Schoolgirls in Amritsar posed with placards forming a red ribbon on December 1, 2025, to mark World AIDS Day. Meanwhile, South Africa, Eswatini, and Zambia have begun administering a groundbreaking new HIV-prevention injection in Africa, home to the world’s highest HIV burden.

The drug, lenacapavir, is taken twice a year and has been shown to reduce the risk of HIV transmission by more than 99.9 percent, functioning similarly to a powerful vaccine.

In South Africa, where one in five adults lives with HIV, the rollout is being overseen by a research unit at Wits University, as part of an initiative funded by Unitaid, the United Nations health agency.

“The first individuals have begun using lenacapavir for HIV prevention in South Africa … marking one of the first real-world uses of the six-monthly injectable in low- and middle-income countries,” Unitaid said, without specifying the number of initial recipients. A broader national rollout is expected next year.

Zambia and Eswatini received 1,000 doses last month under a U.S. program and launched the drug at World AIDS Day ceremonies on Monday. Manufacturer Gilead Sciences has agreed to provide lenacapavir at no profit to two million people in high HIV-burden countries over three years. Critics argue that this falls short of actual needs, and the current market price—$28,000 per person per year in the U.S.—remains out of reach for most.

Eastern and southern Africa account for roughly 52% of the 40.8 million people living with HIV worldwide, according to 2024 UNAIDS data.

Generic versions of lenacapavir are expected from 2027 at around $40 per year in more than 100 countries, through agreements by Unitaid and the Gates Foundation with Indian pharmaceutical companies.

While pre-exposure prophylaxis (PrEP) has been used for over a decade to prevent HIV, its daily pill requirement has limited its impact on reducing global infections, highlighting the potential of lenacapavir’s twice-yearly dosing.