The Ministry of Health is increasing the number of health facilities offering Lenacapavir to expand access to the HIV prevention drug, which is increasingly being described as a game changer in HIV prevention.
The drug was recommended by the World Health Organization in July 2025 as an HIV prevention option after studies, including research conducted partly in Uganda, found that the twice-yearly injection was highly effective as a long-acting alternative to daily oral pills and other shorter-acting HIV prevention options.
Uganda began dispensing Lenacapavir in April 2026 after receiving a donation of 19,200 doses from the Global Fund. The first consignment enabled the country to offer the injection at more than 100 health facilities, where demand has quickly outstripped available supplies.
Dr. Pamela Achii, a Supply Chain Management Specialist at the Ministry of Health, said the government has earmarked a total of 300 health facilities to provide Lenacapavir in 2026, with 196 additional facilities expected to join the programme in November.
For the expanded rollout, Achii said the ministry is prioritising facilities recording high numbers of people at substantial risk of HIV infection, particularly those providing services to refugees, sex workers, truckers, migrants, people who inject drugs and fisherfolk.
The country is also expecting another donation of 19,200 doses, Achii said. She noted that demand has been high even among people outside the groups initially prioritised for the drug, meaning the government has not had to invest heavily in generating demand as it did with earlier HIV prevention innovations such as daily oral PrEP.
However, the growing demand is raising concerns about the sustainability of Lenacapavir supplies because the drug remains expensive.
Dr. Flavia Matovu Kiweewa, a senior research scientist at the Makerere University-Johns Hopkins University (MUJHU) Research Collaboration and lead researcher in the Lenacapavir studies conducted in Uganda, said the drug currently costs about $28,000 per person per year in the United States. That is more than 100 million Ugandan shillings, putting it far beyond the reach of most Ugandans seeking to access it privately without donor support.
Kiweewa said global advocacy is underway to reduce the price, while work to produce generic versions is also progressing.
Information on the website of Lenacapavir manufacturer Gilead Sciences indicates that lower-cost versions could become available from 2027, with estimates suggesting that generics could cost about $40 per person per year.
In Uganda, Achii said the government is planning for between $16 million and $25 million annually to provide Lenacapavir until the drug becomes more widely available and its price falls.
With supplies currently limited, Achii urged health workers and clients to ensure that available doses are not wasted. She said the ministry is strengthening medicine surveillance both to ensure accountability for dispensed doses and to regulate their use.
She also urged people receiving Lenacapavir to report any adverse reactions to the National Drug Authority.
Second doses
Experts have urged people who have already received their first injection to return for their second dose on schedule and to consider combining Lenacapavir with other HIV prevention measures.
They stress that while Lenacapavir is highly effective, it is not an HIV vaccine.
The first recipients of the twice-yearly injection are due for their second dose in October. Dr. Vincent Bagambe, Policy Planning and Strategic Manager at the Uganda AIDS Commission, said people receiving Lenacapavir should return on the prescribed dates to maintain protective levels of the drug in their blood.
Bagambe said the introduction of Lenacapavir as another HIV prevention tool could help Uganda reduce the roughly 37,000 new HIV infections recorded each year to fewer than 10,000 by 2030.
But achieving that target, he said, will depend partly on people adhering to the dosing schedule and maintaining the drug levels required for protection.
At the April launch of Lenacapavir, Uganda had received 19,200 doses, which were distributed to 103 health facilities across the country. The main target groups included people at high risk of HIV infection, such as sex workers, couples in which one partner is living with HIV, fisherfolk and pregnant women engaging in risky behaviour.
However, Ministry of Health reports show that people outside the priority groups also accessed the drug as demand quickly surpassed available supplies.
Dr. Herbert Kadama, who coordinates PrEP at the Ministry of Health, said about 60% of the facilities that received the first batch have now received additional doses to support people due for their second injection.
Kadama said the second batches were delivered earlier than originally planned because some facilities were exhausting their supplies within two to three weeks. Initially, health officials had expected the available doses to last about two months.
The country is also awaiting another donation of 19,200 doses.
Dr. Peter Mudiope, who heads HIV prevention at the Ministry of Health, said that the additional consignment had initially been expected in June. However, Gilead Sciences later informed the ministry that the shipment could not arrive as planned because of shortages of a tablet used alongside the injection as a loading dose.
Mudiope said that despite growing calls for more Lenacapavir and the need for people to receive their doses on schedule, the government currently has limited options for increasing supplies because of the drug’s high cost.
At about $28,000 per person per year, he said Uganda cannot currently afford to purchase enough Lenacapavir to meet demand and must rely on additional donations from the Global Fund and the U.S. government to maintain availability.
With supplies not yet guaranteed, Mudiope urged the public to continue using other proven HIV prevention options, including condoms, pre-exposure prophylaxis (PrEP), post-exposure prophylaxis (PEP) and being faithful in relationships.
He said these options remain scientifically proven to prevent HIV infection.
However, a study conducted by the Makerere University School of Public Health found that uptake of some HIV prevention services remains low among key populations.
The study found that only 24% of female sex workers and people who inject drugs had used PEP in the previous three months. Seventy-six percent said they had not used PEP despite knowing where they could access it.
HIV prevalence also remains substantially higher among these groups than in the general population. While national HIV prevalence is currently 4.9%, prevalence among sex workers is about 30% and among people who inject drugs about 17%.
Kadama said these are precisely the populations the ministry considers a priority for access to Lenacapavir as the rollout expands.
