Lenacapavir: Uganda’s key to ending AIDS by 2030
Uganda has a special reason to celebrate this scientific milestone because our scientists and research institutions were among those that participated in the groundbreaking studies that generated evidence on the safety and effectiveness of Lenacapavir.
Lenacapavir: Uganda’s key to ending AIDS by 2030
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OPINION
By Dr Nelson Musoba
For more than four decades, the world has searched for the elusive breakthrough that could finally bring the HIV epidemic under control. While an HIV vaccine and cure still remain beyond our reach, science may have delivered the next best thing: Lenacapavir, a long-acting HIV prevention injection that has the potential to transform the global fight against HIV.
The excitement surrounding Lenacapavir is well deserved. Clinical trials have demonstrated that a single injection administered every six months can provide almost complete protection against HIV infection. For the first time in the history of the epidemic, the world has a prevention option that combines extraordinary efficacy with exceptional convenience. For many scientists, this represents one of the most significant HIV prevention breakthroughs since the discovery of antiretroviral therapy itself.
Uganda has a special reason to celebrate this scientific milestone because our scientists and research institutions were among those that participated in the groundbreaking studies that generated evidence on the safety and effectiveness of Lenacapavir. Our country’s contribution to this global research effort once again demonstrates that Uganda is not merely a consumer of scientific innovations but also an active contributor to global health discoveries.
It is therefore not surprising that Uganda’s National Drug Authority moved swiftly to approve Lenacapavir following the emergence of compelling scientific evidence and international regulatory approvals. This prompt action has positioned Uganda among the countries that are rapidly deploying this revolutionary prevention technology. Although Uganda’s HIV response is internationally recognised as one of Africa’s success stories, the epidemic remains far from over.
This challenge explains why HIV prevention remains the centrepiece of Uganda’s new National HIV and AIDS Strategic Plan 2025/26–2029/30 and the commitments made under the recent United Nations Political Declaration on HIV and AIDS. Both frameworks call for accelerated investments in evidence-based prevention interventions, reduction of inequalities, and expansion of access to innovative technologies that can dramatically reduce new infections.
The Uganda AIDS Commission, in fulfilment of its national coordination mandate, has consistently advocated for strengthening primary prevention as the most sustainable strategy for ending AIDS. The Commission has repeatedly emphasised that treatment alone will not end the epidemic if thousands of Ugandans continue to become infected every year.
Indeed, evidence suggests that even countries that meet global treatment targets may continue to record substantial numbers of new infections if prevention efforts are not intensified. This is precisely where Lenacapavir could become a game-changer.
One of the major challenges with existing oral pre-exposure prophylaxis is adherence. Daily pills require consistency, yet many people discontinue treatment because of stigma, pill fatigue, forgetfulness, mobility or fear of being identified as being at risk of HIV.
A Lenacapavir injection administered only twice a year could dramatically improve adherence and uptake among populations that continue to experience elevated HIV risk, including adolescent girls and young women, fisherfolk, sex workers, truck drivers, couples in discordant relationships and other vulnerable groups.
Moreover, because it is highly discreet, Lenacapavir could significantly reduce the stigma that still surrounds HIV prevention services.
However, scientific breakthroughs do not automatically translate into public health impact.
Uganda is, therefore, approaching this innovation strategically and responsibly. Before introducing Lenacapavir at scale, the Ministry of Health is undertaking a comprehensive assessment of potential demand, target populations, delivery systems, projected utilisation and financing requirements.
This assessment will answer several important questions, including: How many Ugandans would benefit from this intervention? Which populations should be prioritised? What health system investments are necessary? How can equitable access be guaranteed? What will be the long-term financial implications?
At the same time, government is preparing for Lenacapavir to become a cornerstone of Uganda’s HIV prevention programme by investing in implementation research, strengthening service delivery systems, training health workers, generating community demand and identifying sustainable domestic financing mechanisms.
The need for domestic investment has become even more urgent in light of recent reductions in global HIV financing, which threaten prevention programmes in many countries, including Uganda. Increasingly, the sustainability of national HIV responses will depend on greater domestic ownership and financing.
Lenacapavir is not an HIV cure. It is not a vaccine. But it is set to become one of the most powerful tools ever developed to prevent HIV infection. Due to Uganda’s careful approach to assessment of demand, and planned investment in this innovation to ensure equitable access for those who need it most, Lenacapavir will become one of the interventions that finally bends the curve of new infections and brings our nation to achieving the dream of ending AIDS by 2030.
The future of HIV prevention has arrived. Uganda is ready to lead once again.
The writer is the director general of Uganda AIDS Commission