By Michael Gwarisa
Zimbabwe has received the first 23,000 doses of US-funded lenacapavir from a consignment of 43,000 doses secured to expand access to the twice-yearly HIV prevention medicine, just days before the United States is set to end its health assistance programmes in the country.
The latest shipment is separate from the approximately 2,000 doses Zimbabwe received earlier this year when the country began its initial rollout of lenacapavir.
The remaining 20,000 doses from the US-funded consignment are expected to arrive soon, according to the Ministry of Health and Child Care.
Dr Owen Mugurungi, Director of the AIDS, TB and Malaria Unit in the Ministry of Health and Child Care, confirmed the arrival to HealthTimes.
“To date, 23,000 doses of Lenacapavir have arrived from the 43,000 we ordered. We are still expecting the remaining 20,000 to arrive soon,” said Dr Mugurungi.
The arrival comes less than a week before the United States is expected to conclude its health assistance programmes in Zimbabwe, raising questions about the longer-term sustainability of programmes and commodities that have benefited from American support.
US Ambassador to Zimbabwe Pamela Tremont said last week that US-supported health programmes would conclude at the end of September after Zimbabwe declined to proceed with a proposed bilateral health Memorandum of Understanding.
“With Zimbabwe’s decision to decline a bilateral health MOU, U.S.-supported health programs will conclude at the end of September,” Tremont said at a “Beyond Assistance” reception in Harare.
She said the US Embassy was working with the Ministry of Health and Child Care and other partners to ensure a “thorough and responsible handover”.
The timing of the lenacapavir shipment therefore puts a new focus on how Zimbabwe will maintain access to HIV prevention commodities as the US assistance model changes.
Lenacapavir is a long-acting pre-exposure prophylaxis (PrEP) medicine administered twice a year to prevent HIV-1 infection. Unlike daily oral PrEP, it provides a longer-acting prevention option and is intended to expand the choices available to people at risk of HIV infection.
Zimbabwe began rolling out lenacapavir in February, initially receiving about 2,000 doses for a phased programme. Early uptake prompted plans to significantly expand the programme, with an additional 43,000 doses expected to bring the 2026 target to about 46,500 users.
The programme has already shown demand for the new prevention option. By May, 1,478 people had been initiated on lenacapavir, with women accounting for 67 percent of those receiving the medicine. About 42 percent had switched from oral PrEP or long-acting injectable cabotegravir.
The drug is administered as a six-monthly injection following an initiation phase and was approved for use in Zimbabwe by the Medicines Control Authority of Zimbabwe after an expedited regulatory review.
Health authorities have been expanding the programme beyond the initial sites, with Manicaland among the areas earmarked for the second phase of rollout. Mutare, Chipinge and Buhera were identified for expanded access as part of efforts to widen the availability of the new prevention option.
The additional supply is particularly significant because lenacapavir formed part of a broader HIV prevention expansion supported through international financing, including US-linked assistance. Earlier plans envisaged reaching tens of thousands of people with the medicine during 2026.
However, the future financing and support arrangements are now unfolding against a dramatically different US-Zimbabwe health relationship.
The proposed US$367 million bilateral health agreement, which Zimbabwe withdrew from earlier this year, was intended to provide support over five years for HIV/AIDS, tuberculosis, malaria, maternal and child health and disease outbreak preparedness. Zimbabwe raised concerns about provisions relating to health data, while the US maintained that the proposed arrangement was designed to support sustainability and greater country ownership.
The United States has since confirmed that its health assistance in Zimbabwe will end at the close of September.
Tremont said the change marked a shift in Washington’s relationship with Harare, from one largely centred on health and humanitarian assistance towards trade, investment and wider economic cooperation. She said the US would continue engaging Zimbabwe in areas including agriculture, water, technology, energy, infrastructure, climate-smart solutions, artificial intelligence and mining.
For Zimbabwe’s HIV response, the immediate issue is now continuity. The country has made significant progress in HIV prevention and treatment over the past two decades, supported in part by large-scale international programmes. The US has been a major partner in that response, supporting HIV prevention, testing, treatment and health-system interventions.
The arrival of 23,000 lenacapavir doses provides an immediate boost to Zimbabwe’s prevention programme, but with 20,000 doses still outstanding and the US health assistance framework ending within days, attention will increasingly turn to who will finance, procure and sustain access to the medicine beyond the current supply.
For thousands of people who may benefit from the twice-yearly prevention option, the issue is no longer simply whether lenacapavir has reached Zimbabwe. It is whether the country can sustain access to it as a major chapter of US-supported health assistance comes to an end.
