What's happened
Gilead Sciences' long-acting HIV injection, lenacapavir, is set for rollout in Africa, starting with Eswatini, as part of a US-led initiative. The drug offers hope for improved adherence and prevention, but high costs and regulatory hurdles remain. Namibia is among potential future recipients.
What's behind the headline?
The rollout of lenacapavir marks a significant milestone in HIV prevention, especially in high-burden African countries. Its twice-yearly administration could dramatically improve adherence, reduce stigma, and lessen the burden on healthcare systems. However, the high initial cost and regulatory delays pose substantial barriers. The focus on Eswatini, with the highest HIV incidence, underscores the urgency but also highlights disparities in access. The decision to include Namibia in future phases depends on government readiness and resource allocation. This initiative reflects a broader shift towards long-acting HIV prevention methods, which will likely become standard in the coming years, transforming the landscape of HIV management in Africa. The controversy over licensing and local manufacturing rights, especially in South Africa, indicates ongoing debates about equitable access and economic sovereignty in global health efforts.
What the papers say
The articles from All Africa, The Independent, and AP News collectively emphasize the historic nature of this rollout, with Gilead's commitment to no-profit supply for high-burden countries. While all sources highlight Eswatini's early participation, The Independent provides additional context on the global demand and the political implications, including concerns over funding cuts and manufacturing rights. AP News underscores the logistical and regulatory challenges, as well as the high costs in the US contrasted with future affordability for low-income countries. The sources collectively portray a cautious optimism, tempered by economic and political hurdles, about the potential of lenacapavir to revolutionize HIV prevention in Africa.
How we got here
The injectable, called lenacapavir, was approved by the US in June 2025 and demonstrated near-total protection in clinical trials. It is designed to be administered twice yearly, addressing challenges of daily medication adherence and stigma. The rollout is part of PEPFAR and the Global Fund's efforts to reduce HIV infections in high-burden African countries, with initial focus on Eswatini, which has the highest HIV incidence globally. The initiative aims to benefit at least 2 million people by 2027, with Gilead supplying the drug at no profit to high-burden nations. The high cost of the drug in the US ($28,000+ annually) contrasts with the lower expected price ($40) for low- and middle-income countries from 2027.
Go deeper
Common question
-
What is the new HIV prevention shot being rolled out in Africa?
A groundbreaking long-acting HIV prevention shot called lenacapavir is now being introduced in Africa, starting with Eswatini. This new treatment aims to improve HIV prevention efforts by offering a less frequent, more manageable option for those at risk. But what exactly is this shot, how does it work, and who will benefit most? Below, we answer the most common questions about this promising development and explore what it means for HIV prevention across the continent.
More on these topics
-
Gilead Sciences, Inc., is an American biopharmaceutical company headquartered in Foster City, California that researches, develops and commercializes drugs.
-
Eswatini, officially the Kingdom of Eswatini, sometimes written in English as eSwatini, and formerly and still commonly known in English as Swaziland, is a landlocked country in Southern Africa.
-
Lenacapavir is an experimental drug for the treatment of HIV being developed by Gilead Sciences. As of 2021, it is in Phase 2/3 clinical trials.