Zambia’s fight against HIV has reached a milestone with the rollout of Lenacapavir, a long-acting injectable pre-exposure prophylaxis (PrEP) for HIV prevention.
The approval of Lenacapavir is part of a broader effort to increase access to HIV prevention and treatment in sub-Saharan Africa, particularly among adolescent girls and young women who are disproportionately affected.
Lenacapavir will be provided free of charge to all eligible Zambians, with warnings that no one should pay to access the drug.
The drug has also been approved in other countries, including South Africa, Eswatini, and Zimbabwe, with more countries expected to follow.
Administered once every six months, Lenacapavir offers protection against HIV infection for the same duration.
According to Dr. Elijah Muchima, former Minister of Health, the registration of Lenacapavir makes Zambia the second country in Africa, after South Africa, to approve the drug.
“The Lenacapavir injection brings renewed hope to young people and vulnerable populations,” Dr. Muchima said.
He attributed this achievement to the visionary leadership of President Hakainde Hichilema, whose government continues to champion investments in health innovations and public health advancements.
Zambia currently has around 1.3 million people living with HIV, and Dr. Muchima noted that Lenacapavir gives hope to those who could not access two-monthly injectable ARVs for HIV prevention.
“It gives hope to the mothers who are pregnant and those breastfeeding and who contract HIV and transmit it to their babies,” he said.
“It gives hope to those who want to access HIV prevention in privacy.”
However, Dr. Wiza Tembo, a Medical Doctor, noted that the national rollout of Lenacapavir has been phased and somewhat slow.
“The Government, through Zambia Medicines Regulatory Authority (ZAMRA), agreed to begin using the drug in Zambia, but actual procurement of thousands of Lenacapavir drugs has not yet been done, and only a few people are receiving Lenacapavir in Lusaka,” he explained.
Eligibility focuses on individuals at substantial risk of acquiring HIV, particularly key populations such as homosexuals, transgender individuals, sex workers, and other groups facing higher HIV rates.
Before starting each injection, World Health Organization (WHO) guidelines recommend confirming HIV-negative status using rapid diagnostic tests (RDTs).
The main benefits of Lenacapavir for patients include its high effectiveness, convenient dosing, and improved privacy, which helps decrease stigma associated with visible daily medication.
“These factors make it particularly appealing for those who struggle with adherence to oral regimens and reduce the burden of daily pills,” Dr. Tembo said.
But is it all smooth sailing?
Dr. Tembo noted that some challenges have been observed, with clients reporting side effects such as body aches, fever, and pain at the injection site.
While Lenacapavir is specifically designed for HIV prevention and has shown no direct protective effect against other sexually transmitted infections, its success in reducing HIV infections could indirectly influence broader sexual health trends.
“Encouraging frequent HIV testing and clinic visits every six months may increase opportunities for STI screening and counseling, potentially helping curb rising cases of other STDs if integrated with comprehensive sexual health services,” Dr. Tembo explained.
Lenacapavir is a powerful tool in HIV prevention, but can it protect you from everything?
Dr. Tembo emphasized that Lenacapavir does not replace the need for condoms or other barrier methods for STI prevention.