Zimbabwe Launches Lenacapavir HIV Prevention Injection

Zimbabwe has started rolling out lenacapavir, the new long-acting injectable HIV-prevention drug, becoming one of the first countries in the world to do so. The roll-out took place on February 19 in Epworth, a shanty settlement some 20 km south of the capital Harare, and started with 46,000 doses.

Lenacapavir is the first twice-yearly injectable pre-exposure prophylaxis (PrEP) for HIV, offering a highly effective, long-acting alternative to daily oral pills. With only two doses per year, experts say it provides a practical option for people who face challenges with adherence, stigma, or limited access to healthcare.

Launching the new drug, Zimbabwe's Health and Child Care minister Douglas Mombeshora said the programme, funded by the United States government and the Global Fund, would initially target more than 46,000 people at high risk of contracting HIV across 24 sites nationwide. "Lenacapavir is a long-acting injectable option for HIV prevention and demonstrates our commitment to protecting lives and ending HIV/AIDS as a public health threat," Mombeshora said.

He revealed that despite concerted efforts to curb the disease, new HIV infections continue to occur, especially among adolescents, girls and young women and other populations at increased risk. "This tells us something important, prevention must fit into real life. Not everyone finds it easy to take a pill every day. Life gets busy, sometimes people forget, and stigma can make it harder to be seen taking pills," he said.

This first phase of the drug's roll-out programme will target just over 46,000 people at high risk of HIV infection in districts recording high rates of new cases. Health authorities say those given priority include adolescent girls and young women, sex workers, homosexuals, pregnant and breastfeeding women, and others whose social or economic circumstances increase their risk of contracting HIV.

The Deputy Chief of Mission at the US embassy in Harare, Phil Nervig, highlighted how this innovation is driving meaningful progress toward an HIV-free generation. "LEN (lenacapavir) is a ground-breaking HIV prevention innovation developed by American scientists at Gilead Sciences — designed to make protection from HIV simpler, more private, and easier to stay on track with just two doses every six months," Nervig said.

Mombeshora emphasized that lenacapavir does not replace existing HIV prevention options such as abstinence, being faithful to one's sexual partner, the consistent use of condoms, oral PrEP, and other injectables, but rather complements them. He also encouraged the public to rely on trained health professionals for accurate information, noting that health services are there to help and not to judge.

The director of the AIDS and TB Unit in the Ministry of Health and Child Care, Owen Mugurungi, said Zimbabwe's HIV response has long been guided by the principle that no single intervention can end the epidemic. "When I say combination prevention, I mean that one tool might not be enough to prevent the acquisition of HIV," he explained. "For many years, Zimbabwe has been guided by this simple principle that no magic bullet or single intervention can end HIV. However, we can reduce new HIV infections by combining different proven biomedical, behavioural, and structural interventions."

Mugurungi pointed out that available behavioural interventions include abstinence, monogamy and reducing concurrent sexual partnerships, while biomedical approaches cover HIV testing and counselling, treatment, proper and consistent condom use, management of sexually transmitted infections, post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP).

Zimbabwe introduced oral PrEP in 2016, the dapivirine vaginal ring in 2021 and long-acting injectable cabotegravir in 2024. Lenacapavir becomes the latest addition to this HIV prevention tool kit. "It does not come to replace, but to complement the existing options, and thereby strengthening our prevention package," Mugurungi said.

Zimbabwe, one of the African countries that were ravaged by HIV/AIDS at its peak and still has one of the highest infection rates in the world, is among the nine countries selected by the World Health Organization for the early receipt of this breakthrough next generation HIV prevention injection.