South Africa, Eswatini, and Zambia began administering a groundbreaking HIV-prevention injection on Monday, marking the drug’s first public deployment in Africa, which continues to carry the world’s highest HIV burden.
Lenacapavir, taken twice yearly, has been proven to reduce HIV transmission risk by more than 99.9 percent, giving it an almost vaccine-like level of protection.
In South Africa, where one in five adults is living with HIV, a research team at Wits University supervised the introduction of the drug through an initiative supported 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.
The organisation did not mention how many people received the initial doses of the drug, which costs $28,000 per person annually in the United States. A more extensive national rollout is anticipated next year.
Neighbouring Zambia and Eswatini received 1,000 doses last month under a United States programme and were expected to introduce the injection during World AIDS Day events on Monday.
As part of the programme, the manufacturer, Gilead Sciences, agreed to supply lenacapavir at no profit to two million people in high HIV-burden countries over a three-year period.
Critics contend that this commitment falls far short of the real demand and that the commercial price remains beyond the means of most people.
Eastern and southern Africa make up approximately 52 percent of the 40.8 million individuals living with HIV worldwide, according to 2024 UNAIDS figures.
Generic versions of lenacapavir are expected from 2027, priced at around $40 per year in more than 100 countries, following agreements made by Unitaid and the Gates Foundation with pharmaceutical companies in India.
Pre-exposure prophylaxis, or PrEP, has existed for more than a decade as a method to prevent HIV, but its dependence on daily pills has limited its overall effect on global infection rates.
What you should know
Lenacapavir represents a major advancement in HIV prevention, especially for regions with the highest infection rates.
Although access is currently limited, the drug’s twice-yearly dosage offers transformative potential once wider distribution and affordable generics become available.
