Twice-yearly injectable HIV prevention reaches about 100,000 people across nine African countries

Lenacapavir, the twice-yearly injectable used for HIV pre-exposure prophylaxis, had reached roughly 100,000 people across nine high-burden African countries by mid-August 2026, up from 20,000 at the end of May. The figures were published on 16 September 2026 by the Global Fund to Fight AIDS, Tuberculosis and Malaria, which presents the rollout as the fastest introduction of a new HIV prevention tool in low-income settings on record. Uptake is nonetheless running far behind the 2026 target of more than one million people.

Lenacapavir is a long-acting HIV capsid inhibitor given by subcutaneous injection every six months. Gilead Sciences supplies it to these programmes at no profit. Delivery is run as a partnership of the US Department of State, the Global Fund and Gilead, with a target of at least 3 million people by the end of 2028 and 24 countries expected to have received lenacapavir by the end of 2026.

The nine first-wave countries are Eswatini, Kenya, Lesotho, Mozambique, Nigeria, South Africa, Uganda, Zambia and Zimbabwe. The Global Fund reported 20,000 people reached by the end of May 2026, 49,000 by the end of June and nearly 100,000 by mid-August.

The specialist HIV bulletin aidsmap reported on 29 July 2026, in an analysis by Krishen Samuel, that 191,620 doses had been delivered across the nine countries, roughly 14 per cent of the 2026 plan of more than one million. On that account nearly 66,000 people had been newly started across 900 sites and more than 10,000 healthcare providers had been trained.

Reporting from the same period gave country-level detail. Eswatini had 32 delivery sites, with roughly 1,000 adolescent girls and young women and around 700 pregnant and breastfeeding women initiated. Mozambique had about 10,000 initiations across 55 facilities in three provinces since an April launch. Kenya had over 4,000 initiations among key populations. Malawi started 303 clients between May and mid-July, 60 per cent of them new to pre-exposure prophylaxis and more than half of them women. South Africa is projected to give the most injections in 2026, at 345,000.

The binding constraint is supply rather than demand. Eswatini reserved 10,000 doses for returning clients, which made those doses unavailable for new initiations.

Professor Ingrid Katz, Director of the Yale Institute of Global Health and Chief of Evidence and Programme Innovation at the US Department of State, said: "Our goal is not just to launch LEN. It's to get countries to use it strategically." Other named national programme leads include Sindy Matse, Director of the Eswatini National AIDS Program; Dr Barbara Mambo, Head of HIV Prevention at Kenya's National AIDS and STI Control Programme; Aleny Cuoto, Director of the STI/HIV/AIDS Control Programme at Mozambique's Ministry of Health; and Feliya Nyirenda of Malawi's Ministry of Health.

The efficacy grounding for the rollout was updated in July. Open-label extensions of the two pivotal trials were reported at AIDS 2026 in Rio de Janeiro, held from 26 to 31 July 2026. PURPOSE 1, in cisgender women in Uganda and South Africa, reported no new HIV infections across 4,493 person-years of follow-up, with 96 per cent injection adherence, in abstract OAC2802. PURPOSE 2, in cisgender men and in transgender and non-binary people across Argentina, Brazil, Mexico, Peru, South Africa, Thailand and the United States, reported one transmission across 2,452 person-years, in abstract OAC2806LB.

The Global Fund's modelling holds that at scale lenacapavir "could prevent nearly one-third of new HIV infections across parts of Eastern and Southern Africa" and could bring forward the end of the epidemic by up to 14 years in some countries. Its 2026 Results Report, released the same day, sets that against a contraction elsewhere: pre-exposure prophylaxis coverage across the countries the Fund supports fell from 1.4 million people in 2024 to 1.1 million in 2025 as funding was cut, even as lenacapavir was introduced. The same report records 26.9 million people on antiretroviral therapy in 2025 and 72 million lives saved since 2002.

Generic lenacapavir is expected to enter the market from late 2026 into 2027 at around USD 40 per person per year. That is the point at which supply could stop being the constraint.