South Africa, Eswatini, and Zambia have begun administering a revolutionary new HIV-prevention injection, marking the first public rollout of the drug in Africa, which continues to bear the highest global burden of HIV. The initiative started on Monday, coinciding with efforts to accelerate HIV prevention across the continent.
The drug, lenacapavir, is administered twice a year and has been shown to reduce the risk of HIV transmission by more than 99.9%, effectively functioning like a potent vaccine.
South Africa Leads Initial Rollout
In South Africa, where one in five adults is living with HIV, the rollout is being managed by a Wits University research unit as part of a program funded by Unitaid, the global health agency of the United Nations.
“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 in a statement.
While the agency did not disclose the exact number of people who have received the initial doses, a broader national rollout is expected in 2026.
Regional Expansion to Eswatini and Zambia
Neighboring Zambia and Eswatini received 1,000 doses last month under a U.S.-supported program. Both countries were expected to formally launch the drug during World AIDS Day ceremonies on Monday.
Under the program, Gilead Sciences, the manufacturer of lenacapavir, has pledged to provide the drug at no profit to two million people in high HIV-burden countries over the next three years. Critics, however, argue that this falls far short of the continent’s needs and that the U.S. market price—$28,000 per person annually—remains unattainable for most Africans.
Addressing a Longstanding HIV Challenge
Eastern and Southern Africa account for approximately 52% of the 40.8 million people living with HIV worldwide, according to 2024 UNAIDS data. The new injection represents a potential breakthrough for prevention, especially in regions where daily pill-based pre-exposure prophylaxis (PrEP) has seen limited uptake due to adherence challenges.
Future Prospects and Accessibility
Generic versions of lenacapavir are expected to become available from 2027 at around $40 per year in more than 100 countries, through partnerships between Unitaid, the Gates Foundation, and Indian pharmaceutical companies.
Health experts hope that the six-monthly injection will overcome barriers linked to daily PrEP use, expand access to HIV prevention, and significantly reduce new infections across Africa, providing hope for millions of people at risk.
This rollout marks a historic moment in the fight against HIV, combining innovation with targeted public health strategies to address one of the continent’s most pressing health challenges.
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