Zimbabwe Leads the Way with Long-Acting HIV Prevention: A Game Changer for Africa?
Harare, Zimbabwe – A new chapter in HIV prevention is unfolding in Zimbabwe, as the country becomes one of the first globally to roll out lenacapavir, a long-acting injectable drug requiring administration only twice a year. This development, launched on February 19, 2026, offers a potential turning point in the fight against HIV, particularly for high-risk populations.
Addressing the Challenges of Traditional HIV Prevention
For years, daily oral PrEP (pre-exposure prophylaxis) has been a cornerstone of HIV prevention. However, adherence has consistently been a hurdle. Individuals facing stigma, unpredictable schedules, or simply the inconvenience of daily pills often struggle to maintain consistent protection. Constance Mukoloka, a 27-year-vintage sex worker in Harare, exemplifies this challenge. She described how daily PrEP pills created tension with clients and were tough to take consistently.
“When I took tablets, customers would see a container of pills and leave,” Mukoloka shared. “They couldn’t tell the difference between PrEP and treatment drugs. With the work we do, that stigma costs you money.”
Lenacapavir: A Discreet and Effective Alternative
Lenacapavir, developed by Gilead Sciences, offers a discreet and extended-duration alternative. The injectable is being offered for free in Zimbabwe to high-risk groups, including sex workers, adolescent girls and young women, gay men, and pregnant and breastfeeding women. This approach addresses the practical challenges of daily medication, potentially leading to improved adherence and reduced infection rates.
Douglas Mombeshora, Zimbabwe’s health minister, emphasized this point: “Prevention must fit into real life. If a health solution is too complicated, too demanding, or too visible, people simply won’t use it. Lenacapavir represents a new way of doing things.”
Expanding Access Across Africa
Zimbabwe isn’t alone in embracing this new approach. Lenacapavir has similarly been rolled out in Zambia and Eswatini. A donor-supported rollout is underway across 10 African countries, supported by the United States President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund.
The rollout in Zimbabwe will initially target approximately 46,000 people across 24 sites in key urban centers like Harare, Bulawayo, and Gweru, before expanding to other districts with high HIV rates.
The Cost Factor and Sustainable Implementation
Despite the promise, significant challenges remain. The high cost of lenacapavir is a major concern for widespread implementation. In Kenya, the drug is priced at approximately $54 per person per year, a substantial expense for many African governments. While Gilead Sciences has pledged to sell the drug at no profit to low and middle-income countries, sustainable funding remains a critical issue.
Bellinda Thibela, from Health GAP, highlighted the reliance on external funding: “What’s the point of having a reduced price if there is no staff and equipment in clinics?”
Beyond Lenacapavir: A Comprehensive Approach
Experts emphasize that lenacapavir should complement, not replace, existing prevention methods. Condoms remain a vital tool, offering protection against other sexually transmitted infections as well. A comprehensive approach, combining various prevention strategies, is essential for maximizing impact.
Enerst Chikwati, Zimbabwe program director at AIDS Healthcare Foundation, stated, “Condoms remain key. They are cheap and they also prevent other sexually transmitted infections.”
Looking Ahead: The Future of HIV Prevention
Zimbabwe’s pioneering rollout of lenacapavir signals a potential shift in HIV prevention strategies. The drug’s discreetness and extended duration offer a compelling alternative for those struggling with traditional methods. However, overcoming financial barriers and ensuring sustainable implementation will be crucial for realizing its full potential and achieving lasting progress in the fight against HIV across Africa.
Frequently Asked Questions
- What is lenacapavir? Lenacapavir is a long-acting injectable HIV prevention drug administered only twice a year.
- Who is eligible for lenacapavir in Zimbabwe? High-risk individuals, including sex workers, adolescent girls and young women, gay men, and pregnant and breastfeeding women.
- How much does lenacapavir cost? In Kenya, it is priced at approximately $54 per person per year.
- Is lenacapavir a replacement for condoms? No, condoms remain a vital part of HIV prevention.
Did you know? Zimbabwe, Eswatini, and Zambia have emerged as successful models in controlling the HIV epidemic, achieving key World Health Organization targets.
Pro Tip: Consistent adherence to any HIV prevention method is crucial for maximizing its effectiveness.
What are your thoughts on this new approach to HIV prevention? Share your comments below!
