South Africa, Eswatini, and Zambia have commenced the public rollout of a novel HIV-prevention injection, marking a significant milestone in the region’s fight against the disease. The injectable drug, lenacapavir, is administered twice a year and has been shown to reduce the risk of HIV transmission by over 99.9 percent, comparable to a highly effective vaccine.

In South Africa, where approximately one in five adults is living with HIV, a research unit at Wits University is overseeing the initial rollout under a program funded by Unitaid, a United Nations health agency. The agency confirmed that the first individuals have started receiving the injection, describing it as one of the earliest real-world uses of the six-monthly drug in low- and middle-income countries. While the exact number of people who received the first doses was not disclosed, a wider national rollout in South Africa is expected next year.

Zambia and Eswatini, which received 1,000 doses last month through a United States-supported program, also launched the drug on Monday, coinciding with World AIDS Day events. The manufacturer, Gilead Sciences, has committed to providing lenacapavir at no profit to two million people in high-burden countries over three years. However, the drug’s commercial price, around $28,000 per person annually in the United States, has raised concerns about affordability for most people in Africa.

Eastern and southern Africa account for approximately 52 percent of the 40.8 million people living with HIV worldwide, according to 2024 UNAIDS figures. The introduction of lenacapavir is a crucial step in addressing the region’s high HIV burden. With its high efficacy rate, the drug has the potential to significantly reduce the number of new HIV infections. As the rollout continues, it is essential to ensure that the drug is accessible and affordable for those who need it most. The success of this initiative will depend on the ability to scale up distribution and address the concerns surrounding the drug’s affordability.