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By Narratives Hub
In a historic move to combat the HIV epidemic in Africa, the United States has delivered the first doses of Lenacapavir, a groundbreaking twice-yearly injectable HIV prevention drug, to five high-burden African nations — Eswatini, Zambia, Botswana, Kenya, and Malawi. The delivery comes under the America First Global Health Strategy, reflecting a new approach to global health partnerships focused on sustainability and targeted interventions.
US Government Highlights New Health Strategy
Speaking at a press briefing on Tuesday with journalists from across Africa, Brad Smith, Senior Advisor, Bureau of Global Health Security and Diplomacy, emphasized the shift in America’s global health policy. He explained that the strategy aims to strengthen African health systems, promote self-reliance, and create market-driven partnerships while continuing to position the US as a global health leader.
“This initiative represents the best of our partnership with Africa,” Smith said, noting that the rollout of Lenacapavir demonstrates what can be achieved when the US Government, industry, and global institutions work together toward a shared goal.
Lenacapavir: A Game-Changing Innovation
Daniel O’Day, Chairman and CEO of Gilead Sciences, described Lenacapavir as a “historic milestone” in HIV prevention. Tested in both Sub-Saharan Africa and globally, the drug is highly effective, safe, and non-addictive, requiring only two doses per year.
“This is the first time a new HIV medicine is reaching a country in Sub-Saharan Africa in the same year as approval in the United States,” O’Day said. “It sets a new bar for global access and demonstrates the power of speed, partnership, and innovation in the fight against HIV.”
The drug is especially aimed at protecting women of reproductive age, pregnant women, and breastfeeding mothers, groups highly vulnerable to new HIV infections.
Collaborative Efforts with the Global Fund
Peter Sands, Executive Director of the Global Fund to Fight AIDS, Tuberculosis, and Malaria, hailed the partnership with the US Government and Gilead Sciences. He noted that distribution is coordinated with each country’s health system to ensure doses reach those most at risk.
“Lenacapavir is a game-changer,” Sands said. “When deployed at scale and speed, it can significantly reduce new infections and help countries transition to self-reliant, nationally financed health systems.”
Sands highlighted that the Global Fund has procured the first tranche of doses under a global access agreement with Gilead, ensuring that high-burden countries receive priority allocation.
Addressing Key Questions
During the briefing, journalists raised concerns about the safety, long-term effects, and allocation of doses.
Daniel O’Day assured that Lenacapavir had undergone extensive clinical trials and was well tolerated. He emphasized the need for patients to adhere to the six-month dosing schedule for full protection.
Brad Smith and Becky Bunnell, Principal Deputy Assistant Secretary, Bureau of Global Health Security and Diplomacy, elaborated on the distribution strategy, explaining that countries are prioritized based on HIV prevalence and that within each country, the highest-risk populations are targeted. They noted that lessons from Eswatini’s rollout would inform other nations’ implementation plans.
Peter Sands added that epidemiology drives allocation, ensuring the maximum impact of the drug, and that the Global Fund and US Government are coordinating closely with national health systems to optimize reach.
Looking Ahead
The initial delivery in Eswatini targets over 6,000 high-risk individuals, with plans to scale up to 2 million doses by mid-2027 across multiple African nations. The initiative represents a major step toward ending new HIV infections, linking prevention, testing, and treatment in a coordinated effort.
“This is a historic moment in the fight against HIV,” Smith said. “By combining innovation, targeted distribution, and strategic partnerships, we are accelerating progress toward a future where HIV is no longer a public health threat in Africa.”
