Kairu Karega | kairukarega@gmail.com
The Global Fund has signed a landmark agreement with Gilead Sciences to provide access to lenacapavir, a long-acting injectable for HIV prevention, to low- and middle-income countries (LMICs). The move marks the first time a new HIV prevention drug will be introduced in LMICs simultaneously with high-income countries.
Lenacapavir, approved by the U.S. FDA in June, is the first injectable PrEP option requiring only two doses per year. The drug is expected to improve adherence and access, particularly in high-burden regions such as sub-Saharan Africa, where daily oral PrEP has faced uptake challenges due to stigma and logistical barriers.
“This is a significant step forward,” said Peter Sands, Executive Director of the Global Fund. “But impact depends on swift rollout, funding, and political will. Our target is to reach 2 million people with long-acting PrEP.”
Countries with high HIV incidence, including South Africa, have expressed interest in early access. The first deliveries are expected by the end of 2025. South Africa’s Minister of Health, Dr. Aaron Motsoaledi, welcomed the development, noting its potential to protect adolescent girls and young women, who remain disproportionately affected.
The introduction will be supported by a coalition including WHO, UNAIDS, CIFF, the Gates Foundation, and other partners, focusing on country-level implementation, regulatory support, and community engagement.
CIFF CEO Kate Hampton emphasized the urgency: “Without access, innovation is meaningless. This partnership ensures vulnerable communities are not left behind.”
While lenacapavir is not a standalone solution, it adds a critical option to the prevention toolkit, which includes condoms, oral PrEP, and voluntary medical male circumcision. The Global Fund is leveraging donor support to reduce financial barriers and accelerate uptake.
Without sustained investment, however, the goal of reaching 2 million people with long-acting PrEP may fall short, a missed opportunity in the global effort to end AIDS.
