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South Africa, Eswatini, and Zambia began administering a groundbreaking HIV-prevention injection on Monday, marking the drug’s first public rollout in Africa.
The drug, lenacapavir, given twice a year, has been shown to reduce HIV transmission risk by over 99.9 per cent, effectively functioning like a potent vaccine.
In South Africa, where one in five adults lives with HIV, a Wits University research unit managed the rollout as part of a Unitaid-funded initiative.
“The first individuals have begun using lenacapavir for HIV prevention in South Africa … making it among the first real-world uses of the six-monthly injectable in low- and middle-income countries,” Unitaid stated.
The exact number of first recipients was not disclosed.
In the United States, the drug costs $28,000 per person annually. A nationwide rollout in South Africa is planned for next year.
Zambia and Eswatini received 1,000 doses last month through a U.S. programme and launched the injection during World AIDS Day ceremonies on Monday.
Under the initiative, Gilead Sciences will supply lenacapavir at no profit to two million people in high HIV-burden countries over three years.
Critics note that this is far below the demand and remains inaccessible at market prices for most people.
Eastern and southern Africa account for roughly 52% of the 40.8 million people living with HIV worldwide, according to 2024 UNAIDS data.
Generic versions of lenacapavir are expected from 2027, costing around $40 per year in over 100 countries, thanks to agreements with Indian pharmaceutical manufacturers supported by Unitaid and the Gates Foundation.
Unlike traditional daily pre-exposure prophylaxis (PrEP), lenacapavir’s six-monthly injection could significantly increase the reach and impact of HIV prevention programmes.
