South Africa, Eswatini and Zambia have become the first nations on the African continent to introduce a new, six‑monthly injectable called lenacapavir.
The drug delivers more than 99.9 % protection against HIV infection and represents the inaugural public rollout of such a long‑acting prevention method in a region that bears the greatest HIV burden worldwide.
In South Africa, where roughly one‑fifth of adults are living with the virus, the programme is being run by a research group at the University of the Witwatersrand under a grant from Unitaid.
Participants receive the injection every six months, and trials have shown it to be almost completely effective at preventing new infections—functionally comparable to a highly potent vaccine.
The manufacturer, Gilead Sciences, has committed to supplying lenacapavir at no charge to two million people in high‑prevalence countries over the next three years.
The United States lists the drug at about $28,000 per patient per year, and initial shipments have been limited to 1,000 doses each for Zambia and Eswatini, delivered through a U.S.-supported initiative and unveiled during World AIDS Day events.Nevertheless, the rollout faces significant obstacles.
Current supplies fall far short of demand, and the high price puts the treatment out of reach for most Africans. Health advocates stress that affordable generic versions will be essential; such generics are expected to become available from 2027 at roughly $40 per patient annually, which could enable widespread use across dozens of countries.
