By Monica Kayombo, Zambia, Lusaka,
THE first United States ( US) funded shipment of lenacapavir, an HIV prevention medication developed by U.S. pharmaceutical company Gilead Sciences and administered twice a year, has arrived in Zambia.
Speaking during the official handover of the consignment to the Ministry of Health at the University Teaching Hospital (UTH) Women and Newborn Hospital today, U.S. Assistant Secretary of State for African Affairs Frank Garcia said the arrival of lenacapavir provides women and other populations at risk of HIV with an additional and highly effective prevention option requiring only two doses per year.
He said its availability was particularly significant for pregnant and breastfeeding mothers, whose health was closely linked to the health and well-being of their children.
“This is a Zambian achievement, led by Zambians, for Zambians, and the United States is proud to stand beside you as a partner in that effort,” Assistant Secretary Garcia said.
Joined by Ministry of Health Permanent Secretary for Donor Coordination Dr George Sinyangwe and other Zambian health leaders, Mr Garcia said the event highlighted the strength of the U.S.-Zambia health partnership and Zambia’s progress towards building a sustainable health system increasingly led by Zambian institutions.
Mr Garcia also recognised the leadership of Zambian health professionals, including Professor Lloyd Mulenga, Dr Chimika Phiri and Dr Mundia Mwitumwa, who play central roles in implementing the country’s national HIV pre-exposure prophylaxis (PrEP) programme.
He emphasised that U.S.-funded lenacapavir would be available at no cost to individuals receiving care at Zambian health facilities.
The investment, he said, reflects the America First Global Health Strategy’s focus on supporting government-led health priorities, strengthening partner-country capacity and delivering measurable health results.
“The relationship between the United States and Zambia has never been stronger,” Assistant Secretary Garcia said.
“It is built not on dependency, but on partnership and mutual respect—on shared goals, shared investment and shared results.”
The delegation later observed the administration of lenacapavir to an eligible patient.
The event concluded Mr Garcia’s three-day visit to Zambia, his first visit to Southern Africa.
During his visit, Mr Garcia attended the presidential inauguration of President Hakainde Hichilema and engaged Zambian leaders on shared priorities, including expanding trade and investment, advancing regional peace and security, and strengthening the U.S.-Zambia health partnership.
Strong Retention Rates
Meanwhile, Professor Lloyd Mulenga, who is in charge of infectious diseases at UTH, said Zambia’s HIV prevention programme using lenacapavir began in December 2025.
He said that by the end of June 2026, close to 4,000 people had been initiated on the medication.
“We had initiated close to 4,000 individuals by the end of June. By that time, we looked at how many people were supposed to come for the second injection, and about 80 percent came for the second injection. So retention is very good,” Prof. Mulenga said.
He said retention was significantly lower among people using daily oral PrEP, with only about 25 percent returning to receive their next doses.
“But this one, 80 percent of people had returned to come and receive the next injection. So, it is excellent,” Prof. Mulenga added.
However, he said the Ministry of Health was facing challenges in retaining certain populations, particularly pregnant and breastfeeding women.
Among pregnant and lactating mothers who had been initiated on lenacapavir, only close to 60 percent had returned for their subsequent doses.
Prof. Mulenga said some women may be failing to return because of challenges such as a lack of transport.
He said the Ministry had identified the UTH department for newborn babies as one of the sites for the intervention after observing that some women who tested negative for HIV during pregnancy later contracted the virus during pregnancy or while breastfeeding, often without their knowledge.
“That is why we have now initiated in those sites. Side effects have been minor,” Prof. Mulenga explained.
Focus on Pregnant and Breastfeeding Women
Dr Chimika Phiri said the initial batch of lenacapavir received by the Ministry of Health was supplied through the Global Fund, while the current consignment was funded by the U.S. Government.
He said the partners supporting the HIV prevention injectable were particularly interested in ensuring that lenacapavir reached pregnant and breastfeeding mothers.
“Remember, in this population, we have a number of women who are HIV-negative, but they get HIV during the pregnancy and breastfeeding period. So we want to intensify the efforts so that they do not transmit HIV to their children,” Dr Phiri said.
Dr Phiri said between 56 and 60 percent of women who had been initiated on lenacapavir had so far received the medication, although further clarity may be required on the exact figures and measurement.
He said there was a strong commitment from cooperating partners to support the country with the necessary commodities.
“As you have witnessed, the U.S. Government came through just to showcase that they are committed to supporting us. So, we are looking at at least 93,000 initiations this year,” he said.
Dr Phiri said the Ministry of Health was deliberate about ensuring that 40 percent of the lenacapavir provided was allocated to priority populations, including pregnant and breastfeeding women, adolescents and young women.
He said the Ministry was targeting 93,000 initiations by the end of 2026.
“We are looking at rolling it out and activating close to about 543 sites in total by the end of 2026. But so far, we are at about 122 sites that are currently offering lenacapavir,” he explained.
Dr Phiri said the Ministry also wanted to reach all 10 provinces and ensure that lenacapavir was available at health facilities operated by the defence forces.
PrEP is offered to sexually active Zambians aged 16 years and above, although it may also be administered to pregnant minors below the age of 16 where medically appropriate.
He said recipients of lenacapavir were counselled before being enrolled on the programme.
Dr Phiri added that recipients were being reminded that lenacapavir only prevents HIV and does not protect against other sexually transmitted infections (STIs).
He said ice could be used to reduce pain and irritation after receiving the injection.
For decades, the United States and Zambia have worked together to combat HIV/AIDS and strengthen Zambia’s health system.
The United States says it will continue working with the Government of Zambia to strengthen national institutions, expand sustainable capacity and ensure that lifesaving prevention and treatment services reach the Zambian people.
