Africa has officially launched one of the most advanced HIV-prevention tools in medical history as South Africa, Eswatini, and Zambia begin administering Lenacapavir, a groundbreaking twice-yearly injection proven to reduce HIV transmission by more than 99.9 percent. The rollout, which commenced on Monday, marks the first time the drug is being offered to the public in any low- or middle-income region, signaling what experts describe as a historic shift in the fight against the virus.
In South Africa where nearly one in five adults lives with HIV, the first doses were given under the supervision of the Wits University research unit as part of a Unitaid-supported programme. Unitaid, a United Nations global health agency, confirmed the milestone, noting that South Africa has now become one of the first real-world settings to deploy the six-month injection. A full national rollout is expected in 2026.
Neighbouring Zambia and Eswatini, which each received 1,000 doses last month through a U.S.-backed programme, are also introducing the drug as part of their World AIDS Day activities. The countries, both heavily impacted by HIV, hope the long-acting injection will close prevention gaps caused by stigma, pill fatigue and inconsistent use of daily PrEP medication.
Lenacapavir works by blocking a key step in the HIV replication process, essentially giving the immune system a long-lasting shield against infection. Its twice-yearly dosing schedule makes it far easier to maintain than oral PrEP, which requires strict daily adherence.
Despite global excitement, concerns remain over affordability. The drug currently costs $28,000 per person annually in the United States—far beyond the reach of African health systems. While manufacturer Gilead Sciences has pledged to supply two million doses at no profit over three years, critics argue this covers only a fraction of the need across high-burden nations. Eastern and Southern Africa currently account for 52 percent of all people living with HIV worldwide, according to 2024 UNAIDS data.
Hope for wider access lies in the upcoming release of generic versions expected by 2027, which could be priced as low as $40 per year through partnerships supported by Unitaid and the Bill & Melinda Gates Foundation. Public health experts say the combination of affordability and the injection’s high efficacy could transform HIV prevention strategies and drastically cut new infections.
For now, African health leaders are calling the rollout a major victory and a glimpse into a future where long-acting HIV protection becomes routine and accessible to all.
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