By Michael Gwarisa
Doctors Without Borders (MSF) has secured a limited supply of long-acting injectable cabotegravir (CAB-LA), a groundbreaking HIV prevention medication, following months of negotiations with Viiv, its sole manufacturer. The initial rollout is set to begin later this year in Zimbabwe, Mozambique, Malawi, and Eswatini.
To prepare for this rollout, MSF conducted a four-day training workshop for clinicians, nurses, and future implementers. The training aimed to build capacity among healthcare workers to effectively administer CAB-LA and integrate it into HIV prevention efforts.
Dr. Gerald Hangaika, from MSF’s Mbare project in Zimbabwe, participated in the CAB-LA training and emphasized its potential to benefit at-risk populations.
The launch of CAB-LA will greatly benefit our clients and the people of Zimbabwe. It offers a higher level of protection than oral PrEP and eliminates the need for daily tablets, addressing adherence challenges while enhancing privacy,” he said.
He highlighted the “triad of privacy, convenience, and effectiveness” as key factors that appeal to most clients, making CAB-LA a promising tool for increasing pre-exposure prophylaxis (PrEP) uptake among at-risk groups.
CAB-LA is part of a new wave of long-acting injectable HIV prevention tools, alongside lenacapavir, which is administered every six months. These innovations have the potential to revolutionize global HIV prevention efforts by reducing the burden of adherence and substantially lowering new infection rates. However, challenges remain. High costs and limited access to these medications restrict their availability in low- and middle-income countries, undermining their impact on the global HIV epidemic.
Dr. Antonio Flores, MSF’s HIV/TB advisor based in South Africa, expressed optimism about CAB-LA’s effectiveness and scalability. “CAB-LA, administered every two months, is more effective than oral PrEP in preventing new HIV infections. With no vaccine or cure in sight, long-acting formulations like CAB-LA can be game changers if scaled up globally, particularly in low- and middle-income countries and among populations at higher risk,” he said.
According to UNAIDS, new HIV infections have decreased by 60% since their peak in 1995, with 3.3 million infections in 1995 compared to 1.3 million in 2023. While this progress is significant, the global fight against HIV remains incomplete, particularly for vulnerable populations such as women, girls, and marginalized groups in Sub-Saharan Africa, who accounted for 62% of all new infections in 2023.
“For MSF, this is our very first order of CAB-LA, and we’re excited to implement it,” Dr. Flores added. “Building capacity in settings like Malawi and Mozambique is essential. We work with many vulnerable populations in conflict and unstable contexts who could benefit greatly from this innovative injection. We hope Viiv can ensure an adequate supply to meet demand.”
CAB-LA has been lauded for its discreet and long-lasting protection compared to oral PrEP. Lenacapavir, another long-acting injectable, is expected to further expand prevention options, with a six-month dosing schedule offering even more convenience.
The training for MSF medical staff covered both theoretical and practical aspects of CAB-LA implementation. Topics included clinical eligibility, management of side effects, PrEP counseling, patient education, and promotional strategies. The goal was to empower healthcare workers with the skills needed to coordinate the rollout and enhance health outcomes for high-risk populations.
Globally, women and girls remain disproportionately vulnerable to HIV, accounting for 44% of all new infections in 2023. In Sub-Saharan Africa, these vulnerabilities are especially pronounced, while key populations—including gay men and other men who have sex with men, transgender people, sex workers, people who inject drugs, and incarcerated individuals—continue to face elevated risks in all regions.
