Africa to Receive Revolutionary Twice-Yearly HIV Prevention Shot

A groundbreaking partnership between Gilead Sciences and the Global Fund has paved the way for low- and middle-income countries—especially in Africa—to access lenacapavir, the world’s first twice-yearly injectable for HIV prevention (PrEP). Approved earlier this year and backed by royalty-free licensing for generic versions, the program will deliver up to 2 million doses over three years, starting as early as late 2025 in countries including South Africa.

Gilead will supply the medication at cost, while several generic manufacturers ramp up production for broader distribution. The Global Fund, prioritizing countries with high HIV incidence, will coordinate initial rollout efforts. Support from major donors further underpins the initiative, though additional funding is still needed to ensure long-term impact.

Lenacapavir represents a leap forward: clinical trials in Africa showed as much as 100% efficacy in preventing HIV transmission. Experts say its biannual regimen addresses key barriers—namely adherence and access—that have limited uptake of daily oral PrEP, particularly among vulnerable young women and key populations.

However, challenges remain. Health systems across Africa face cold-chain infrastructure gaps and a shortage of trained healthcare workers to administer injections—a legacy of disruptions caused by funding cuts in the HIV sector. Additionally, while generic production may someday reduce costs to around $25–$40 per person annually, scaling up manufacturing and distribution networks will take time.

Despite these hurdles, modeling studies from countries like South Africa, Kenya, and Uganda suggest vast public health gains if long-acting injectables like lenacapavir become widely available. Successful rollout could prevent millions of new infections and reignite momentum toward the goal of ending the AIDS epidemic by 2030.

The next critical steps include securing additional donor support, expanding community-based delivery models, and strengthening health systems. International organizations have already issued calls for proposals to fund cost-effective implementation in sub-Saharan Africa, indicating strong institutional support.

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