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South Africa, Eswatini, and Zambia have officially begun administering a groundbreaking HIV-prevention injection—marking the first public rollout of the drug in Africa, the region most affected by HIV globally.
The injectable medicine, lenacapavir, is taken just twice a year and has demonstrated an extraordinary ability to reduce HIV transmission by over 99.9%, making it functionally similar to a highly effective vaccine.
In South Africa—where one in five adults lives with HIV—the rollout was coordinated by a Wits University research unit as part of a Unitaid-funded initiative under the United Nations health agency.
Unitaid confirmed the milestone, noting:
“The first individuals have begun using lenacapavir for HIV prevention in South Africa … making it among the first real-world use cases of the six-monthly injectable in low- and middle-income countries.”
While the agency did not disclose how many people received the initial doses, it highlighted the significant cost gap: in the United States, a year’s supply of the drug costs $28,000 per person.
Last month, Zambia and Eswatini each received 1,000 doses through a U.S. programme and were expected to officially launch the injection during World AIDS Day ceremonies on Monday.
Under this initiative, Gilead Sciences, the manufacturer, has agreed to supply lenacapavir at no profit to two million people in high-burden countries over the next three years.
According to 2024 UNAIDS data, eastern and southern Africa account for 52% of the world’s 40.8 million people living with HIV, underscoring the importance of this rollout.
More accessible treatment options are also on the horizon. Generic versions of lenacapavir are expected to reach the market by 2027, priced at about $40 per year across more than 100 countries, thanks to agreements between Unitaid, the Gates Foundation, and Indian pharmaceutical manufacturers.
