Breaking the sound barrier: global monoclonal antibody pharmacoequity

Monoclonal antibodies represent one of biomedicine's greatest successes, yet global access remains profoundly inequitable, with low- and middle-income countries bearing the brunt of limited access. This perspective proposes that long-acting infectious disease mAbs, starting with WHO-recommended nirsevimab for RSV prevention, could catalyze transformation by connecting with existing WHO Essential Medicines List mAbs. Picture two static half-circles: WHO Essential Medicines List mAbs with proven value but limited access, and infectious disease prevention mAbs with transformative potential. Connected, they form a complete wheel capable of rolling toward the aspirations of global pharmacoequity. HIV antiretroviral therapy demonstrates precedent-costs declined 100-fold through political mobilization, not technological breakthroughs.