Michael Gwarisa
Following weeks of anticipation, the Zimbabwean government has finally announced the dates for the rollout of lenacapavir, an injectable pre-exposure prophylaxis drug.
The rollout had initially been scheduled for January 2026. According to The Herald, the Permanent Secretary in the Ministry of Health and Child Care, Dr Aspect Maunganidze, confirmed that the drug will be rolled out on Wednesday, February 18, 2026, in Epworth.
“The launch of lenacapavir is expected to take place on February 18 in Epworth, Harare,” said Dr Maunganidze.
The doses will be coming in batches, with the first consignment having already brought in 2,000 doses. These will be distributed across 12 sites before the rollout is expanded to other sites across the country. An estimated 45,000 people are set to receive the injectable, a move expected to transform Zimbabwe’s HIV prevention landscape.
Zimbabwe has been implementing a PrEP programme for more than a decade, with oral PrEP being the first product to be introduced.
Dr Owen Mugurungi, Director of the AIDS and TB Unit in the Ministry of Health, said numerous lessons learned over the years would guide the rollout of lenacapavir.
In pre-exposure prophylaxis, there are four main PrEP modalities currently recognised. First is oral PrEP, which mainly consists of tenofovir-based oral formulations. Second is the dapivirine vaginal ring, which is primarily used by women. Third is long-acting injectable PrEP, specifically cabotegravir long-acting. Finally, there are newer long-acting PrEP options being introduced alongside oral lead-in or oral support packages.
“Because of these multiple PrEP options, it is clear that meaningful discussion and informed choice are essential before individuals can decide which PrEP method best suits them. Despite PrEP being available for over a decade, awareness remains low. In many settings, awareness is below 30 percent and in some cases even below 20 percent. This remains a significant concern and is closely linked to low risk perception, which continues to affect PrEP uptake,” said Dr Mugurungi.
At ministerial and national level, targets have been set to scale up PrEP uptake. In the early years, Zimbabwe often set targets and successfully achieved or exceeded them. For example, in 2021 the country reached 121 percent of its target. However, in subsequent years, performance fluctuated. In 2023 and 2024, achievement stood at around 27 percent of targets, indicating growing demand but also highlighting implementation challenges.
These challenges prompted a strategic shift. It became clear that reliance on the public sector alone would not be sufficient and that there was a need to expand beyond public health facilities to reach national targets. Encouragingly, in the most recent reporting period, Zimbabwe came close to achieving 100 percent of its PrEP targets, demonstrating renewed momentum.
“Zimbabwe first introduced oral PrEP in 2016. In 2021, the country began preparations for newer PrEP options and by 2022 initiated early rollout processes. These efforts were consolidated further by 2024. Throughout this period, several key lessons emerged,” he added.
One important lesson, according to Dr Mugurungi, was the need to set realistic and appropriate targets while prioritising populations at highest risk. There is also a critical need for continuous training of healthcare providers, as they play a central role in counselling, initiation and continuation of PrEP services. Strong monitoring and evaluation systems are equally important to track progress, identify bottlenecks and respond to gaps in real time.
Supply chain challenges were also identified, emphasising the need for better forecasting and logistics management. In addition, while facility-based services remain important, Zimbabwe has learned that community-based and differentiated service delivery models offer valuable opportunities to expand access beyond traditional health facilities.
Resource constraints, particularly in the public sector, continue to affect service delivery. Although many healthcare providers have been trained, consultation time remains a challenge. In the public sector, client-provider interactions are often limited to just a few minutes, which is insufficient for comprehensive PrEP counselling and informed decision-making.
In contrast, the private sector offers an opportunity for longer, more in-depth consultations, allowing clients to better understand PrEP options, adherence requirements and follow-up schedules. Leveraging the private sector could therefore strengthen demand creation and quality of care.
Finally, the importance of communication and digital platforms has become increasingly evident. Digital tools can support client education, demand creation, appointment reminders and adherence support. For example, flexible scheduling around long-acting PrEP dosing windows, such as allowing clients to come earlier or later than the exact 26-week mark, can improve continuation and user satisfaction.
