High demand drives second phase of Lenacapavir roll out

Rumbidzayi Zinyuke

Senior Health Reporter

ZIMBABWE is set to roll out the second phase of its Lenacapavir programme in the third quarter of this year as health authorities move to expand access to the long-acting HIV prevention drug following strong early uptake and demand.

The expansion comes after an initial phase launched in February this year, which saw about 46 000 people receiving the twice-yearly injectable at 11 sites in high HIV incidence districts.

In an interview, Health and Child Care Secretary Dr Aspect Maunganidze said the next phase would be guided by data and lessons drawn from the pilot rollout.

“The next phase of rollout is planned in line with increased supply and will target additional districts and facilities based on HIV burden, equity considerations and potential public health impact. This expansion will build on lessons from the initial phase to ensure a more efficient and sustainable scale-up,” he said.

Lenacapavir, developed by Gilead Sciences in partnership with the Global Fund, is the world’s first twice-yearly HIV prevention drug and is expected to significantly transform the country’s pre-exposure prophylaxis (PrEP) landscape.

Zimbabwe was selected in August 2025 as one of 10 countries to introduce the drug under a global early access programme and has since moved quickly to operationalise its rollout following regulatory approval.

The country became one of the first in Africa to approve and deploy the drug through the Medicines Control Authority of Zimbabwe.

Dr Maunganidze said the phased approach adopted in the initial rollout ensured a smooth introduction, with sites selected based on epidemiological need and readiness.

“The rollout is being implemented in a phased manner, starting with 11 priority sites in high HIV incidence districts, which were selected based on epidemiological need and service readiness. Extensive preparatory work, including staff training, facility readiness and community engagement, has supported a smooth and effective introduction,” he added.

He added that the drug has now been integrated into Zimbabwe’s broader HIV prevention framework.

Zimbabwe currently offers oral PrEP, as well as the three-monthly injectable Cabotegravir (CAB-LA), alongside other prevention measures such as condoms, voluntary medical male circumcision and behavioural interventions.

“Lenacapavir is now fully integrated into our pre-exposure prophylaxis programme, expanding prevention options and strengthening client choice. This ensures that clients can access a wider range of prevention methods tailored to their needs,” said Dr Maunganidze.

Early demand for the drug has been strong, with many first-time users accessing HIV prevention services through the programme.

Dr Maunganidze said this trend indicates that Lenacapavir is helping to reach populations that had previously not engaged with prevention services.

“Most clients so far are women, but uptake among men is also notable, which is encouraging for a balanced prevention response. Although long-term adherence data is still limited, the long-acting nature of Lenacapavir is expected to improve adherence compared to daily regimens,” he said.

However, the strong uptake has also exposed supply constraints, necessitating a phased expansion approach.

“We have experienced high demand relative to the initial limited supply, which is why the rollout is being carefully managed in phases. Additional supplies are already in the pipeline, and we are aligning availability with demand to ensure continuity of care,” he said.

Authorities say the rollout strategy is anchored on equity, with priority being given to populations at highest risk of HIV infection, including adolescent girls and young women, key populations, pregnant and breastfeeding women, and sero-discordant couples. “Initial sites were deliberately located in high-incidence districts to ensure we reach those most at risk,” Dr Maunganidze said.

Community engagement has also been central to the programme’s early success.

“Working with local leaders and community-based organisations has been critical in raising awareness and building trust around this new prevention option. These efforts are helping to ensure that communities understand and accept Lenacapavir,” he added.

To expand access, particularly in rural and underserved areas, the Ministry is leveraging existing primary healthcare platforms and differentiated service delivery models.

“As we expand to additional sites, access will continue to improve and gaps will be reduced,” he said.

Meanwhile, efforts are underway to strengthen logistics and supply chain systems ahead of the next phase.

“The rollout has been carefully planned, with the initial limited supply supporting a controlled introduction, while additional supplies are being secured. We are strengthening forecasting, closely monitoring stock levels and integrating Lenacapavir into national supply systems to ensure continuity of care,” he said.