Zimbabwe to Pilot Game-Changing HIV Injection

Zimbabwe is set to pilot lenacapavir, a twice-yearly injectable HIV prevention drug (image source)

Zimbabwe has been selected among ten countries worldwide to pilot lenacapavir, a twice-yearly injectable HIV prevention drug hailed as a breakthrough in the fight against HIV/AIDS. The announcement, made by the U.S. Embassy in Harare on September 23, positions Zimbabwe at the forefront of a new era in HIV prevention, building on decades of public health interventions.

Lenacapavir, developed by Gilead Sciences, is a long-acting pre-exposure prophylaxis (PrEP) that requires only two injections per year. Clinical trials have shown it to be over 99% effective in preventing HIV transmission among high-risk populations. Its extended dosing interval is expected to improve adherence and reduce stigma associated with daily or monthly regimens.

“This is more than medicine—it’s a pathway to a safer, stronger, and healthier future for Zimbabwe,” the U.S. Embassy said in its official statement.

Zimbabwe’s HIV response has relied on oral PrEP, antiretroviral therapy (ART), and more recently, the Dapivirine vaginal ring and Cabotegravir (CAB-LA) injections. Oral PrEP, introduced in 2016, faced adherence challenges, especially among adolescents and mobile populations. The Dapivirine ring offered a discreet monthly option for women but had limited uptake due to cultural and logistical barriers.

Cabotegravir, introduced in 2023, shifted focus to long-acting prevention, though rollout was limited by cost and cold-chain requirements. Lenacapavir’s twice-yearly schedule and room-temperature stability are seen as more scalable solutions for Zimbabwe’s healthcare system.

“Lenacapavir gives clients more options to choose from and see which method works best for them,” said Getrude Ncube, National HIV Prevention Coordinator at the Ministry of Health and Child Care.

The pilot will prioritize adolescent girls and young women, female sex workers, and pregnant and breastfeeding women—groups disproportionately affected by HIV. UNAIDS reports that Zimbabwe recorded 22,000 new infections in 2024, with young women accounting for nearly 60%.

Pilot sites have been identified in Harare, Bulawayo, and Mutare, with support from the Global Fund and PEPFAR. The drug will be provided free of charge for the first three years, pending regulatory approval by the Medicines Control Authority of Zimbabwe.

Peter Sands, Executive Director of the Global Fund, stressed the importance of timely rollout: “Accelerating access to innovations like lenacapavir is crucial in our fight against HIV. We must ensure breakthrough tools are deployed quickly, affordably, and effectively.”

Civil society groups, however, are calling for transparency on long-term pricing, procurement agreements, and community engagement. In South Africa, similar concerns have been raised about access and affordability.

Zimbabwe’s HIV response, long praised for its community-driven approach, will now be tested by whether lenacapavir can deliver sustained reductions in new infections. As the country prepares for a 2026 rollout, stakeholders hope the initiative will not only curb HIV but also set a precedent for innovation-led healthcare across sub-Saharan Africa.