Africa Launches Landmark HIV-Prevention Injection Offering 99.9% Protection

South Africa, Eswatini, and Zambia have begun administering a new twice-yearly HIV-prevention injection, marking the drug’s first public rollout on the continent with the world’s highest HIV burden. The injectable, lenacapavir, has demonstrated more than 99.9 percent protection against HIV transmission, giving health authorities optimism that it could play a transformative role in prevention efforts.

In South Africa, where roughly one in five adults lives with HIV, a Wits University research unit coordinated the introduction of the treatment through a Unitaid-funded initiative. Unitaid said the first participants have already received the injection, describing it as among the earliest real-world uses of the six-monthly preventive drug in low- and middle-income countries. The organisation did not disclose the number of initial recipients; in the United States, the drug carries an annual cost of about $28,000 per person.

Zambia and Eswatini received 1,000 doses in November under a US-supported programme and planned to launch public access during World AIDS Day events on Monday. As part of the initiative, manufacturer Gilead Sciences has agreed to supply lenacapavir at no profit to two million people in high-burden countries over three years.

Eastern and southern Africa account for about 52 percent of the 40.8 million people living with HIV globally, according to 2024 UNAIDS estimates. To widen future access, generic versions of lenacapavir are expected from 2027 at approximately $40 per year across more than 100 countries through agreements involving Unitaid, the Gates Foundation, and Indian pharmaceutical producers.