New HIV infections in low- and middle-income countries (LMICs) could soon decline significantly following a landmark agreement to expand access to prevention tools.

An agreement between the Global Fund to Fight Aids, Tuberculosis and Malaria and Gilead Sciences will see Lenacapavir, a long-acting injectable for HIV prevention supplied to LMICs for the first time at the same time as in high-income countries.

The agreement follows the US Food and Drug Administration’s approval of Lenacapavir for HIV prevention in June this year and represents one of the most significant advances in HIV prevention in decades. “This is a pivotal moment not just for the fight against Aids, but for the fundamental principle that lifesaving innovations must reach those who need them most. Our ambition is to reach two million people with long-acting PrEP,” said Peter Sands, executive director of the Global Fund.

As the first twice-yearly, long-acting injectable for pre-exposure prophylaxis (PrEP), Lenacapavir expands the HIV prevention choice basket offering a powerful new option for people who experience stigma, adherence challenges with existing PrEP tools, or other barriers in their daily lives.

Available resources

Sands revealed that under this agreement, countries supported by the Global Fund can access Lenacapavir for PrEP. Early access will be prioritised based on HIV epidemiology, national prevention strategies, and available resources. Countries particularly those with high HIV incidence, mostly in sub-Saharan Africa have expressed strong interest in introducing Lenacapavir for PrEP early and at scale.

Kenya is one of the countries that already expressed strong interest in adopting Lenacapavir.

In fact, the first national meeting to discuss its introduction is taking place today. According to HIV advocates, this product could be a game changer because it will help address challenges like poor adherence to daily oral PrEP, offering people an easier, longer-lasting option to protect themselves and reduce the spread of HIV.

Speaking during a meeting organised by Media for Environment, Science, Health, and Agriculture(MESHA), Patricia Jeckonia from LVCT Health said that unlike oral PrEP, which many people stop taking over time, the injectable cannot be removed once administered, ensuring continuous protection. “With just two injections a year, they don’t have to worry about hiding pills or remembering them every day they stay protected for months at a time without the daily burden,” Jeckonia added.

According to Sands, Global Fund’s ambition is to have the first shipment and delivery of the products reaching at least one African country by the end of 2025, to mark the beginning of a transformational shift in how HIV prevention is delivered to communities with the highest burden of new infections.