Zimbabwe Rolls Out Twice-Yearly HIV Prevention Shot in Groundbreaking Initiative
In a major advancement in the global fight against HIV/AIDS, Zimbabwe has been selected as one of ten nations worldwide to introduce lenacapavir, a revolutionary twice-yearly injection that represents the first long-acting HIV prevention medication requiring only two doses annually. The groundbreaking prophylactic drug, hailed by global health experts as potentially transformative in HIV prevention, offers nearly 100% protection against infection and could significantly alter the landscape of AIDS prevention in a country grappling with one of the world’s highest HIV prevalence rates.
The announcement, made by the US Embassy in Harare, positions Zimbabwe at the forefront of HIV prevention technology and underscores the country’s progress in building robust healthcare infrastructure capable of implementing advanced medical interventions. With approximately 1.3 million people living with HIV in Zimbabwe according to UNAIDS figures, the introduction of lenacapavir offers new hope in the nation’s ongoing battle against the epidemic that has affected countless families and communities for decades.
A Revolutionary Approach to HIV Prevention
Lenacapavir represents a paradigm shift in HIV prevention strategies, moving from daily pill regimens to biannual injections that dramatically reduce the adherence challenges that have long complicated pre-exposure prophylaxis (PrEP) programs. The drug’s exceptional efficacy rates, demonstrated in clinical trials showing more than 99% effectiveness in preventing HIV infections, have generated unprecedented excitement among global health organizations and public health experts monitoring the HIV/AIDS landscape.
“While an HIV vaccine remains elusive, lenacapavir is the next best thing: a long-acting antiretroviral shown in trials to prevent almost all HIV infections among those at risk,” said Dr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, emphasizing the drug’s transformative potential in global HIV prevention efforts.
The selection of Zimbabwe for the initial rollout recognizes the country’s significant progress in developing what public health expert Ponesai Nyika describes as a “very solid HIV response infrastructure.” According to detailed reporting from AllAfrica, Zimbabwe’s established healthcare partnerships with organizations like PEPFAR (the US President’s Emergency Plan for AIDS Relief) and local institutions created an ideal foundation for introducing this advanced medical intervention. Nyika noted that these existing systems “create a solid foundation for the introduction of lenacapavir,” ensuring the drug reaches those most vulnerable to infection.
The Zimbabwean rollout will specifically target populations with heightened HIV susceptibility, including adolescent girls and pregnant or breastfeeding women—groups that have historically faced disproportionate infection risks due to biological, social, and economic factors. This targeted approach reflects the growing sophistication of HIV prevention strategies that recognize the need to address the epidemic through both medical and social lenses.
Global Enthusiasm and Local Realities
International health organizations have greeted the development of lenacapavir with unprecedented enthusiasm, with UNAIDS officials describing the medication in remarkably optimistic terms. The organization’s deputy director, Angeli Achrekar, characterized the drug as representing a potential watershed moment in the decades-long global response to HIV/AIDS, highlighting both its exceptional efficacy and its position as the most advanced prevention tool currently available.
“We are talking about it as a potential miracle drug,” Achrekar stated in an interview. “Right now, the fact that it is nearly 100% effective at stopping new infections is remarkable, it’s unprecedented. It’s the best thing we’ve got in the HIV response. We do not have a vaccine or cure, but this is extraordinary.”
The drug’s development pathway included two major clinical trials—one conducted in sub-Saharan Africa focusing on women and girls, and another in the United States involving gay and bisexual men and transgender women. The consistent demonstration of over 99% efficacy across these diverse populations has bolstered confidence in lenacapavir’s potential to significantly reduce the approximately 1.3 million new HIV infections occurring globally each year. This breakthrough comes at a critical time, as reported by various Zimbabwe news outlets covering the country’s ongoing health challenges.
Beyond its remarkable efficacy, lenacapavir’s twice-yearly administration schedule addresses one of the most persistent challenges in HIV prevention: medication adherence. Nyika explained that reducing the frequency of dosing “makes it even more effective as it reduces incidents of low adherence to HIV treatment,” potentially overcoming a significant barrier that has limited the impact of previous prevention methods requiring daily commitment.
Addressing Concerns and Ensuring Accessibility
Despite the widespread optimism surrounding lenacapavir, the rollout has prompted important questions about cost, safety, and equitable access—concerns that echo historical challenges in global health implementation. Some Zimbabweans have expressed skepticism about whether this advanced medical intervention will truly be accessible to those most in need, with cost emerging as a particularly significant barrier given the drug’s initial pricing structure.
The medication’s journey from conception to implementation highlights the complex economics of pharmaceutical development. Originally projected to cost approximately $28,000 per person annually, aggressive negotiations and partnerships with global health organizations have dramatically reduced the price to around $40 per year for prevention regimens in low and middle-income countries. However, even this reduced cost raises questions about sustainability and scalability in nations with constrained healthcare budgets.
“How is it going to help us? Because I’m sure it’s for the rich,” questioned one Ugandan citizen, reflecting concerns shared by many across the region about whether groundbreaking medical advances truly reach ordinary citizens in resource-limited settings.
Safety considerations represent another dimension of public concern, though health experts have sought to provide reassurance based on available data. Nyika acknowledged that, like any new medication, lenacapavir may produce side effects, but emphasized that “the data that we have does show that lenacapavir is very safe and well tolerated.” He stressed the importance of transparent communication about potential side effects to build public trust and facilitate successful adoption of the new prevention method.
The lenacapavir prevention regimen involves an initial oral component—two tablets taken on the day of the first injection and two additional tablets the following day—before transitioning to the twice-yearly injection schedule. This hybrid approach ensures immediate protection while establishing the long-acting preventive coverage that makes the intervention so revolutionary.
To address cost and accessibility challenges, experts point to multiple potential strategies, including continued negotiations by middle- and low-income countries, possible local or regional production of pharmaceutical components, and leveraging existing supply chains and community health systems. Nyika suggested that “leveraging the existing supply chain, community health system and different service delivery modules will help ensure equitable access,” emphasizing the importance of building on established infrastructure rather than creating parallel systems.
Partnerships with major global health initiatives like PEPFAR and the Global Fund are expected to play a crucial role in making lenacapavir accessible throughout Zimbabwe and other participating nations. These organizations’ established networks, funding mechanisms, and implementation experience position them to facilitate the complex process of introducing a novel medical intervention in diverse healthcare settings.
Zimbabwe joins nine other African nations in the initial lenacapavir rollout, including Kenya, Nigeria, Zambia, Uganda, Tanzania, South Africa, Eswatini, and Botswana, with full implementation targeted by January 2026. The ambitious plan envisions expanding access to approximately 120 low- and middle-income countries by 2027, potentially transforming HIV prevention on a global scale.
As Zimbabwe prepares to implement this groundbreaking prevention tool, the country stands at a pivotal moment in its long battle against HIV/AIDS. The successful integration of lenacapavir into existing healthcare frameworks could not only reduce new infections but also demonstrate how scientific innovation, when coupled with thoughtful implementation strategies, can address some of the world’s most persistent public health challenges.
