South Africa, Eswatini, and Zambia have started administering a new HIV-prevention injectable, lenacapavir, marking the first public rollout in Africa. The drug, taken twice a year, reduces HIV transmission risk by over 99.9 percent, offering a vaccine-like protection. In South Africa, Wits University leads the programme under Unitaid’s funding, while Zambia and Eswatini began distribution with 1,000 doses provided through a US-supported initiative. Manufacturer Gilead Sciences plans to provide lenacapavir at no profit to two million people in high-burden countries over three years. While the drug promises unprecedented protection, critics warn that supply is insufficient and the US commercial price of $28,000 per person annually makes it largely unaffordable locally. Eastern and southern Africa account for over half of the global HIV population, highlighting the urgent need for accessible prevention.
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