Africa Rolls Out a Twice-Yearly Jab That Could Change the HIV Fight

A quiet revolution in HIV prevention is taking hold across Africa, as country after country begins rolling out lenacapavir — a long-acting injection, given just twice a year, that has proven almost 100 percent effective at stopping new infections.

South Africa, home to one of the world's largest HIV epidemics, has become the ninth African nation to launch the drug, and early uptake has been striking. In Gauteng province, health authorities surpassed their target, starting more than 6,000 people on the injection in a single month — well above the goal they had set. For a country that has long borne a staggering HIV burden, the enthusiasm is telling.

Lenacapavir is not a vaccine but a preventive medicine, and its appeal lies in its simplicity. Instead of a daily pill that many struggle to take consistently, users need only two injections a year, removing one of the biggest obstacles to effective prevention. Experts say it is rolling out across Africa faster than any HIV-prevention tool before it.

The momentum extends well beyond South Africa. Rollouts are under way in Kenya, Zimbabwe, Eswatini and Zambia, backed by partnerships involving Unitaid and research institutions, as part of a coordinated push to get the drug to those most at risk. A generic version is expected to arrive in 2027 at a cost of around $40 per person per year — a price that could put it within reach of stretched public-health systems.

After decades in which HIV has cut through African communities, a tool this effective and this easy to use carries the promise of bending the epidemic's curve. The challenge now is scale: turning a breakthrough medicine and encouraging early numbers into a continent-wide shift in the fight against a disease that has defined a generation.