Africa Begins Rollout of Groundbreaking HIV-Prevention Injection

South Africa, Eswatini, and Zambia have begun the first public rollouts of a revolutionary HIV-prevention injection, marking a major step in the fight against the virus in the region that carries the world’s highest HIV burden. The new drug, lenacapavir, is administered twice a year and has been shown to reduce the risk of HIV transmission by more than 99.9 percent, effectively functioning like a powerful vaccine.

In South Africa, where approximately one in five adults lives with HIV, the initiative is being overseen by a Wits University research unit as part of a program funded by Unitaid, a United Nations-backed health agency. The rollout, which began on Monday, represents one of the first real-world uses of the six-monthly injectable in low- and middle-income countries.

While initial doses have been administered, the exact number of recipients was not disclosed. A broader national rollout in South Africa is expected next year.

Experts Hope New Injection Will Overcome Limitations of Daily PrEP

Previous HIV-prevention strategies, such as pre-exposure prophylaxis (PrEP), relied on daily oral medication. While effective, adherence challenges have limited its impact on global infection rates. Lenacapavir’s biannual schedule addresses this limitation, providing a practical alternative for people at high risk of HIV infection.

Neighbouring Zambia and Eswatini received 1,000 doses last month as part of a US-backed program and launched the injection on Monday, coinciding with World AIDS Day ceremonies. Under the program, manufacturer Gilead Sciences has committed to providing lenacapavir at no profit to two million people in countries with a high HIV burden over the next three years. However, critics argue that this number is far below the actual need and that the market price in wealthier nations, around $28,000 per person per year, is unattainable for most in Africa.

Looking ahead, generic versions of lenacapavir are expected from 2027 at an estimated $40 per year in over 100 countries. These will be made available through agreements brokered by Unitaid and the Bill & Melinda Gates Foundation with Indian pharmaceutical companies, potentially expanding access to millions more at-risk individuals.

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Eastern and southern Africa account for roughly 52 percent of the 40.8 million people living with HIV globally, according to 2024 UNAIDS data. Health officials hope lenacapavir will significantly curb new infections and help turn the tide against HIV in the region.

“This is a historic moment for HIV prevention in Africa,” Unitaid said in a statement. “The rollout of lenacapavir provides an innovative option that could transform the landscape of HIV prevention for those most vulnerable.”