Zimbabwe Among First to Roll Out Groundbreaking Twice-Yearly HIV Prevention Injection

Zimbabwe joins nine other nations in launching lenacapavir, the world’s first twice-yearly HIV prevention injection (image source)

Harare — Zimbabwe has been selected among 10 pioneering countries to roll out lenacapavir, the world’s first twice-yearly HIV prophylactic injection, marking a major leap in global HIV prevention and a new chapter in the country’s public health response. The US Embassy in Harare confirmed Zimbabwe’s inclusion via a post on X, calling it “a breakthrough development in the fight against HIV.” The announcement follows successful global trials showing that lenacapavir prevents nearly all HIV infections when administered correctly.

“While an HIV vaccine remains elusive, lenacapavir is the next best thing — a long-acting antiretroviral shown in trials to prevent almost all HIV infections among those at risk,” said Dr. Tedros Adhanom Ghebreyesus, WHO Director-General. Zimbabwe’s inclusion reflects its robust HIV infrastructure, built through partnerships with PEPFAR and the Global Fund. According to UNAIDS, the country has achieved the 95-95-95 targets — meaning 95% of people living with HIV know their status, 95% of those diagnosed are on treatment, and 95% of those on treatment have achieved viral suppression.

Public health expert Dr. Ponesai Nyika praised the country’s readiness: “Zimbabwe has a very solid HIV response infrastructure, supported by strong partnerships that create a foundation for lenacapavir’s introduction.” The initial rollout will prioritise adolescent girls, pregnant and breastfeeding women, and other populations most at risk of new infections.

Lenacapavir’s key advantage lies in its twice-yearly injection schedule, drastically reducing adherence challenges common with daily pills. In major trials conducted in sub-Saharan Africa and the United States, the drug achieved over 99% efficacy in preventing HIV transmission among women, men who have sex with men, and transgender individuals. “It is highly effective, which is what makes it very exciting compared to others. If used correctly and consistently, lenacapavir can prevent infection almost entirely,” Dr. Nyika said.

The World Health Organisation and UNAIDS have hailed lenacapavir as a “watershed moment” and a “potential miracle drug” for HIV prevention. Despite global excitement, concerns remain about affordability. The injectable was initially priced at US$28,000 per person annually, but through PEPFAR and Global Fund partnerships, the cost has dropped to around US$40 per year for eligible low- and middle-income countries.

Still, access and equity remain major challenges. “These can help to bring the cost down, but leveraging existing supply chains and community health systems will be critical to ensuring equitable access,” Nyika noted. Lenacapavir requires an initial oral loading dose — two tablets on day one and two more the following day — before the first injection is administered.

By January 2026, lenacapavir will be introduced in Kenya, Nigeria, Zambia, Uganda, Tanzania, South Africa, Eswatini, and Botswana, alongside Zimbabwe. Global health partners aim to expand access to 120 countries by 2027, potentially cutting the 1.3 million new annual HIV infections worldwide by half within a decade.

Health experts stress that transparent communication about the drug’s safety, side effects, and consistent funding will be key to maintaining public trust. “Every new medication will have side effects,” Nyika said, “but lenacapavir has been proven safe and well tolerated. The real challenge is equitable access.”

For Zimbabwe and its regional peers, lenacapavir represents hope and scientific progress — the closest the world has come to a vaccine-like HIV prevention tool. If implemented successfully, it could redefine Africa’s leadership in the global fight against HIV. “This is the best thing we’ve got in the HIV response,” said UNAIDS Deputy Director Angeli Achrekar. “We do not yet have a vaccine or cure, but this is extraordinary.”