On Tuesday, 18 November 2025, health authorities in Eswatini marked a historic milestone as the country became the first in Africa to receive lenacapavir, a twice-yearly HIV prevention injection proven to offer near-total protection in clinical trials.
The rollout forms part of the U.S. President’s Emergency Plan for AIDS Relief in collaboration with the Global Fund, targeting 10 high-risk African countries and aiming to reach at least 2 million people by 2027.
Zambia also secured its first shipment on Tuesday, while regulatory processes continue in several other countries. The United States expanded its planned distribution from 250,000 to 325,000 doses this year due to early demand, even as recent aid cuts under President Donald Trump have strained health programmes across the continent.
Eswatini, with a population of about 1.2 million and one of the world’s highest HIV incidence rates, expects around 6,000 high-risk individuals to benefit initially, particularly mothers at risk of transmitting HIV to newborns. The World Health Organization approved lenacapavir as an additional prevention option in July, with UNAIDS highlighting long-acting injectables as critical amid fears of declining foreign support. South Africa’s health minister described the drug as groundbreaking ahead of the nation’s own rollout scheduled for April 2026, though concerns persist over limited supply and Gilead’s refusal to license production to local manufacturers despite extensive regional participation in clinical trials.