By Paul Sixpence
GLOBAL partnerships bringing together governments, pharmaceutical companies, international organisations and international non-governmental organisations will see millions of people across the world including Zimbabwe accessing Lenacapavir, an HIV prevention jab, at a fraction of the original cost beginning in 2027.
What is Lenacapavir?
Lenacapavir is a long-acting HIV Pre Exposure Prophylaxis (PrEP) twice yearly injection that prevents HIV infection in HIV negative persons. Through large scale clinical efficacy trials, PURPOSE 1 and 2, Lenacapavir proved to be 99,9% effective and safe in preventing primary HIV infections in broad sets of populations.
Zimbabwe, an early beneficiary
The US embassy in Harare announced that Zimbabwe has been selected as one of the 10 countries globally set to receive support to roll-out Lenacapavir.
In a statement, the US embassy in Zimbabwe noted that, “While this has the potential to save millions of lives, here in Zimbabwe it represents a major step toward ending new infections…this is more than medicine—it advances us on a pathway to a safer, stronger, and healthier future.”
The National Aids Council (NAC) welcomed the US government’s support for Lenacapavir roll out in Zimbabwe.
“We are very greatful for this development as it will ensure that that babies are born free of HIV and this will lead to the achievement of the 2020 targets of ending AIDS,” said Dr Bernard Madzima, Chief Executive Officer of NAC.
Local and international health experts have long called for the reduction of pricing, removal of hurdles in licensing and expanding access.
“Once the drug has been approved and licensed in Zimbabwe, the government and its partners in the health sector should then make sure that people are given more information about injectable PrEP so that they can make informed decisions,” said Itai Rusike, Executive Director of Community Working Group on Health (CWGH).
Youth led organisations and advocates have welcomed the US government’s commitment to support procurement and roll-out of Lenacapavir in Zimbabwe but emphasised the need for duty bearers to ensure that there is equity in access.
“This is a good start but let us make sure that no one is left behind, especially adolescent girls and young people,” said Tjedu Moyo – Maphosa, Executive Director at Lunia Centre for Youths. “We need to address issues of access, availability and demand creation. The government should lead in ensuring that PrEP is widely and easily accessible to all those who need it through public health institutions.”
Gender responsiveness and equity in accessing PrEP
Studies indicate that women in their diversity bear a disproportionate burden to HIV and therefore prioritisation in access to HIV prevention tools is of paramount importance.
“Equity is the compass of the HIV response,” said Gaston Devisich, Community Engagement Coordinator at Fundación Huésped during a post International Aids Society (IAS) 2025 reflection meeting. “Without it, policy and funding lose their meaning, and those most affected are left behind.”
In announcing the US government’s support for the roll out of Lenacapavir in Zimbabwe, the US embassy highlighted the deliberate focus on pregnant and breastfeeding women to access PrEP so as to protect the next generation.
Long-acting PrEP offers an additional HIV prevention tool for women, thereby expanding choices and flexibility.
“The importance of a long-acting drug is that it reduces the frequency of women going to health facilities to get the drug (PrEP) which ensures adherence and that there is no discrimination,” Dr. Madzima further added. “As we work with the Ministry of Health, National Aids Council, US government and the Global Fund we want to ensure that every pregnant woman who needs to get PrEP gets it.”
How much will it cost?
The current yearly cost for Lenacapavir in the US stands at US$28 000 per person. However, this is set to change in 2027 through global partnerships that will result in drastic price reductions. Lenacapavir will cost US$40 yearly per person.
In a statement, AVAC, a global biomedical HIV prevention and treatment advocacy organisation indicated that it is important to translate science into public health impact.
“This means national programs in many, but not all, countries can begin planning for 2027, at which time ongoing oral PrEP and Lenacapavir use will be available at similar prices, meaning many countries will be truly able to offer people who need prevention choice when it comes to the PrEP method that best meets their needs,” said Mitchell Warren, Executive Director at AVAC. “This could be a transformational moment in HIV prevention if political will, coordination, and further procurement investment meet this moment to deliver Lenacapavir with speed, scale and equity to all communities and populations who need and want prevention options. Many questions remain, but in this current environment, we need to seize opportunities and good news when we can.”
Global partnerships accelerating rapid roll-out
In the midst of drastic funding cuts towards international public health programmes and fears that this may result in roll-backs in gains attained over decades in the fight against HIV and AIDS, the latest collaborations offer hope and keep the promise to end AIDS by 2030 alive.
“The impact of budget cuts on the HIV epidemic was shown, in one modelling study, to be extensive, with community and prevention services being most affected,” said Prof. Alexandra Calmy, Professor of Medicine at the University of Geneva during an International Aids Society (IAS) organised reflection meeting on key messages from the IAS 2025 conference that was held in Kigali, Rwanda.
The Global Fund and United States (US) Presidential Emergency Plan for Aids Relief (PEPFAR) further announced that through an access agreement, Gilead Sciences, will supply Lenacapavir at no profit, for up to two million people over two years. This agreement represents the US government’s re-commitment to funding HIV programmes international.
Separate announcements have also been made by the Gates Foundation and Unitaid to invest in the development, roll-out and price reductions for generic versions of PrEP to ensure access to millions at risk of HIV globally.
Gilead Sciences, the pharmaceutical manufacturer of Lenacapavir, has entered into agreements with Indian pharmaceuticals, Hetero and Dr. Reddy’s, to produce a generic form of Lenacapavir for distribution to low to middle income countries beginning in 2027.
Experts also highlighted the need to expand current partnerships to ensure that Lenacapavir roll-out reaches all those who need it as part of combination prevention approaches.
“To achieve true impact against HIV requires early commitments from additional donors to procure large volumes of Lenacapavir, which will enable a bigger rollout, exceeding targets, and reaching more people who need PrEP in more places, which in turn secures the kind of market scale that accelerates further prices reductions,” said Wawira Nyagah, AVAC’s Director of Product Introduction and Access. “It requires country regulators, ministries of health, implementers, advocates and communities where HIV prevention is needed to prepare with policies and programs that will succeed in connecting people with products that work in the context of their lives. The field has learned these lessons before. Technology alone gets you nowhere; it’s delivering the product with speed, scale and equity that gets the job done.”
According to AVAC’s PrEP watch, an estimated 337 000 people are currently accessing PrEP in Zimbabwe. UNAIDS estimates that 1.3 million people are living with HIV in Zimbabwe, with 1.2 million on anti-retroviral treatment. Yearly new infections are estimated at 32 000 per year.
Support CITE’s fearless, independent journalism. Your donation helps us amplify community voices, fight misinformation, and hold power to account. Help keep the truth alive. Donate today