. They are splintered, often angrily, along familiar ideological lines, and at the same time the diminished liberal wing, rather than being unified in opposition, often finds itself fractured. The institution that the country needs most right now is not a happy place, and the junior Justice may be the unhappiest of all. ♦