Zimbabwe launches twice-yearly HIV prevention drug

Young women, mothers holding babies and some men lined up in a dusty field on the outskirts of Zimbabwe’s capital, Harare, on Thursday to receive injections of a new HIV prevention drug that only needs to be administered twice a year.

Zimbabwe, where HIV has led to tens of thousands of deaths over the past two decades, is one of the first countries to roll out lenacapavir.

With clinical studies demonstrating near total protection, the drug has been described by some health officials as a turning point for high-risk groups. Others warn that turning scientific promise into broad impact will require overcoming funding constraints, infrastructure gaps and the challenge of keeping patients engaged.

At the launch, Constance Mukoloka stepped out of a mobile clinic beaming with relief after receiving one of the first doses of the donor-supported rollout across 10 African countries.

“I am safe, I can work with confidence now,” said the 27-year-old sex worker.

For Mukoloka, the drug represents more than convenience.

“When I took tablets, customers would see a container of pills and leave. They would never return due to fear,” she said. “They couldn’t tell the difference between PrEP and treatment drugs. With the work we do, that stigma costs you money.”

Developed by California-based Gilead Sciences, the drug’s introduction in selected countries is supported by the United States President’s Emergency Plan for AIDS Relief in partnership with the Global Fund.

The injection is offered free to high-risk people such as sex workers, adolescent girls and young women, gay men, and pregnant and breastfeeding women.

Daily oral PrEP has long been available in Zimbabwe alongside condoms, vaginal rings and shorter-acting injectables. Yet adherence has remained a challenge, particularly for people facing stigma or unpredictable schedules.

“I work in beer halls looking for clients. Sometimes I would get drunk and forget to take my drugs. Sometimes I would work all night and not have time to take tablets,” Mukoloka said.

Despite gains in dealing with the epidemic, new HIV infections remain a concern in Zimbabwe, particularly among adolescent girls and young women.

UNAIDS says women and girls of all ages accounted for 63 per cent of all new infections in sub-Saharan Africa in 2024, driven by gender inequality, poverty and uneven access to health services.

The authorities say about 46,000 people across 24 sites are expected to benefit in the early phase of the rollout, a fraction of potential demand in a country of roughly 15 million.

Details for the next phase are not clear. The government says it hopes the number of beneficiaries will increase as more donor-funded doses arrive. It also hopes to acquire its own doses for a mass rollout, but, like many other African governments, lacks enough money.

Dr Ernest Chikwati, Zimbabwe programme director at AIDS Healthcare Foundation, described lenacapavir as a “game changer” for HIV prevention, though warning that “it’s not a silver bullet.”

He emphasised the continued importance of cheaper options such as condoms.

SOURCE: AP