Nigeria is set to introduce lenacapavir, a new twice-yearly injectable drug for HIV prevention that global health experts say could significantly boost efforts to reduce new infections.
According to the National Agency for the Control of AIDS (NACA), the injection is expected to arrive in March 2026. Regulatory approval has already been secured from the National Agency for Food and Drug Administration and Control (NAFDAC), while readiness assessments have been completed in 10 states, including Lagos, Kano, Akwa Ibom and Anambra.
The rollout follows a landmark recommendation by the World Health Organization (WHO) in July 2025 endorsing injectable lenacapavir as an additional HIV prevention option.
What Is Lenacapavir?
Lenacapavir is a long-acting antiretroviral medicine that targets the HIV capsid — the protein shell that protects the virus and plays a key role in viral replication.
By disrupting the capsid, the drug prevents HIV from replicating and establishing infection after exposure. Unlike daily oral pre-exposure prophylaxis (PrEP), which requires consistent daily use, lenacapavir is administered once every six months — reducing the burden to just two injections per year.
The WHO describes the drug as a “highly effective, long-acting alternative” for people at substantial risk of HIV infection, particularly those who face challenges with daily adherence, stigma, or limited access to health services.
Global Backing and WHO Recommendation
Lenacapavir gained international attention after clinical trials demonstrated strong protection against HIV among high-risk populations.
In July 2025, the WHO formally recommended the injectable as an additional PrEP option during the International AIDS Society Conference on HIV Science in Kigali, Rwanda. The agency emphasised that it should complement — not replace — existing prevention tools such as oral PrEP and condoms.
The recommendation came amid concerns about slowing progress in global HIV prevention. According to WHO data, 1.3 million new HIV infections were recorded worldwide in 2024. An estimated 40.8 million people were living with HIV, while about 630,000 died from HIV-related causes. Nearly 65 per cent of people living with HIV reside in the WHO African Region.
The UNAIDS also welcomed the development, describing innovative prevention tools as critical to reversing new infections globally.
Affordability Breakthrough
Initial concerns about lenacapavir centred on cost. In high-income countries, the annual list price was estimated at around $28,000 per person.
However, in September 2025, during the 80th United Nations General Assembly and at a Clinton Global Initiative meeting, Nigeria joined other countries in announcing a major price-reduction agreement. Under the deal, eligible low- and middle-income countries will access the injection at about $40 per person per year.
Following early public rollouts in South Africa, Eswatini and Zambia, Nigeria announced in December 2025 that it would adopt the drug.
Data indicates the injection reduces HIV transmission by up to 99.9 per cent, making it one of the most effective prevention tools available to date.
Why It Matters for Nigeria
HIV remains a significant public health issue in Nigeria. Data cited by NACA and global partners show that HIV prevalence among Nigerians aged 15 to 49 stands at 1.3 per cent, with an estimated 1.9 million people living with the virus.
While treatment coverage has improved — with more people enrolled in care than ever before — prevention gaps persist. Daily oral PrEP, though effective, requires strict adherence and has faced challenges including stigma, pill fatigue and limited access.
Long-acting injectables like lenacapavir could address these barriers by offering a more discreet and convenient option. Populations expected to benefit most include adolescent girls and young women, sex workers, men who have sex with men, people who inject drugs and other key populations identified by WHO.
Nigeria’s Rollout Plans
NACA says preparations are well underway. Landscape and readiness assessments have been completed in selected states to evaluate service delivery capacity. A national training-of-trainers programme has been conducted, followed by step-down training for healthcare workers in implementation states.
Information and communication materials are also being developed to support awareness and demand generation ahead of distribution.
NACA Director-General Temitope Ilori described the introduction of lenacapavir as part of efforts to build a more sustainable and self-reliant HIV response, especially amid global funding uncertainties. The federal government has also approved additional funding to ensure uninterrupted HIV prevention and treatment services.
With its twice-yearly dosing schedule and significantly reduced cost, lenacapavir’s expected arrival in March 2026 marks a major milestone in Nigeria’s HIV prevention strategy — potentially expanding access to protection for those who struggle with daily medication.
