In December 2025, Unitaid approved an additional US$31 million to support two new projects designed with countries to expand access to lenacapavir, a twice-yearly injectable for HIV prevention. This new investment builds on Unitaid’s earlier US$22 million commitment announced in November 2024 to accelerate access to this innovative prevention option. Together, these projects complement efforts in South Africa and Zambia to roll out lenacapavir over the next three years and reinforce Unitaid’s broader work to ensure that new HIV prevention tools reach people who need them as quickly and equitably as possible.
Lenacapavir is a breakthrough in HIV prevention. Given as an injection every six months, it was shown in clinical trials to be safe and nearly 100% effective, offering strong protection for women and girls in particular. Developed by Gilead Sciences, it reduces the need for daily pills. To support affordable access, Unitaid, Wits RHI and the Clinton Health Access Initiative (CHAI) announced in September 2025 an agreement with Dr. Reddy’s Laboratories to make a quality-assured generic version available at a ceiling price of US$40 per person per year by 2027.
“We are proud to be working with early adopter countries such as South Africa and Zambia to help accelerate access to lenacapavir,” said Dr. Philippe Duneton, Executive Director of Unitaid. “By working closely with governments, civil society and academic partners, these grants will help build demand and ensure that women and others at risk of HIV can access this important prevention option as quickly as possible. Lenacapavir is a true innovation that has the potential to change the course of the HIV epidemic.”
Lenacapavir offers a major opportunity to reduce new HIV infections by broadening HIV prevention options so more people can find a method that suits their needs and preferences. Early adopter countries, supported by the Global Fund and PEPFAR, are moving quickly toward national rollout, which will primarily be delivered through public health facilities. While this is critical, many people at high risk of HIV may still struggle to access facility-based services due to barriers such as stigma, long distances, limited clinic hours or concerns about privacy.
To address these challenges, Unitaid will support complementary rollout through decentralized and community-based approaches. Designed in close collaboration with South Africa and Zambia, this new investment aims to strengthen their national plans by supporting and documenting innovative ways to generate demand and deliver lenacapavir in settings closer to people’s everyday lives, with support from communities. By generating real-world evidence on what works, at what cost and with what impact, these new projects will help guide strategies to reach at-risk populations across the region.
In South Africa, the Africa Health Research Institute, working with a consortium of local research, service delivery and community partners, will focus on innovative delivery and demand generation approaches to reach adolescent girls and young women, as well as key populations such as sex workers, men who have sex with men and transgender women. Lenacapavir will be offered through a mix of settings in KwaZulu-Natal and Gauteng including pharmacies, mobile clinics, hair salons and safe spaces for key populations. Community partners will play a central role in peer-led prevention literacy, stigma reduction and demand creation. The project will leverage longstanding health and demographic data systems to measure the impact of these approaches on HIV incidence at the population level, providing valuable real-world evidence.
In Zambia, the University Teaching Hospital/Ministry of Health, in collaboration with national and international organizations and community partners, will build on Zambia’s plans for rollout in public health facilities. The project will implement a hub-and-spoke model in 10 high-burden districts, linking facilities with decentralized delivery such as pharmacies, community health posts and community health workers. This approach will generate essential evidence on how some services – traditionally provided only by clinical staff – can be delivered safely and effectively by trained community health workers, helping health systems reach more people with existing resources. By bringing services closer to where people live and work, the project aims to reach people who may not otherwise access prevention services, including adolescent girls and young women, pregnant and breastfeeding women, sex workers, men who have sex with men and people who use drugs.
By working alongside governments and communities and sharing lessons in real time, these investments will help shape how lenacapavir is delivered in South Africa, Zambia and beyond, supporting more effective, people-centered HIV prevention at scale. Together, these projects strengthen Unitaid’s existing lenacapavir portfolio, which is actively supporting accelerated access to affordable generic supply and early country adoption.
Kyle Wilkinson
Communications officer
+41 79 445 17 45
[email protected]