South Africa, Eswatini, and Zambia began administering a pioneering HIV-prevention injection on Monday, marking the first public deployment of the drug in Africa the region with the highest global HIV burden.
The injection, lenacapavir, is given twice yearly and has demonstrated a reduction in HIV transmission risk of more than 99.9 percent, offering protection comparable to that of a highly effective vaccine.
In South Africa, where roughly one in five adults is HIV-positive, the rollout is being managed by a research team from Wits University under an initiative funded by Unitaid, a United Nationsaffiliated health organization. According to Unitaid, the first individuals have begun using lenacapavir for HIV prevention in South Africa, marking one of the earliest real-world uses of the six-month injection in low- and middle-income settings.
The organisation did not reveal how many people received the initial doses. In the United States, the drug carries an annual price tag of about $28,000 per person. A wider national rollout in South Africa is planned for next year.
Zambia and Eswatini, which each received 1,000 doses through a U.S. programme last month, were expected to introduce the drug during their World AIDS Day events on Monday. Under the same programme, manufacturer Gilead Sciences has committed to supplying lenacapavir at no profit to two million people in high-burden countries over a three-year period.
Critics argue that this commitment falls far short of actual needs and note that the commercial price remains inaccessible for most communities. According to UNAIDS 2024 data, eastern and southern Africa are home to about 52 percent of the worlds 40.8 million people living with HIV.
Generic versions of lenacapavir are expected to become available in 2027 at roughly $40 per year in more than 100 countries, following agreements between Unitaid, the Gates Foundation, and pharmaceutical manufacturers in India.
Pre-exposure prophylaxis (PrEP) has been used globally for over ten years to prevent HIV, but its dependence on daily oral medication has limited its overall impact on infection rates. The long-acting injectable form is seen as a significant step forward in expanding prevention options.
