South Africa, Eswatini, and Zambia have begun 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 more than 99.9 percent, a level of protection comparable to a highly effective vaccine.
In South Africa, where roughly one in five adults lives with HIV, a research unit at Wits University is overseeing the initial rollout under a program funded by Unitaid, a United Nations health agency. Unitaid 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 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 pledged to provide lenacapavir at no profit to two million people in high‑burden countries over three years. However, the drug’s commercial price—about $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 roughly 52 percent of the 40.8 million people living with HIV worldwide, according to 2024 UNAIDS figures. The introduction of lenacapavir is therefore a crucial step in addressing the region’s high HIV burden. With its high efficacy, the drug has the potential to significantly reduce new HIV infections. As the rollout continues, ensuring that the drug remains accessible and affordable for those who need it most will be essential. The success of this initiative will depend on the ability to scale up distribution and address concerns about affordability.
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