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Lenacapavir’s Introduction in Zimbabwe

Lenacapavir’s Introduction in Zimbabwe - Photo: Flickr

April 16, 2026 - The Borgen Project

Zimbabwe’s Human Immunodeficiency Virus (HIV) epidemic has been among the most severe globally, shaped by decades of social, economic and structural pressures. At the turn of the 21st century, the country faced one of the highest HIV prevalence rates worldwide, with an estimated 1.3 million people living with the virus. The epidemic has strained families, eroded the workforce and pushed public health services to their limits. Although sustained national efforts and global partnerships have driven major progress, the Joint United Nations Program on HIV/AIDS (UNAIDS) Global AIDS Update 2022 warns that prevention gains are now faltering, with inequalities continuing to fuel new infections in high-burden countries.

Lenacapavir’s Introduction in Zimbabwe

In February 2026, Zimbabwe became one of the first countries in Africa to introduce Lenacapavir, a long-acting injectable HIV-prevention drug developed by Gilead Sciences. Administered only twice a year, Lenacapavir’s introduction in Zimbabwe marks a major milestone in the region’s response to HIV. The rollout positions Zimbabwe at the forefront of next-generation prevention strategies, offering a discreet and highly effective alternative to daily oral pre-exposure prophylaxis (PrEP).

Health officials and global health bodies have welcomed the introduction. Zimbabwe’s Health Minister Douglas Mombeshora described Lenacapavir as a new approach, noting that it offers a less complicated method compared with daily oral PrEP.

While daily oral PrEP has been available for years, its impact has been limited by stigma, partner suspicion, unpredictable schedules and social scrutiny. A survey conducted by The Lancet found that 51% of participants held discriminatory attitudes toward HIV and reported shame of association.

A discreet biannual injection removes many of these barriers. As one early recipient explained, clients often misinterpreted PrEP pills as HIV treatment, leading to stigma and lost income, a challenge that the injection avoids.

Constance Mukoloka, one of the first recipients, said the injection makes her “feel safe” and able to “work with confidence,” explaining that daily PrEP pills often created tension with clients and were difficult to take consistently.

A Tool for High-Risk Groups

Lenacapavir’s introduction in Zimbabwe is significant for vulnerable communities, particularly adolescent girls, young women, sex workers and other high-risk groups who face disproportionate vulnerability to new infections. Its introduction signals a shift in HIV prevention strategy, particularly in regions where incidence remains high despite decades of progress. Early evidence from large-scale trials shows that more than 99% of participants remained HIV negative while on the twice-yearly regimen, underscoring its potential to overcome adherence challenges that have previously undermined daily oral PrEP uptake.

Although national HIV prevalence has declined significantly over the past two decades, women and girls continue to bear a disproportionate share of new infections, driven by structural inequalities, gender-based violence and economic precarity.

The rollout has also sparked public debate, as some community voices celebrate the new treatment while others raise concerns about access, affordability and the need for transparent communication to build trust in long-acting biomedical prevention. As global partners such as the U.S. government and the Global Fund frame this as a landmark in innovation and health system strengthening, Zimbabwe may become a critical test case for how long-acting PrEP can be scaled equitably across Sub-Saharan Africa.

Early Evidence and Implementation

Early pilot programs indicate that Lenacapavir’s introduction in Zimbabwe has seen strong uptake, with clinics reporting that the simplified regimen is easier to manage, reduces drop-off rates and integrates smoothly into existing reproductive health services. These findings mirror broader regional trends, as early adopters across Africa have seen strong interest in Lenacapavir even before full national rollout. Public health experts argue that the injection could significantly reduce new infections if scaled nationally, especially in rural areas where clinic visits are infrequent and transport costs are high. Several states are already exploring similar pathways.

Looking Ahead

Zimbabwe’s decision to move early on long-acting PrEP signals a broader shift in global health leadership. Rather than waiting for donor-driven adoption cycles, the country is asserting itself as a regional pioneer in HIV-prevention innovation. The rollout is supported by partnerships including the President’s Emergency Plan for AIDS Relief (PEPFAR) and the Global Fund, but Zimbabwe’s strong HIV-response infrastructure, having already met the UNAIDS 95-95-95 targets, has enabled rapid integration of the new technology.

In a region where HIV remains a leading cause of mortality, the introduction of a discreet, effective and user-friendly prevention tool represents a meaningful step forward. It offers new autonomy to individuals who face stigma or safety risks when using visible prevention methods, strengthens health system efficiency and demonstrates African leadership in adopting public health technologies.

– Max Kenway

Max is based in London, UK and focuses on Technology and Politics for The Borgen Project.

Photo: Flickr


Contact:

Lynsey Alexander
Chief of Staff
openings@borgenproject.org
The Borgen Project

Source: https://borgenproject.org/lenacapavirs-introduction-in-zimbabw/

"Reproduced with permission - The Borgen Project"

The Borgen Project
borgenproject.org


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