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The United States government, in partnership with the Global Fund and Gilead Sciences, announced a significant increase in its order for a groundbreaking HIV prevention drug, Lenacapavir, as the first doses were delivered to the Kingdom of Eswatini on Tuesday.
The U.S. Department of State announced the collaboration, which is a key component of the new America First Global Health Strategy, aimed at strengthening African health systems and fostering sustainable, market-driven partnerships.
Lenacapavir is a new, highly effective HIV prevention injection that only needs to be administered twice a year. According to Gilead Sciences, the drug has been shown to be capable of averting nearly 100 percent of new HIV infections in clinical trials, making it a “game-changer” in the fight to end the HIV epidemic.
“Lenacapavir is an American innovation from an American company, and it demonstrates American excellence in science and leadership in HIV prevention,” said Senior Advisor Brad Smith of the U.S. Department of State’s Bureau of Global Health Security and Diplomacy.
CEO Daniel O’Day of Gilead Sciences confirmed that the company will provide Lenacapavir at no profit to the countries with the highest burden of HIV, underscoring the focus on speed and partnership in global access.
The U.S. Department of State (via PEPFAR-supported programs) and the Global Fund are collaboratively purchasing a total of over 2 million doses of Lenacapavir over time.
For the first year of the program in 2026, the demand signals, mainly from Africa, have led the U.S. to increase its initial commitment from 250,000 doses to 325,000 doses. Together with the Global Fund’s commitment, the partners have reserved 100 percent of Gilead’s 600,000 dose capacity for 2026.
Executive Director Peter Sands of the Global Fund emphasized that innovation only has an impact if it is deployed “at scale and at speed,” noting that this partnership accelerates access to life-saving technology.
The first purchases and deliveries of Lenacapavir are taking place immediately in the Kingdom of Eswatini, which has historically been among the countries most affected by HIV.
In Eswatini, where 98 percent of people living with HIV are already on treatment, this new phase of programming will support over 6,000 people at high risk of HIV. A particular focus will be placed on eliminating transmission of HIV from mothers to their newborns.
The U.S. Government and the Global Fund are collaborating closely with the Eswatini government to integrate distribution, leveraging existing PEPFAR-supported supply chains to reach patients.
Looking ahead, Gilead has voluntarily licensed the technology to six generic manufacturers, and generic suppliers are anticipated to begin serving the market as early as 2027, a move expected to significantly reduce the cost and ensure the long-term sustainability of prevention efforts across the continent. The initial rollout will begin in 10 African countries.
