Preface: Special Collection Commemorating John C. Martin

The 1990s ushered in the modern era of antiviral chemotherapy. For the first time, several small molecules selectively inhibited viral replication, and in some cases cured, life threatening diseases, including those caused by herpes viruses, HIV, hepatitis B virus and hepatitis C virus. The development of these new molecules, especially the nucleosides and nucleotides ganciclovir, adefovir, tenofovir, emtricitabine and sofosbuvir, into effective medicines required a vision that combined novel insights and ideas, with the application of advances in medicinal chemistry and chemical manufacturing. Further, scientific and commercial strategies led to unprecedented advances in individual and community health. At the forefront of this public health triumph was John C. Martin, then CEO of Gilead Sciences, who unexpectedly and tragically passed away 30 March 2021. John was a visionary who possessed that unique quality of the ‘quiet pioneer’. The success of individual small molecule inhibitors was quickly followed by potent combinations of synergistic medicines given as one pill once a day. Diseases once regarded as deadly and untreatable could now be successfully controlled and even in some cases, cured.

John guided Gilead through the 1990s and into the new millennium with his abundant and unique commercial common sense, resulting in Gilead emerging as ‘the antiviral company’ globally. He saw the opportunity to combine emtricitabine with tenofovir to make Truvada which became the most potent backbone for HIV treatment. John built on this success with Atripla, the triple combination of Truvada and efavirenz (BMS/Merck), thereby creating the first successful ‘one pill once a day’ era in HIV management, reducing the patient’s pill burden and substantially improving patient adherence. By 2011, Gilead’s arsenal of HIV therapeutics accounted for more than half of the USA market. Since 2003, witnessing the huge economic disparity and devastation of HIV/AIDS brought to generations of populations among world regions, John took steps to pioneer equitable access in developing countries to Gilead’s anti-HIV drugs, based primarily on that country’s gross domestic product. Several years later, John built on this humanitarian precedent with equitable access for Gilead’s HCV cure medicines as well.

John was staunchly committed to philanthropy and in 2014 established the John C. Martin Foundation, with his life partner Lillian Lou. The goal of the Foundation is to facilitate the establishment of sustainable improvement in human health in socially and economically disadvantaged settings.

John’s mantra over the 30 year span that I knew him was two-fold: firstly to focus on the science and secondly to develop mechanisms to create access to medicines in those countries that urgently needed them. This special issue of Antiviral Therapy is a tribute to John’s vision, his humility and dogged perseverance that led to his unrivalled professional success and impact on human health. We have tried to capture a snippet of his amazing life, with his many contributions to the field of antiviral chemotherapy that have translated into so many remarkable benefits for millions of patients, allowing many to live normal productive lives instead of succumbing to fatal disease. A review of the Table of Contents reflects this breadth of John’s contributions, starting with ganciclovir and CMV, the evolution of the HIV medical landscape culminating in the development and then application of Truvada, Atripla, TAF, then meeting the challenges head on with HBV and achieving a cure for HCV. These successes are followed with other achievements including the milestone of oral treatment of influenza with oseltamivir and the ongoing need for the development of new antivirals including the broad-spectrum agent remdesivir. Also described are selected activities, supported by the Foundation, on building tools and knowledge towards impacting viral hepatitis global elimination. This Special Issue concludes with the description of a model of a successful business case based on informed decision making to access and purchase of these high-quality, low-cost medicines across low and middle income countries.

Our sense of loss since John’s passing has only deepened with the passage of time because we miss his passionate adherence to the values of science, his practice of scientific principles and his commitment of fairness to the world we live in and the people we share it with. We think that it is fair comment to think of John as the ‘quiet pioneer’ who also brought honour to his many awards rather than deriving honour from them. This philosophy is reflected in the following articles contained in this Special Issue to John.