Will Lenacapavir be the silver bullet in fight against HIV?

What you need to know about the new anti-HIV jab (Photo: Getty Images)

In 2016, Kenya was hailed as a global pioneer for rolling out daily Oral PrEP. Fast forward to 2026, and the data tells a more sobering story. According to the NSDCC 2025 Report, new HIV infections in Kenya surged by 19 per cent last year, reaching 20,000 cases.

Despite having initiated over 544,000 people on oral PrEP, we have hit a structural ceiling. The "daily pill" model is failing our most vulnerable.

The launch of Lenacapavir in February 2026, a twice-yearly injectable with near 100 per cent efficacy, was to be the "turning point." But months after the initial launch at Riruta Health Centre, the conversation has gone quiet.

For the vulnerable woman in Mombasa’s informal settlement or the truck driver in Busia, the difference between a "medical breakthrough" and a "lifeline" is access. The reality of oral PrEP is "pill fatigue." For many, keeping a bottle of HIV-related medication is a high-stakes risk of accidental disclosure and stigma.

This isn't a failure of will; it’s a failure of the delivery system. As of this year, 90 per cent of eligible people who inject drugs (PWID) and 68 per cent of sex workers remain uninitiated on daily regimens. Lenacapavir changes the math. 

By replacing 365 daily choices with just two clinical visits a year, it removes the friction of adherence. It replaces the "shame of the pill bottle" with the "discretion of the needle."

While the US list price for this drug is astronomical, generic deals have brought the cost down to approximately Sh7,800 per person per year. For the government, this is a bargain compared to the lifelong cost of treating an infection. For an at-risk Kenyan living below the poverty line, Sh7,800 is a barrier as high as a mountain.

The Ministry of Health and partners like NASCOP have designated sites in 15 high-burden counties, including Mombasa, Nairobi, and Kisumu. However, a "phased rollout" must not become a "stagnant rollout."

The Ministry of Health must view this not as a cost, but as an investment. It must ensure Lenacapavir continues to be provided free of charge; otherwise, many will have no choice but to continue relying on daily oral PrEP and other available HIV prevention options.

To ensure Lenacapavir doesn't become another 'paper success,' we must act on three fronts:

Sustainable Subsidy: The Ministry must guarantee that Lenacapavir remains free at the point of use. If the burden shifts to the patient, the 19 per cent infection surge will only continue.

Supply Chain Integrity: Unlike pills, injectables require robust clinical follow-up. We need "stigma-free" zones where healthcare workers act as allies, not judges.

Community-Led Delivery: Lessons from ICRHK and other implementing partners show that the most effective care is designed by the users themselves. Our DICEs in Mombasa and Kilifi are ready, but they need a steady, uninterrupted supply.

We have the science. We have the starter doses. What we need now is the national resolve to ensure "twice a year" isn't just a headline, but a reality for every Kenyan at risk. We ended the silence on HIV decades ago; let us not let the silence on its solution be our undoing.

-The writer is a senior programme officer at the International Centre for Reproductive Health-Kenya (ICRHK)