South Africa, Eswatini, and Zambia on Monday began administering a new HIV-prevention injection in the drug’s first public rollout across Africa, the continent with the world’s highest HIV burden.
The treatment, lenacapavir, is taken twice a year and has been shown to reduce the risk of HIV transmission by more than 99.9 percent, making it functionally similar to a vaccine. In South Africa, where one in five adults lives with HIV, the rollout is being overseen by a Wits University research unit as part of an initiative funded by Unitaid, the United Nations health agency.
“The first individuals have begun using lenacapavir for HIV prevention in South Africa … making it among the first real-world use of the 6-monthly injectable in low- and middle-income countries,” Unitaid said in a statement. It did not specify how many people received the initial doses. The drug costs $28,000 per person annually in the United States, though a broader national rollout is expected next year.
Zambia and Eswatini, which received 1,000 doses last month under a US programme, were expected to launch the drug during World AIDS Day ceremonies. Manufacturer Gilead Sciences has agreed to provide lenacapavir at no profit to two million people in high-burden countries over three years, though critics argue this falls far short of actual demand and that the market price remains unaffordable.
Eastern and southern Africa account for 52 percent of the 40.8 million people living with HIV worldwide, according to UNAIDS 2024 data. Generic versions of lenacapavir are expected to be available from 2027 at around $40 per year in more than 100 countries, through agreements between Unitaid, the Gates Foundation, and Indian pharmaceutical companies.
Pre-exposure prophylaxis (PrEP) has been used for over a decade to prevent HIV, but its reliance on a daily pill has limited its global impact. Lenacapavir’s twice-yearly injection is being hailed as a potential game-changer in the fight against HIV.
