The twice-yearly injection could be a game-changing alternative in the decades-long fight against the deadly virus
A groundbreaking HIV prevention injection, lenacapavir, has been approved by the U.S. Food and Drugs Administration (FDA) as the world’s first twice-a-year shot to prevent HIV.
This innovation could be a turning point in the global fight against HIV—but the big question for Rwanda and other African countries is: when will it be available, and will it be affordable?
Lenacapavir—marketed in the U.S. as Sunlenca for treatment and now Yeztugo for prevention—was developed by Gilead Sciences.
It offers six months of protection from HIV with a single shot, dramatically improving on the current methods of daily pills or injections every two months.
Clinical trials showed it to be 99% effective in preventing new infections, even in high-risk groups.
Why This Matters for Rwanda
Rwanda has made strong progress in reducing HIV infections and expanding treatment, but the disease remains a major public health concern.
According to the Rwanda Biomedical Centre (RBC), as of 2023:
- Over 220,000 people were living with HIV in Rwanda.
- New infections were estimated at around 4,000 per year, with a higher concentration among young women and key populations.
- HIV prevalence stands at 3% among adults aged 15–49, and over 97% of people diagnosed are on antiretroviral therapy.
Despite these gains, prevention remains a challenge. Many at-risk individuals—such as young women, sex workers, and men who have sex with men—struggle to consistently take daily PrEP pills due to stigma, forgetfulness, or difficulty accessing health centers.
A twice-yearly injection could be a game-changing alternative.
Officials and the patients will be waiting in anticipation at the new development.
The Cost Barrier and Access Timeline
In the U.S., Gilead has priced the drug at over $28,000 (Rwf 35 million) per year—an amount far out of reach for most African countries, including Rwanda.
But there’s good news: Gilead has licensed generic production to six manufacturers for supply in 120 low- and middle-income countries, including Rwanda.
While Gilead has not confirmed the final cost for Africa, experts estimate a generic version could be made for $25–$40 per person per year or between Rwf 30,0000 and Rwf 60,000.
Gilead has also committed to providing 2 million doses at no profit, in partnership with global health programs like PEPFAR and the Global Fund, which is where Rwanda gets all it’s current ARVs.
According to Reuters and the Associated Press, rollout to eligible African countries could begin as early as 2026, following regulatory approvals and supply agreements.
How the Shot Works
Lenacapavir works by blocking the virus from entering and multiplying in human cells.
It is injected just twice a year, compared to the current PrEP (pre-exposure prophylaxis) options that require daily pills or injections every two months.
This longer protection period solves several problems: People don’t have to remember to take pills every day; Fewer visits to clinics means less exposure to stigma.; It’s easier for health systems to manage distribution, especially in rural areas.
