South Africa, Eswatini, and Zambia have launched the first public rollouts of a groundbreaking HIV-prevention injection, offering hope in the fight against the world’s highest HIV burden.
The drug, lenacapavir, administered twice a year, has been shown to reduce HIV transmission by over 99.9 percent, functioning similarly to a highly effective vaccine.
This long-acting injectable is expected to revolutionize HIV prevention, particularly in low- and middle-income countries where daily oral pre-exposure prophylaxis (PrEP) has had limited uptake.
In South Africa, where one in five adults lives with HIV, Wits University oversaw the rollout as part of a Unitaid-funded initiative.
“The first individuals have begun using lenacapavir for HIV prevention in South Africa, marking one of the first real-world uses of the six-monthly injectable in low- and middle-income countries,” Unitaid said.
Zambia and Eswatini received 1,000 doses last month through a US-supported programme and planned to launch the injection during World AIDS Day ceremonies on Monday.
Gilead Sciences, the manufacturer, has pledged to supply the drug at no profit to two million people in high-HIV-burden countries over three years.
Critics, however, argue this number falls short of actual demand, noting that the US price of $28,000 per person per year is unaffordable for most Africans.
Eastern and southern Africa currently account for roughly 52 percent of the 40.8 million people living with HIV worldwide, according to UNAIDS 2024 data.
Generic versions of lenacapavir are expected by 2027, costing around $40 per year in over 100 countries, under agreements facilitated by Unitaid and the Gates Foundation with Indian pharmaceutical manufacturers.
The launch represents a significant milestone in the continent’s fight against HIV.
Unlike daily oral PrEP, lenacapavir’s twice-yearly administration reduces the challenges of adherence and promises more consistent protection, especially in vulnerable populations.