{"id":363068,"date":"2026-04-04T06:30:15","date_gmt":"2026-04-04T06:30:15","guid":{"rendered":"https:\/\/www.newsbeep.com\/nz\/363068\/"},"modified":"2026-04-04T06:30:15","modified_gmt":"2026-04-04T06:30:15","slug":"following-the-initial-trials-in-africa-of-the-groundbreaking-drug-that-could-put-an-end-to-aids-science","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/nz\/363068\/","title":{"rendered":"Following the initial trials in Africa of the groundbreaking drug that could put an end to AIDS | Science"},"content":{"rendered":"

Precious closes her eyes and clenches her fists as the syringe needle penetrates her right thigh, slowly injecting a greenish-yellow liquid. The same procedure is repeated in her left thigh. \u201cYou\u2019re protected for six months now!\u201d the nurse exclaims. On that sunny March morning, in a small health center in Lobamba, a rural area of \u200b\u200bEswatini, this 32-year-old sex worker has just become one of the first people in the world to receive lenacapavir<\/a>, a drug that, administered twice a year, offers nearly 100% protection against HIV.<\/p>\n

\u201cI\u2019m relieved. Several girls who work with me tested positive recently. I try to use condoms, but my clients don\u2019t like it. Besides, they pay more without a condom,\u201d explains Precious, who prefers to use a pseudonym in the interview.<\/p>\n

This small country, located between South Africa and Mozambique, where UNAIDS estimates that 26% of its inhabitants \u2014 some 220,000 people \u2014 are living with HIV, the highest prevalence rate in the world, is one of the nine African states pioneering the distribution of lenacapavir. This drug opens a new chapter in prevention and could eliminate the virus as a public health threat by 2030.<\/p>\n

\u201cEswatini, because of its small size and the progress it is already making in prevention, is a perfect place to start seeing results. And I think the world desperately needs a positive story related to HIV,\u201d says Mark Edington, director of grant management at the Global Fund, the multilateral organization in charge of distributing these first doses.<\/p>\n

Eswatini, because of its small size and the progress it is already making in prevention, is a perfect place to start seeing results. And I think the world desperately needs a positive story related to HIV<\/p>\n

Mark Edington, Global Fund<\/p>\n

Precious doesn\u2019t know it, but the commercial price of the injection she just received exceeds $11,600, an amount that must be doubled to calculate the annual cost per person. This woman embodies \u201chealth equity\u201d today, in the words of the Global Fund. Because it is the first time in the fight against AIDS that a new drug has reached the Global South at the same time as wealthier countries, and this is happening amid abrupt cuts in development aid<\/a> that threaten the significant progress made against HIV.<\/p>\n

A \u201csolution,\u201d especially for women<\/p>\n

\u201cLenacapavir is a tremendous opportunity and will be a game-changer. That\u2019s why the idea is that everyone who needs it in Eswatini can receive it,\u201d says Sindy Matse, program manager for the AIDS Action Plan in the country, which still widely known internationally by its former name, Swaziland.<\/p>\n

But for now, in this first phase of distribution, the drug\u2019s doses are limited. In 2025, the Global Fund and the United States President\u2019s Emergency Plan For AIDS Relief (PEPFAR) reached an agreement with the U.S. pharmaceutical company Gilead, the manufacturer of lenacapavir, to supply this pre-exposure prophylaxis (PrEP) to two million people in low- and middle-income countries until 2028. Generic versions are expected to arrive before then, in 2027, reducing the price to $40 per person per year. In total, nine countries, including Eswatini, Zambia, Kenya, Lesotho, and Zimbabwe, received these first doses of lenacapavir, and another 13 countries will be added to the list in the coming months.<\/p>\n

\"\"Precious, a sex worker from Eswatini, moments before receiving her first injection of lenacapavir, on March 17, 2026.The Global Fund\/Brian Otieno<\/p>\n

Currently, more than 40 million people worldwide are living with HIV<\/a>, 65% of them in Africa. Eighty-two percent of HIV-positive individuals on the continent are receiving treatment, compared to 45% a decade ago. \u201cThis injectable will be a turning point, a solution to the increase in positive cases among young people, especially girls,\u201d Eswatini\u2019s Minister of Health Mduduzi Matsebula told this newspaper. \u201cI believe that by 2028 everyone in my country who needs lenacapavir will be able to receive it. And, little by little, the resources we no longer have to spend on treatment will be used for prevention,\u201d he added.<\/p>\n

\u2014 Do you think this drug could mean the end of AIDS as a public health problem by 2030?<\/p>\n

\u2014 Yes, definitely.<\/p>\n

Counted doses<\/p>\n

Eswatini administered the first dose of lenacapavir on December 1, 2025, World AIDS Day, just months after its approval in the United States and Europe. To date, the country has received 4,200 units from the Global Fund, which will send another 1,800 in the coming weeks or months. Several thousand doses are also expected from the United States via PEPFAR, a program severely hampered by funding cuts<\/a>.<\/p>\n

\u201cI knew I wanted the vaccine,\u201d Precious repeats several times. Vaccine. That\u2019s what the people waiting, seated on the reddish earth or under the shade of the generous trees at this clinic in the town of Lobamba, call lenacapavir. It\u2019s one of 27 clinics administering the new drug in the country, where 59% of its 1.2 million inhabitants live in poverty. Most of the patients are young women who received information from healthcare workers or community educators.<\/p>\n

\u201cThey sent us 50 doses, then 100, then 30. And every day more people arrive who have heard about this almost miraculous drug,\u201d says Charles Mduli, the most senior nurse at this clinic, explaining that they had administered a total of 147 injections up to that day. \u201cIt\u2019s the perfect treatment. It\u2019s effective and completely discreet. Women come here who decide on their own to receive it and don\u2019t have to explain themselves to anyone,\u201d he adds.<\/p>\n

\"\"A healthcare worker records a dose of lenacapavir at a clinic in Eswatini, where several thousand doses of this HIV preventive medication began to be distributed in December.The Global Fund\/Brian Otieno<\/p>\n

Precious meets all the criteria to be considered at-risk, given her sex, age, and profession. She left her husband, the father of her two children, aged 13 and seven, two years ago after a beating that left her with a broken leg. \u201cHe almost killed me,\u201d she explains. Since then, she and her children have been living with her mother. \u201cI\u2019ve been prostituting myself for over a year. I haven\u2019t found a job, and I need to put food on the table, pay for school uniforms and supplies,\u201d she explains. To survive, she needs about 4,000 lilangenis a month (around $230), and the math is clear in her mind. \u201cA 15-minute encounter with a condom is 100 lilangenis, and without a condom, at least 150,\u201d she explains.<\/p>\n

It\u2019s the perfect treatment. It\u2019s effective and completely discreet. Women come here who decide on their own to receive it and don\u2019t have to explain themselves to anyone<\/p>\n

Charles Mduli, nurse in Eswatini<\/p>\n

Precious had occasionally taken PrEP in the form of daily pills. But she found it difficult to be consistent, as is the case for many people who use it, because it\u2019s a rather conspicuous method that draws questions or criticism from partners and family members, and because it requires more frequent visits to a health center.<\/p>\n

\u201cMost of the people who turn to lenacapavir in Eswatini and other countries had never taken any PrEP before. We are managing to attract people at risk, which is good news,\u201d says Carmen P\u00e9rez Casas, strategic manager for HIV and pandemics at Unitaid, the international initiative working to improve access to treatment in low-resource countries.<\/p>\n

\"\"Several women leave the clinic in Lobamba, a rural area of Eswatini, where services such as HIV prevention and treatment and family planning are provided, on March 17, 2026.The Global Fund\/Brian Otieno\"\"The waiting room at the Lobamba clinic, which sees about 100 patients a day, most of them for HIV prevention or treatment consultations.The Global Fund\/Brian Otieno\"\"The first dose of lenacapavir consists of two injections, which must be repeated six months later. The drug offers nearly 100% protection against HIV infection. Photo taken at a clinic in Eswatini on March 17, 2026.The Global Fund\/Brian Otieno<\/p>\n

Last September, Unitaid and the Gates Foundation<\/a> announced separate agreements with Indian laboratories to make the generic version of lenacapavir available in 120 low- and middle-income countries starting in 2027. \u201cBut right now we\u2019re running out of stock. Some centers have no doses left, others have enough for a few days. I hope the next shipment doesn\u2019t take too long,\u201d sighs Sindy Matse, from the national HIV program.<\/p>\n

A visit to the central warehouse where medications are stored in Eswatini reveals that the shelf reserved for lenacapavir has very few boxes and plenty of space. Matse explains that the authorities have reserved 500 doses \u201cjust in case\u201d for people who received the lenacapavir injection in December and are due for their second dose in May.<\/p>\n

The impact of cuts<\/p>\n

Authorities, health organizations, and experts agree that lenacapavir supplies will be limited in 2026, as Gilead, its sole manufacturer today, has already allocated all the doses it is capable of producing. P\u00e9rez Casas, from Unitaid, assures that the marketing of generic versions is progressing rapidly and they have already entered the World Health Organization\u2019s (WHO) prequalification system.<\/p>\n

\u201cOnly when generic drugs become available will we see a significant difference in infection rates. But if we don\u2019t see any change by the end of 2027 or in 2028, then we\u2019ll have to ask ourselves what\u2019s going on,\u201d says Edington of the Global Fund, the largest multilateral provider of funding for HIV\/AIDS, tuberculosis, and malaria.<\/p>\n

UNAIDS estimates that around two million people worldwide take some form of PrEP to protect themselves from HIV, the vast majority taking daily pills, but it estimates that to \u201cdrastically change the curve of new infections and move towards the end of AIDS by 2030\u201d it would be necessary to reach 20 million people considered at risk.<\/p>\n

\"\"People wait at the Lobamba Clinic in Eswatini to be seen by the nurse specializing in HIV treatment and prevention on March 17, 2026.Beatriz Lecumberri<\/p>\n

In the corridors of the clinics in Eswatini visited by EL PA\u00cdS, plaques commemorate the fact that these centers, dedicated to sexual health and prevention, received U.S. funding to open their doors. Sixty percent of Eswatini\u2019s HIV response was funded through PEPFAR, and the impact of the abrupt funding cuts decreed by Donald Trump has been keenly felt.<\/p>\n

The Minister of Health cites, for example, a reduced capacity for diagnostic testing, training of healthcare personnel, and maintenance of mobile units that traveled to remote areas to provide assistance to at-risk individuals who often do not visit health centers. \u201cBut the system has not collapsed, and the government is trying to address these shortfalls and expand its own capabilities so as not to always depend on external partners and donors,\u201d he asserts. In December 2025, the U.S. and Eswatini signed a five-year memorandum of understanding on health matters, under which Washington plans to allocate up to $205 million to modernize public health data systems and disease surveillance technology, and to facilitate access to antiretroviral drugs for HIV<\/a>.<\/p>\n

According to UNAIDS, the impact of U.S. funding cuts could lead to, in the worst-case scenario, 6.6 million additional infections and 4.2 million more HIV-related deaths by 2029. Regarding prevention, figures published by the Clinton Health Access Initiative (CHAI) indicate that in 2025 the number of people who should have started oral PrEP was reduced by 37% compared to 2024 due to the cuts.<\/p>\n

Men decide<\/p>\n

Everyone in Eswatini knows someone living with HIV or who has died from AIDS-related complications. It\u2019s a very real fear among young people in this country, which registers 4,000 new HIV cases annually, compared to more than 20,000 25 years ago.<\/p>\n

\u201cLenacapavir is a milestone. Many people still don\u2019t know this drug exists, and I think we need to be cautious until there is a greater supply,\u201d says Nkululeko Dube, representative in Eswatini for the U.S.-based AIDS Healthcare Foundation (AHF). \u201cBut we mustn\u2019t forget that lenacapavir protects against HIV\/AIDS, but not against syphilis or pregnancy. People shouldn\u2019t let their guard down,\u201d urges Dube, speaking from the foundation\u2019s LaMvelase clinic, the country\u2019s largest medical center for HIV prevention and treatment.<\/p>\n

The official still remembers the not-so-distant past when families in Eswatini had to sell their livestock and homes and were plunged into poverty in a futile attempt to save a son or brother suffering from AIDS. He also remembers the young people who died from pneumonia, meningitis, or other complications linked to the disease, and the people lying in the streets, exhausted and weakened by the lack of treatment. \u201cIt sounds like a movie, but that\u2019s how it was.\u201d<\/p>\n

Another obstacle to prevention is the weight of a highly patriarchal society in a country where a significant portion of women depend on the will and finances of men, who also decide whether or not to use a condom during sex. \u201cThat\u2019s just how things work here,\u201d the women interviewed for this report repeatedly stated.<\/p>\n

Sandra MKambule breaks those molds. She\u2019s 24, runs a small beauty salon, and prides herself on being an independent woman. She received her first injection of lenacapavir in January because she doesn\u2019t trust the men she has relationships with. \u201cThey don\u2019t tell you the truth, and I want peace of mind,\u201d she explains. \u201cIt was my decision, and nobody cares. It\u2019s much more discreet than taking a pill every day. I think it\u2019s going to change the lives of many young women like me,\u201d she says, recalling that \u201csome people can\u2019t bear being sick,\u201d like her 15-year-old niece, who found out she had contracted HIV and took her own life.<\/p>\n

It was my decision, and nobody cares. It\u2019s much more discreet than taking a pill every day. I think it\u2019s going to change the lives of many young women like me<\/p>\n

Sandra MKambule, businesswoman\u201cThey don\u2019t want to use condoms\u201d<\/p>\n

In Kayise Gama\u2019s office at the Lyengo Clinic in Eswatini, there are three clear plastic containers filled with red and green beads, which she uses in her HIV prevention and treatment consultations. \u201cThe one with most green beads and a third red beads represents the person with HIV who comes to the clinic. The second one, with most red beads, represents that same person if they don\u2019t receive treatment. The third one, where there are practically only green beads, represents the person after undergoing antiretroviral treatment,\u201d she explains.<\/p>\n

That day, Gama has two prostitutes in their early twenties before her, whom she must test for HIV before offering them lenacapavir. \u201cI can\u2019t protect myself because they don\u2019t want to use condoms. And I don\u2019t think much about myself because I have to bring money home,\u201d sighs Princess, 27, who doesn\u2019t want to give her real name. The young woman explains that she is responsible for her siblings, her two children, and her father. \u201cI met an older man who paid me for sex, and I thought that was the life I was destined for,\u201d she recalls, trying to hide her tears.<\/p>\n

When she goes to the nurse\u2019s office with her negative HIV test result, the girl must answer several questions before receiving the injection.<\/p>\n

\u2014 Did you have unprotected sex in the last 72 hours?<\/p>\n

\u2014 Yeah.<\/p>\n

Princess won\u2019t be able to receive lenacapavir that morning because the virus can take a few days to manifest even if the diagnostic test is negative. The nurse advises her to protect herself properly and return in a month. \u201cYou will, right?\u201d she insists, seeing the young woman\u2019s unconvinced expression.<\/p>\n

\u201cI was hoping to get my injection today, and I don\u2019t know if I\u2019ll be able to come back here again,\u201d Princess says, disappointed.<\/p>\n

This report from Eswatini was made possible thanks to support from the Global Fund.<\/p>\n

Sign up for our weekly newsletter<\/a> to get more English-language news coverage from EL PA\u00cdS USA Edition<\/p>\n","protected":false},"excerpt":{"rendered":"Precious closes her eyes and clenches her fists as the syringe needle penetrates her right thigh, slowly injecting…\n","protected":false},"author":2,"featured_media":363069,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[10],"tags":[190,65,58983,134,6512,111,139,69,25275,5507],"class_list":{"0":"post-363068","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health","8":"tag-africa","9":"tag-donald-trump","10":"tag-gilead-sciences","11":"tag-health","12":"tag-malaria","13":"tag-new-zealand","14":"tag-newzealand","15":"tag-nz","16":"tag-un","17":"tag-zambia"},"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/363068","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/comments?post=363068"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/363068\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media\/363069"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media?parent=363068"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/categories?post=363068"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/tags?post=363068"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}