South Africa, Eswatini, and Zambia began administering a pioneering HIV-prevention injection on Monday, marking the first public rollouts of the drug in Africa, the continent with the world’s highest HIV burden.
Lenacapavir, administered twice a year, has demonstrated a reduction in HIV transmission risk by more than 99.9 percent, effectively functioning like a potent vaccine.
In South Africa, where one in five adults is living with HIV, a Wits University research unit is overseeing the rollout, which is part of a project funded by Unitaid, the United Nations health agency.
“The first individuals have begun using lenacapavir for HIV prevention in South Africa … making it among the first real-world use of the 6-monthly injectable in low-and middle-income countries,” Unitaid said in a statement.
The agency did not provide figures on how many people received the initial doses. In the United States, lenacapavir costs $28,000 per person per year. A wider national rollout in South Africa is anticipated next year.
Neighboring Zambia and Eswatini received 1,000 doses last month under a US programme and were set to launch the injection during World AIDS Day ceremonies on Monday.
As part of the initiative, manufacturer Gilead Sciences has pledged to supply lenacapavir at no profit to two million people in high HIV-burden countries over three years.
Critics, however, argue that this falls far short of the actual need and that the market price remains prohibitive for most.
Eastern and southern Africa account for roughly 52 percent of the 40.8 million people living with HIV globally, according to 2024 UNAIDS data.
Generic versions of lenacapavir are expected from 2027, priced at around $40 per year in over 100 countries, through partnerships brokered by Unitaid and the Gates Foundation with Indian pharmaceutical companies.
Pre-exposure prophylaxis used for more than a decade to prevent HIV, has had limited global impact due to its reliance on a daily pill. Lenacapavir’s six-monthly schedule is seen as a potential game-changer.
