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<p>Lenacapavir is a first-in-class HIV capsid inhibitor with a long-acting formulation that enables twice-yearly dosing for both treatment and prevention. Its novel mechanism and extended dosing interval represent a paradigm shift in HIV care. Sub-Saharan Africa bears the highest global HIV burden but has historically experienced delayed access to biomedical innovations, raising concerns about equity and persistent global health disparities. This article presents a narrative review and policy analysis examining lenacapavir’s scientific potential, its role in HIV<!--Query ID="Q1" Text="Please check and confirm the edit made in title." Resolved="yes"--> treatment and prevention, and the structural, economic, and policy challenges affecting equitable access in African settings. Emerging evidence indicates that lenacapavir is highly effective in heavily treatment-experienced individuals, including those with multidrug-resistant HIV, and its long-acting pharmacokinetic profile supports sustained viral suppression. As a prevention strategy, twice-yearly administration offers a practical alternative to daily oral pre-exposure prophylaxis (PrEP), with the potential to improve adherence and overcome barriers related to stigma and pill burden. Despite its promise, equitable access across Africa may be limited by high costs, patent protections, restricted licensing agreements, health-system weaknesses, and evolving global HIV financing. These challenges could hinder timely introduction and widespread uptake, particularly in resource-constrained settings. Ensuring equitable access will require coordinated action among governments, international agencies, pharmaceutical manufacturers, donors, and civil society to strengthen affordability, availability, and implementation within existing HIV prevention and treatment programs. Lenacapavir represents a transformative advance in HIV therapy and prevention. Its impact in Africa will depend not only on scientific innovation but also on equity-focused policies, sustainable financing, and coordinated implementation strategies.</p>

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Lenacapavir: a transformative advance in HIV therapy and prevention—promise, access, and equity in Africa

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月6日

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  • Stephen Olaide Aremu,
  • Deborah Bukola Aremu,
  • Abdillahi Abdi Barkhadle

摘要

Lenacapavir is a first-in-class HIV capsid inhibitor with a long-acting formulation that enables twice-yearly dosing for both treatment and prevention. Its novel mechanism and extended dosing interval represent a paradigm shift in HIV care. Sub-Saharan Africa bears the highest global HIV burden but has historically experienced delayed access to biomedical innovations, raising concerns about equity and persistent global health disparities. This article presents a narrative review and policy analysis examining lenacapavir’s scientific potential, its role in HIV treatment and prevention, and the structural, economic, and policy challenges affecting equitable access in African settings. Emerging evidence indicates that lenacapavir is highly effective in heavily treatment-experienced individuals, including those with multidrug-resistant HIV, and its long-acting pharmacokinetic profile supports sustained viral suppression. As a prevention strategy, twice-yearly administration offers a practical alternative to daily oral pre-exposure prophylaxis (PrEP), with the potential to improve adherence and overcome barriers related to stigma and pill burden. Despite its promise, equitable access across Africa may be limited by high costs, patent protections, restricted licensing agreements, health-system weaknesses, and evolving global HIV financing. These challenges could hinder timely introduction and widespread uptake, particularly in resource-constrained settings. Ensuring equitable access will require coordinated action among governments, international agencies, pharmaceutical manufacturers, donors, and civil society to strengthen affordability, availability, and implementation within existing HIV prevention and treatment programs. Lenacapavir represents a transformative advance in HIV therapy and prevention. Its impact in Africa will depend not only on scientific innovation but also on equity-focused policies, sustainable financing, and coordinated implementation strategies.