Zambia and Eswatini each received roughly 500 doses. The delivery is touted as a game‑changer in the fight against HIV in a region where the burden remains extremely high.
Lenacapavir has shown near‑complete protection in clinical studies. Daniel O'Day, chair and CEO of Gilead Sciences, called the Eswatini rollout 'extraordinary,' noting that it is the first time a new HIV medicine has reached a sub‑Saharan African country in the same year it was approved in the United States.
The rollout is part of a collaborative effort between the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund, initially planned for ten high‑risk African countries and aiming to reach at least two million people by 2027. The initial target for 2025 was 250,000 doses, later increased to 325,000 due to early demand.
In Eswatini, a kingdom with roughly 1.2 million people and over 200,000 living with HIV, about 6,000 high‑risk individuals, particularly those at risk of mother‑to‑child transmission, are scheduled to receive the first doses. Most of those living with HIV in Eswatini receive treatment funded by PEPFAR.
Despite the milestone, concerns remain about access and affordability. Civil society groups in South Africa have criticised Gilead for excluding local manufacturers from licensing agreements, even though South Africa hosted Lenacapavir clinical trials.
The World Health Organization (WHO) issued new guidelines recommending injectable Lenacapavir for HIV prevention on July 14, 2025. The recommendation was announced during the International AIDS Conference in Kigali, Rwanda, where the guidelines were formally released.
During the forum, the Global Fund and the Children's Investment Fund Foundation committed to supplying lenacapavir to at least nine early adopter countries starting in early 2026, with Rwanda currently engaged in discussions on how to access and roll out the drug.
Lenacapavir joins other WHO‑recommended pre-exposure prophylaxis (PrEP) options, including daily oral pills and injectable Cabotegravir (CAB-LA). The WHO hailed the long-acting shot as a valuable new choice for people who struggle with a daily pill regimen.
Rania Umutoni
