Twice-a-year HIV prevention drug rollout next year

ZIMBABWE will beginning next year introduce a bi-annual long-acting injectable HIV prevention drug, Lenacapavir, aimed at preventing key and high-risk populations from contracting the virus.

The drug is expected to significantly reduce new HIV infections, bringing the country closer to ending AIDS by 2030.

The breakthrough drug was announced by Gilead Sciences, a global leader in HIV treatment, prevention and cure research that has developed 13 HIV medicines over the past 35 years.

The injection will be available through a partnership between the Global Fund, Zimbabwe, and other heavily burdened countries for an initial three-year period, targeting about two million beneficiaries.

National HIV Prevention Co-ordinator at the Ministry of Health and Child Care Ms Getrude Ncube told Sunday News that the drug will complement existing HIV prevention measures.

She said the country has already identified sites that will begin administering Lenacapavir once it is approved by the Medicines Control Authority of Zimbabwe.

“In Zimbabwe, our prevention toolkit already includes oral Pre-Exposure Prophylaxis (PrEP). We started with oral PrEP, then introduced the Dapivirine ring, and now the long-acting injectable Cabotegravir (CAB-LA). Lenacapavir will be an addition, providing clients with more options to choose from and see which method works best for them,” she said.

Executive Director of the Global Fund, Mr Peter Sands emphasised the potential impact of the intervention in low to middle-income countries. “Accelerating access to innovations like Lenacapavir is crucial in our fight against HIV.

In resource-limited settings, we must ensure that breakthrough tools are deployed quickly, affordably and effectively.

“By focusing on where Lenacapavir can have the greatest impact and collaborating with the US and Gilead, we can help countries integrate it efficiently into their prevention programmes — reducing new infections and supporting their transition toward self-reliance,” he said.

Who will benefit?

Ms Ncube indicated that all HIV prevention strategies in Zimbabwe target high-risk and key populations, such as those at increased risk due to their jobs or circumstances beyond their control.

“We are still focusing on the same groups — adolescent girls and young women (AGYW), female sex workers, pregnant and lactating women — who are at high risk of HIV. Our site selections are based on epidemiological data, targeting areas with higher infection rates. These biomedical prevention strategies are also supported by behavioural and structural interventions,” she said.

The national co-ordinator stressed the importance of reducing HIV incidence among the population, especially within high-risk groups. Zimbabwe is pursuing a Triple Elimination Agenda—aiming to eliminate mother-to-child transmission of HIV, syphilis and hepatitis B by 2030.

“We’ve seen cases where pregnant women initially test negative for HIV but test positive near delivery. Lenacapavir will be available to women at risk of acquiring the virus during pregnancy,” she added.

Availability in Zimbabwe

The new injection will be accessible in the coming year, with support from the Global Fund, which has prioritised Zimbabwe’s HIV, tuberculosis, and malaria interventions.

“Zimbabwe was one of the first countries to approve CAB-LA and the second in the region to start using it, in April 2024.

We were also among the first to approve the Dapivirine ring. Given this history and our existing infrastructure, plans are already advanced for beginning Lenacapavir distribution by January 2026,” Ms Ncube said.

Funding mechanisms

The United States President’s Emergency Plan for AIDS Relief (PEPFAR) announced last week that Zimbabwe will be among the first countries to benefit from the new drug.

“We’re pleased with this development, especially considering recent cuts in HIV prevention funding. Additional support is very positive.

We’ve always aimed to reduce new infections, and this development helps us move closer to that goal by 2030,” she expressed optimism.

The ministry also emphasised the need for increased domestic funding through joint efforts to raise awareness about HIV prevention.

This will build on Zimbabwe’s previous successes in HIV prevention.

Advantages of Lenacapavir

This twice-yearly injection is a game-changer, addressing challenges associated with other prevention methods like daily oral PrEP.

“A major issue with daily pills is pill fatigue, which can lead to non-adherence. The bi-annual injection reduces the frequency of visits to health facilities and is discreet, helping those concerned with disclosure,” she noted.

Cost of the Injection

Ms Ncube stated that while prevention strategies usually incur costs, the Global Fund will cover these expenses, providing the drug free of charge, similar to antiretroviral distribution.

“For now, our focus on sustainability is ensuring the drug is accessible to those in need.

The Global Fund will handle the costs, and the drug will be provided free of charge,” she added. Sunday News