South Africa has begun administering lenacapavir,
a revolutionary twice-yearly HIV prevention injection shown to reduce the risk
of transmission by more than 99.9%—making it functionally comparable to
a highly effective vaccine.
The rollout, overseen by a Wits University research
unit, is part of a Unitaid-funded initiative aimed at expanding access to
advanced HIV prevention tools in low- and middle-income countries.
“The first individuals have begun using lenacapavir
for HIV prevention in South Africa,” Unitaid announced, calling the programme
one of the earliest real-world deployments of the injectable drug outside
high-income nations.
The agency did not disclose how many people received
the initial doses. In the United States, the medication costs $28,000 per
person per year, but a broader and more affordable national rollout is
expected in South Africa next year.
Neighbouring Countries Also Begin
Introduction
Zambia and Eswatini received 1,000 doses last
month under a U.S.-supported programme and were expected to officially launch
the medication during World AIDS Day events on Monday.
Under the initiative, manufacturer Gilead Sciences
has agreed to supply lenacapavir at no profit to two million people
across high HIV-burden countries over the next three years. However, experts
warn that this commitment does not meet actual demand, while the existing
market price remains unaffordable for many.
A Region Carrying the Global Burden
Eastern and southern Africa collectively account for 52%
of the world’s 40.8 million people living with HIV, according to UNAIDS
2024 data. South Africa alone has one of the highest infection rates globally,
with one in five adults affected.
Affordable Generics Expected by 2027
More affordable generic versions of
lenacapavir—estimated at around $40 per year—are expected to become
available from 2027 for over 100 countries. This will be made possible
through agreements brokered by Unitaid and the Gates Foundation with Indian
pharmaceutical manufacturers.
A Major Shift from Daily Pills
Lenacapavir represents a significant advancement over
existing HIV prevention methods. While oral pre-exposure prophylaxis (PrEP)
has been available for more than a decade, its daily dosing requirements have
limited uptake and impact. A twice-yearly injection could dramatically improve
adherence and help curb new infections globally.
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