South Africa, Eswatini and Zambia on Monday commenced the first public rollout in Africa of a groundbreaking twice-yearly HIV-prevention injection.
Lenacapavir, administered every six months, has demonstrated more than 99.9 per cent efficacy in preventing HIV transmission, placing it on the threshold of being a functional vaccine.
The introduction of the injectable represents the most important advance in HIV prevention in years.
In South Africa, where an estimated one in five adults is living with HIV, a research unit at Wits University coordinated the initial deployment under an initiative funded by Unitaid, the UN health agency.
Unitaid confirmed in a statement that “the first individuals have begun using lenacapavir for HIV prevention in South Africa,” describing the move as one of the earliest real-world uses of the drug in low- and middle-income countries.
The agency did not disclose how many people received the first doses. A wider national rollout is expected next year.
Zambia and Eswatini, which each received 1,000 doses in November under a US-backed programme, were due to launch the injection as part of their World AIDS Day activities on Monday.
Under the scheme, 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.
However, health advocates argue the commitment falls well short of demand, saying that the commercial price, about $28,000 per patient annually in the United States, is far beyond the reach of most Africans.
Eastern and southern Africa account for about 52 per cent of the 40.8 million people living with HIV globally, according to UNAIDS’ 2024 estimates.
Generic versions of the drug are expected from 2027 at around $40 per year for more than 100 countries, following agreements between Unitaid, the Gates Foundation and Indian pharmaceutical manufacturers.
The new injection comes as health workers push to strengthen uptake of pre-exposure prophylaxis (PrEP), which has been available for more than a decade but has had limited impact globally due to the need for daily oral doses.
AFP