By Mbongeni Ndlela
MBABANE – A major global breakthrough in the fight against HIV has brought renewed hope for Eswatini, as the United States Food and Drug Administration (FDA) has approved Lenacapavir, a revolutionary injection for HIV prevention that only needs to be administered twice a year.
The drug, developed by Gilead Sciences, is the first of its kind, a long-acting injectable for pre-exposure prophylaxis (PrEP). Unlike current PrEP pills that must be taken daily, Lenacapavir offers sustained protection with just two injections annually, reducing the burden of adherence and eliminating the stigma often associated with taking HIV prevention pills.
The World Health Organization (WHO) has welcomed the approval, and announced that official guidelines for the rollout of Lenacapavir will be released during the International AIDS Conference in Kigali, Rwanda, next month.
Hope for Eswatini
Eswatini, which has made remarkable progress in the fight against HIV/AIDS, stands to benefit immensely from the introduction of Lenacapavir.
The Kingdom is one of only two countries in the world to achieve the UNAIDS 95-95-95 targets by 2020. This means that:
• 95% of people living with HIV know their status,
• 95% of those diagnosed are on treatment, and
• 95% of those on treatment have achieved viral suppression.
These results are a testament to the strong leadership, community partnerships, and well-coordinated national strategies led by the Ministry of Health, NERCHA, and supported by development partners such as PEPFAR and the Global Fund.
Currently, about 220 000 Emaswati are living with HIV, with adult prevalence at approximately 25.9%. However, thanks to sustained interventions and innovative programs, viral load suppression among adults is now estimated at over 88%.
A Tool to Overcome Challenges
The Ministry of Health has welcomed innovations that make HIV prevention more accessible and less intrusive. The “Test and Start” strategy, introduced in 2016, ensured that all people diagnosed with HIV are immediately started on treatment, regardless of CD4 count.
Other game-changing interventions include:
• Community-led HIV testing campaigns,
• Integrated TB-HIV services,
• Support for vulnerable populations through organisations like Young Heroes, and
• Targeted prevention among key populations including young people, sex workers, and truck drivers.
In this context, the arrival of Lenacapavir could further reduce new infections by providing a more private, convenient and stigma-free prevention method, especially for young women and men at higher risk who may shy away from daily pills.
Ready for Rollout
With Gilead committing to making the drug available to over 120 low- and middle-income countries, and with WHO guidelines on the horizon, Eswatini is well-positioned to become an early adopter.
The Kingdom’s robust HIV program, coupled with high levels of treatment adherence and community trust, provides a strong platform for introducing new innovations like Lenacapavir.
As Eswatini continues its journey toward ending HIV as a public health threat by 2030, this new tool brings the goal even closer within reach.
“We celebrate this global medical milestone. Eswatini is ready and able to ensure no one is left behind in accessing this life-saving innovation,” said a health ministry official.
WHAT IS LENACAPAVIR?
• Brand Name: Yeztugo
• Developer: Gilead Sciences
• Dosage: Two injections per year
• Purpose: HIV prevention (Pre-Exposure Prophylaxis – PrEP)
• Benefit: Reduces the need for daily pills; discreet and long-lasting
