The Nigerian authorities have initiated the deployment of a novel long-acting HIV prevention injection known as Lenacapavir. However, the government has specified that this injection will not be available for pregnant women due to a lack of sufficient safety data.
This rollout will take place in eight states: Anambra, Ebonyi, Gombe, Kwara, Akwa Ibom, Cross River, Benue, and the Federal Capital Territory (FCT). This strategic move is aimed at broadening access to innovative options for HIV prevention.
During a media briefing held in Abuja by the National Agency for the Control of AIDS (NACA), Temitope Ilori, the Director-General, provided insights into the initiative. She noted that while international clinical trials indicate the medication’s general safety, there is insufficient evidence to advocate for its use during pregnancy.
"Despite the global studies suggesting Lenacapavir is predominantly safe, it is not recommended for pregnant women. It is crucial to highlight that this is intended as a preventative measure, rather than a treatment,” she explained.
Ilori described Lenacapavir as a significant advancement in the suite of HIV prevention tools but cautioned not to exaggerate its effectiveness, emphasizing that it does not offer protection against other sexually transmitted infections.
Additionally, she stressed, “It is important to remember that it does not prevent sexually transmitted infections, unwanted pregnancies, or diseases like hepatitis. Comprehensive protective measures must remain in place.”
Lenacapavir is characterized as a long-acting injectable antiretroviral agent developed by Gilead Sciences, meant for HIV prevention. It is intended for administration once every six months as a pre-exposure prophylaxis (PrEP), providing an alternative for individuals who find daily oral medications challenging to maintain.
The drug gained international recognition due to its potential to streamline HIV prevention efforts, particularly for high-risk groups. However, health professionals reaffirm that it should not be relied upon as a singular solution but must work in tandem with other methods such as condom use and regular health screenings.
Nigeria ranks fourth globally in terms of HIV prevalence, with approximately 1.9 million citizens currently living with HIV, according to NACA. While there have been improvements in the availability of antiretroviral therapy in recent years, significant gaps in preventive measures remain, especially among youth and marginalized populations, which face obstacles such as stigma, lack of awareness, and variable access to preventive resources.
During the briefing, Iziaq Salako, the Minister of State for Health and Social Welfare, disclosed that Nigeria was identified as one of nine pioneer countries to adopt this initiative by the Global Fund, following its expression of interest in March 2025 and subsequent approval.
Salako highlighted that the drug's biennial rollout represents a crucial advancement in the fight against HIV/AIDS, aiming to eradicate it as a public health issue by 2030 through enhanced preventive, treatment, and care strategies nationwide.
"A total of 52,000 doses of Lenacapavir have been allocated to facilitate its introduction into our HIV prevention efforts,” he stated. The initial batch of the medication has already arrived, with preparations underway for a national launch and distribution across the selected regions.
He reiterated that the injection is not a treatment option but a preventive measure for those at high risk of HIV infection. The government intends to adopt a phased approach to ensure adequate safety monitoring before a nationwide rollout.
Salako further mentioned that the rollout process would encompass a national launch, media outreach, and facility-level introductions in the designated states. "The National Pre-Exposure Prophylaxis Implementation Plan 2025 to 2028 will provide a framework for scaling services, including service delivery, supply chain management, funding, and community involvement,” he noted.
Regarding local production, Salako indicated that the government aims to progressively engage with manufacturers and explore opportunities for domestic manufacturing of the drug. He emphasized the importance of technology transfer and local production to ensure lasting sustainability and lessen dependence on international aid.
The National Coordinator of NASCP, Adebobola Bashorun, emphasized that the rollout strategy was shaped by program data and collaborative efforts among stakeholders. He clarified that the medication is not a cure but should complement existing preventive measures, including oral PrEP and long-acting injectable cabotegravir, thereby expanding options for at-risk individuals.
"We already possess numerous prevention tools. Individuals can continue to utilize oral PrEP. Guidelines from the national policy will determine the optimal integration of this new option into existing programs,” he stated.
Bashorun reassured that no severe adverse reactions have been reported thus far, with only mild discomfort at the injection site being noted as a common side effect. He urged that the availability of this new medication should not lead to increased risk-taking behavior.
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