South Africa, Eswatini, and Zambia on Monday began administering a revolutionary new HIV-prevention injection — the first public rollout of its kind on the continent most affected by the virus.
The injection, lenacapavir, is taken just twice a year and has been shown to reduce the risk of HIV transmission by more than 99.9%, making it one of the most effective prevention tools ever developed — and functionally similar to a powerful vaccine.
In South Africa, where one in five adults lives with HIV, the rollout is being coordinated by a Wits University research unit under a Unitaid-funded initiative.
Unitaid confirmed that:
“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.”
The agency did not disclose how many people received the initial doses. A wider national rollout is anticipated in 2026.
Eswatini and Zambia, which received 1,000 doses last month through a U.S.-supported programme, were expected to officially launch the injection during World AIDS Day activities.
Under the agreement, manufacturer Gilead Sciences will provide lenacapavir at no profit to two million people across high-burden countries over the next three years.
However, health advocates argue the commitment falls short of Africa’s needs, especially given that the drug costs $28,000 per person annually in the United States.
Eastern and southern Africa are home to 52% of the world’s 40.8 million people living with HIV, according to 2024 UNAIDS figures.
More affordable generic versions, expected by 2027, could cost as low as $40 per year under agreements between Unitaid, the Gates Foundation, and Indian pharmaceutical companies.
While oral PrEP has been available for over a decade, its daily pill requirement has limited widespread uptake — a gap lenacapavir’s long-acting formula may finally bridge.
