South Africa, Eswatini and Zambia have begun administering a groundbreaking HIV-prevention injection, marking the first public rollout of the drug anywhere on the African continent — the region most affected by HIV globally.
The twice-yearly injection, known as lenacapavir, has demonstrated more than 99.9% effectiveness in preventing HIV transmission, placing it on par with the protection offered by a highly effective vaccine.
In South Africa — where roughly one in five adults is living with HIV — the initial rollout is being led by a Wits University research unit under a programme supported by Unitaid, a United Nations health agency. Unitaid confirmed that the first group of individuals have now received their injections, calling it one of the earliest real-world uses of the drug in low- and middle-income countries.
A broader national rollout is planned for next year, though the agency did not reveal how many people received the first doses.
Zambia and Eswatini also launched the injection on Monday, coinciding with World AIDS Day events. Both countries recently received 1,000 doses through a U.S.-supported initiative.
As part of the programme, manufacturer Gilead Sciences has pledged to supply lenacapavir at no profit to two million people in high-burden countries over the next three years. Still, critics say the commitment is far below the actual need and warn that the drug’s commercial price — around $28,000 per person annually in the United States — remains far out of reach for most people in Africa.
Latest UNAIDS data show that eastern and southern Africa remain the epicentre of the global epidemic, accounting for 52% of the 40.8 million people living with HIV worldwide.
The rollout marks a major milestone in HIV prevention efforts and could reshape public health strategies across the continent if expanded at scale.
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