South Africa, Eswatini, and Zambia were scheduled to commence on Monday the administration of a groundbreaking new HIV-prevention injection.

This marks the drug’s first public rollouts in Africa, the continent with the world’s highest HIV burden.

The drug, named Lenacapavir, is administered only twice a year. It has been scientifically shown to reduce the risk of HIV transmission by more than 99.9 per cent, effectively making its function similar to that of a powerful vaccine.

In South Africa, where approximately one in five adults is living with HIV, a Wits University research unit took charge of overseeing the rollout. This initiative is part of a programme funded by Unitaid, the United Nations health agency.

Unitaid issued a statement, declaring: “The first individuals have begun using lenacapavir for HIV prevention in South Africa … making it among the first real-world use of the 6-monthly injectable in low-and middle-income countries.”

The agency did not specify the exact number of individuals who received the initial doses of the drug. The annual cost of the drug in the United States is $28,000 per person. A broader national rollout within South Africa is anticipated to take place next year.

Neighbouring countries, Zambia and Eswatini, received 1,000 doses in the preceding month as part of a US programme. They were expected to officially launch the drug at ceremonies commemorating World AIDS Day on Monday.

Under the terms of the programme, the manufacturer, Gilead Sciences, has agreed to provide Lenacapavir at no profit to two million people in countries with a high HIV burden over a three-year period.

Critics of the current arrangement have argued that this commitment is far below the actual requirement needed to address the epidemic. They also point out that the current market price is financially out of reach for the majority of people.

According to 2024 UNAIDS data, the Eastern and southern African region alone accounts for approximately 52 percent of the 40.8 million people living with HIV worldwide.

Generic versions of Lenacapavir are projected to become available starting from 2027. The cost is expected to be around $40 per year in more than 100 countries. This anticipated lower price point is a result of agreements between Unitaid and the Gates Foundation with various Indian pharmaceutical companies.

Pre-exposure prophylaxis, or PrEP, has been in use for over a decade as a method to prevent HIV. However, its reliance on a daily pill has been cited as a limiting factor in its overall impact on global infection rates.