HARARE — In a significant shift for public health policy, Zimbabwe is poised to become one of the first countries to implement a strategic, data-driven rollout of next-generation injectable HIV prevention drugs. This approach, outlined by National AIDS Council Operations Director Raymond Yekeye, marks a new chapter in the nation’s celebrated fight against the HIV/AIDS epidemic.
During a recent address, Mr. Yekeye confirmed that new long-acting injectable drugs, including the highly-anticipated twice-yearly lenacapavir, are on their way. However, he emphasized that a universal rollout at a public health scale is not immediately feasible due to the substantial cost.
- The drug will be rolled out: He confirms that Zimbabwe is planning to introduce the injectable drug.
- Prioritization is necessary: He explains that due to the high cost of the drug, it is not possible to roll it out at a public health scale to everyone who requires it.
- Data will guide the rollout: The priority populations for the drug will be determined by data, specifically looking at where the highest number of new HIV infections are occurring.
“We are not able to roll it out at a public health scale where we give everyone who requires it,” Mr. Yekeye stated. He explained that the rollout will be guided by data, prioritizing populations in areas with the highest rates of new HIV infections. This targeted approach is designed to ensure that these powerful new tools are deployed where they can have the most impact, maximizing the return on investment and accelerating the country’s progress toward global health goals.
The country’s prevention arsenal is expanding rapidly. The new strategy builds on the recent approval and introduction of other long-acting methods: the bi-monthly injectable cabotegravir (CAB-LA) and the monthly dapivirine vaginal ring. These options represent a paradigm shift away from daily oral pills, offering discreet, highly effective alternatives that can significantly improve adherence and empower individuals in their prevention choices.
Zimbabwe’s leadership in this area is a continuation of its long history of proactive HIV/AIDS policy. Supported by international partners, including the Global Fund, the nation has steadily advanced its treatment protocols over the past two decades. From the initial introduction of single-drug therapies in the early 2000s to the widespread adoption of modern, highly effective drug combinations, Zimbabwe has consistently moved to the forefront of medical advancements. The strategic rollout of Lenacapavir, expected in late 2025 or 2026, solidifies this position and places the country among a select group of nations paving the way for the future of HIV prevention.
Lenacapavir, a twice-yearly injectable pre-exposure prophylaxis (PrEP) for HIV prevention, is being prioritized for introduction in South Africa. The country is among the first to introduce LEN into its public health system, with plans to start by the end of 2025. This is a significant development as lenacapavir offers a highly effective, long-acting alternative to daily oral PrEP pills, potentially overcoming adherence challenges. Several other countries, primarily in sub-Saharan Africa, have been prioritized for the introduction of LEN as a twice-yearly injectable PrEP.
This effort is a key part of a strategic partnership between Gilead Sciences and the Global Fund to accelerate access to the drug in low- and middle-income countries with a high burden of HIV. The goal is to provide LEN to up to two million people in these regions. The selection of these countries is based on factors such as their HIV epidemiology, existing prevention strategies, and available resources.
