Zambia, Eswatini first in Africa to receive twice-yearly HIV prevention injection as Kenya eyes approval
Gilead is seeking regulatory approval to distribute lenacapavir in additional African countries, including Kenya, Rwanda, Tanzania and Botswana.
Zambia and Eswatini have become the first countries in Africa to receive lenacapavir, a twice-yearly HIV prevention injection that provides six months of protection and reduces reliance on daily medication.
About 1,000 doses of the drug, developed by Gilead Sciences Inc., were delivered last Thursday under a US-led initiative aimed at supplying high-burden countries with long-acting HIV prevention medication. Each country received roughly 500 doses.
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Officials said the programme represents the first stage of a broader effort to curb HIV transmission in sub-Saharan Africa, the region most affected by the AIDS pandemic.
Gilead is seeking regulatory approval to distribute lenacapavir in additional African countries, including Kenya, Rwanda, Tanzania and Botswana.
“Lenacapavir is a game-changer. It brings forth the promise of ending HIV as a public health threat in a very, very short time if we deploy at scale and at speed,” Peter Sands, executive director of the Global Fund, said, during a media call.
The initiative, announced in September, will provide the drug “at cost” to high-burden countries, aiming to reach two million people over three years through partnerships with the Global Fund and the US President’s Emergency Plan for AIDS Relief (PEPFAR). Gilead CEO Daniel O’Day said the company will supply the long-acting injection without profit until licensed generic manufacturers can produce it.
However, South Africa, which has the world’s largest HIV population, around 8 million people, or one in five adults, will not receive the doses.
Officials said they encourage countries with the capacity, including South Africa, to finance HIV prevention doses for their own populations.
The decision highlights ongoing political tensions between Washington and Pretoria. President Donald Trump imposed a 90-day pause on foreign aid and halted grants by the US Agency for International Development, which had managed most PEPFAR assistance.
The cuts reduced access to HIV-prevention drugs in Africa, including Kenya, particularly among vulnerable populations such as gay men and sex workers, and contributed to a rise in new infections.
“This is somewhat unprecedented, to see an innovation in global health move this fast to low and middle-income countries. Obviously, very small supplies, really just a down payment, but they’re the first of what we think to be many doses in these two countries and in other countries,” Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition, said.
Gilead has also applied for regulatory approval in Malawi, Namibia, Uganda and Zimbabwe, targeting 18 high-burden countries that together account for 70 per cent of the HIV epidemic. The company has confirmed replenishment supplies for Zambia and Eswatini and plans to scale delivery to meet the three-year target of two million doses.
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