Farai Mutsaka
Associated Press
November 18, 2025
Summary:
Eswatini became the first African country to receive lenacapavir, a twice-yearly HIV prevention injection developed by Gilead Sciences that has demonstrated near-total protection in clinical studies.
The rollout is part of the U.S. President's Emergency Plan for AIDS Relief (PEPFAR) in partnership with the Global Fund, initially targeting 10 high-risk African countries with plans to benefit at least 2 million people by 2027.Zambia also received its first shipment on the same day, while Gilead seeks regulatory approval in Botswana, Kenya, Malawi, Namibia, Rwanda, Tanzania, Uganda and Zimbabwe. The U.S. originally planned to distribute 250,000 doses this year but increased this to 325,000 due to early demand.
In Eswatini, approximately 6,000 high-risk people will initially benefit, primarily to prevent HIV transmission from mothers to newborns. The country has over 200,000 people living with HIV among its 1.2 million population and has the world's highest HIV incidence rate.
Gilead reduced the drug's price from over $28,000 per person annually in the U.S. to approximately $40 for lower-income countries. The WHO approved lenacapavir in July 2025 as an additional HIV prevention option. Civil society groups in South Africa have criticized Gilead for excluding local manufacturers from voluntary licensing agreements despite the country's role in clinical trials.
Quotes:
"It's the first time in history that a new HIV medicine is reaching a country in sub-Saharan Africa in the same year as approval of the United States." - Daniel O'Day, chair and CEO of Gilead Sciences
"Eswatini is the country with the highest incidence of HIV in the world." - Daniel O'Day
"Groundbreaking." - South Africa's Health Minister Aaron Motsoaledi describing lenacapavir, while raising concerns over limited supplies
As an old Africa hand I had trouble locating Eswatini on the continental map. Finally I learned that the country of SWAZILAND had changed its name on 19 April 2018, during their 50th year independence celebrations. Eswatini is apparently its original, indigenous name, which means "Land of the Swazis"..
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