Zimbabwe has begun rolling out lenacapavir, a long-acting HIV prevention drug that requires only two injections per year, marking the country as one of the first in Africa to adopt this treatment. The rollout targets high-risk populations, including sex workers, adolescent girls and young women, gay men, and pregnant or breastfeeding women, with the injections offered for free through donor-supported programs. Health authorities and advocates hope lenacapavir will improve adherence and reduce stigma associated with daily oral HIV prevention methods, particularly for people whose work or lifestyles make consistent pill-taking difficult.
Clinical studies indicate that lenacapavir offers near-total protection against HIV, making it a potential game-changer for prevention strategies in high-risk communities. Zimbabwe’s Health Minister, Douglas Mombeshora, highlighted the drug’s discreet and extended dosing schedule as a key advantage, allowing prevention methods to better fit into real-life situations. The initiative is supported by PEPFAR, the Global Fund, and Gilead Sciences, the drug’s developer, with similar rollouts already underway in countries like Zambia and Eswatini.
Despite the promise of lenacapavir, experts warn that achieving broad impact faces challenges including funding constraints, limited healthcare infrastructure, and the need to maintain patient engagement. Zimbabwe initially expects about 46,000 people across 24 sites to benefit, a small portion of potential demand in a country of roughly 15 million people. While Gilead plans to sell the drug at no profit to low- and middle-income countries, the cost of mass rollouts remains high, and health systems heavily reliant on external funding may struggle to scale access.
Health professionals stress that lenacapavir should complement, not replace, existing prevention tools such as condoms, which remain essential for protecting against HIV and other sexually transmitted infections. For early recipients like sex worker Constance Mukoloka, the injections already provide a sense of security and freedom, allowing her to feel protected for six months at a time, highlighting the immediate benefits for individuals at high risk.
This rollout represents a critical step in strengthening HIV prevention in Zimbabwe, especially for vulnerable populations, while underscoring the need for continued investment, health system support, and integrated prevention strategies to maximize the drug’s long-term impact.
