A significant step in the global fight against HIV began recently as South Africa, Eswatini, and Zambia commenced the first public rollouts of Lenacapavir, a groundbreaking new HIV-prevention injectable. This launch is particularly critical in Africa, which carries the world’s highest burden of HIV cases.
Lenacapavir has demonstrated remarkable efficacy, reducing the risk of HIV transmission by more than 99.9 percentwhen taken only twice a year. This high level of protection makes the drug functionally similar to a powerful vaccine. The ease of a semi-annual injection is expected to overcome the limitations of the previous standard, Pre-exposure prophylaxis (PrEP), which relies on a daily pill format that has often limited its impact on global infection rates over the past decade.
In South Africa, where one in five adults is living with HIV, a Wits University research unit oversaw the initial rollout as part of an initiative funded by Unitaid, the United Nations health agency. Unitaid confirmed that this marks one of the first real-world uses of the six-monthly injectable in low- and middle-income countries.
Neighboring Zambia and Eswatini also launched the drug after receiving 1,000 doses through a US program. The manufacturer, Gilead Sciences, has agreed to provide Lenacapavir at no profit to two million people in high-HIV-burden countries over three years. While a positive step, critics argue this commitment falls far short of the actual requirement given the drug’s high US price tag of $28,000 per person per year.
Looking ahead, generic versions of Lenacapavir are anticipated to be available from 2027 at a significantly lower cost of around $40 per year in over 100 countries. This will be made possible through agreements between Unitaid, the Gates Foundation, and Indian pharmaceutical companies, promising a more accessible future for HIV prevention worldwide.
