…bets twice-yearly shot to end new infections by 2030
The Federal Government has cautioned Nigerians not to misinterpret Lenacapavir (Len PrEP), the breakthrough twice-yearly injectable drug for the prevention of HIV, as a free pass for risky sexual behaviour.
Unlike daily oral pills, Lenacapavir is administered once every six months, a shift the government and health officials believe could solve one of the biggest challenges in HIV prevention, poor adherence.
The Minister of State for Health and Social Welfare, Dr Iziaq Salako, who spoke at a pre-rollout session with the media on Monday in Abuja, noted that in a bold push to halt new infections and meet its 2030 elimination target. The government has staked a major part of its HIV prevention strategy on the injectable drug.
Salako, who declared Lenacapavir a “game changer” in the fight against new infections, added that the long-acting injectable pre-exposure prophylaxis marks a major milestone in Nigeria’s HIV response and could transform prevention efforts, particularly among high-risk and hard-to-reach populations.
He said: “One of those advancements is the introduction of long-acting injectable pre-exposure prophylaxis, which expands Nigeria’s HIV prevention toolkit and provides additional prevention options for individuals who are at substantial risk of HIV infection.”
Salako disclosed that Nigeria was selected as one of nine early-adopter countries for the drug, with about 52,000 doses already supplied to support the initial rollout beginning in 2026.
“It is administered once every six months, making it a highly convenient prevention option, particularly for individuals who may experience challenges with adherence to oral PrEP.”
The minister stressed that the innovation would accelerate efforts to reduce new HIV infections, improve access to prevention services and cut long-term treatment costs.
“The introduction of this drug is expected to accelerate the reduction of new HIV infections, expand prevention coverage among populations at substantial risk, and contribute to long-term programme sustainability.”
“We are leveraging scientific evidence and global best practices to strengthen our national response.”
Salako, who acknowledged the struggle to consistently take daily Pre-Exposure Prophylaxis (PrEP) thereby limiting its effectiveness despite widespread availability, noted that the new drug was introduced to “expand Nigeria’s HIV prevention toolkit and provide additional prevention options for individuals at substantial risk of HIV acquisition.”
He added, “Lenacapavir offers high efficacy, a biannual dosing schedule that improves adherence and convenience, and a discreet prevention option for key and vulnerable populations.
The minister said the initial rollout would cover eight states: Anambra, Ebonyi, Gombe, Kwara, Akwa Ibom, Cross River and Benue, alongside the Federal Capital Territory, explaining that the selection was based on programmatic data and transmission patterns.
According to him, the injection would not replace existing prevention methods but complement them.
“Lenacapavir will complement existing HIV prevention options, including oral PrEP and long-acting injectable Cabotegravir, enabling individuals to choose methods aligned with their preferences and risk profiles.”
To support the rollout, the Federal Ministry of Health has developed a Rapid Advice guideline and a National PrEP Implementation Plan for 2025–2028 to coordinate scale-up across the country.
According to the minister, the framework covers “governance, service delivery, supply chain management, demand creation, human resource capacity, financing, sustainability, and community engagement.”
He noted that extensive preparatory work, including regulatory approvals, training of health workers, supply chain strengthening, and community engagement, had already been completed.
Salako expressed confidence that the intervention would significantly reduce new infections and lower long-term treatment costs.
“The introduction of Lenacapavir will accelerate the reduction of new HIV infections, expand prevention coverage, and improve access. It is a critical step toward ending HIV/AIDS as a public health threat in Nigeria.”
The Director of Public Health at the ministry Dr. Charles Nzelu, warned, “People will say I have taken the drug, so I now have the licence to indulge in risky behaviour.’ Please, this drug is not a substitute. Do all the other prevention methods.”
He explained that while the drug’s twice-yearly dosage would improve adherence, it must be used alongside other preventive strategies.
“When you have to take drugs every day, it’s not easy for compliance. This one will help ensure compliance and reduce resistance, but it is still part of a broader prevention package.”
Also speaking, the Director-General of the National Agency for the Control of AIDS (NACA) Dr. Temitope Ilori, emphasised that the drug does not protect against other infections or unintended pregnancies.
“It does not prevent sexually transmitted infections, it does not prevent hepatitis, and it does not prevent unwanted pregnancies. It is not a cure; it is a prevention method.”
She added that the drug was currently not recommended for pregnant women despite its high safety profile in global studies.
The Director and National Coordinator of the National AIDS and STIs Control Programme (NASCP) in Nigeria,.Dr. Adebobola Bashorun reiterated that the injection was “not yet a cure, but a preventive drug taken twice a year.”
The Chief Executive Officer of the Institute of Human Virology, Nigeria (IHVN) Dr. Patrick Dakum, also described the new intervention as “a game-changer”
in Nigeria’s HIV response
Represented by the Director of Special Projects at the (IHVN) Dr. Aderonke Agbaje, he emphasised that Len PrEP was not a replacement but an addition to Nigeria’s HIV prevention arsenal.
“While daily oral PrEP has saved countless lives, adherence has remained a challenge due to stigma, access, and the need for daily dosing. Len PrEP offers a discreet, convenient alternative with just two injections a year. This is especially vital for our key and vulnerable populations who may struggle with daily pills.
“Expanding prevention options means Nigerians can choose what works best for them. This combination approach brings us closer to reducing new infections and ending HIV as a public health threat.”
He added that the IHVN was supporting the rollout through a comprehensive, system-integrated approach, working alongside the Federal Ministry of Health and the National AIDS and STI Control Programme (NASCP).
According to him, key strategies include: integrating Len PrEP into One-Stop Shops, key population-friendly facilities, and selected public health centres to ensure accessibility and sustainability.
Others were training healthcare workers and peer educators through national programmes and digital platforms like Instrat VTR for continuous learning, partnering with civil society and community networks to promote accurate messaging, reduce stigma, and drive uptake, ensuring product integrity through secure warehousing, last-mile distribution, and traceability systems, using tools like ClientShot to track client experience, inform quality improvement, and guide adaptive implementation.
“Our approach ensures Len PrEP is rolled out safely, effectively, and in a way that can be scaled nationwide. With commitment from national leadership and community stakeholders, we are confident this initiative will save lives and strengthen Nigeria’s HIV prevention response.”
Also speaking, Development partners, including the Global Fund, described Nigeria’s selection as an early adopter as a vote of confidence in the country’s HIV response capacity and pledged to continue supporting Nigeria in scaling up access based on evidence from the initial rollout.
