Rwanda is expressing strong interest in Lenacapavir, a newly approved HIV prevention injection, though its high cost poses a challenge for many low-income countries.
Lenacapavir, developed by U.S. pharmaceutical company Gilead Sciences, is administered only twice a year and offers six months of protection for individuals at risk of HIV. In the U.S., the drug is priced at about $28,218 per person annually.
Despite the steep cost, Rwanda could be among the first nine countries to access the medication by early 2026, according to the Rwandan government and the World Health Organisation (WHO).
Speaking during the International AIDS Society (IAS) Conference held in Kigali last week, Rwanda’s Minister of Health, Dr. Sabin Nsanzimana, confirmed that the country is preparing to adopt long-acting injectable HIV prevention into its national treatment protocols.
“Rwanda is working on integrating long-acting injectable treatment into its national HIV care guidelines, and this will be implemented soon,” Dr. Nsanzimana said.
Janvier Kabogo, a Rwandan pharmacist currently studying at Johns Hopkins University in the U.S., said that although negotiating lower prices for new drugs can be difficult, Rwanda has a good track record of securing fair deals.
“I’m optimistic—it’s more a matter of when rather than if,” he said.
Kabogo cited Rwanda’s quick access to Covid-19 vaccines as an example, and highlighted possible paths to acquiring Lenacapavir affordably. These include leveraging the Global Fund’s agreement with Gilead to supply the drug at a no-profit price to eligible countries like Rwanda, and direct negotiations between Rwanda’s Ministry of Health and Gilead for supply planning and technical support. He also noted that joining international or regional bulk purchasing programs could help bring the price down.
WHO’s Dr. Meg Doherty said last week that nine “early-adopter” countries, including Rwanda, are likely to receive the drug free of charge when distribution begins in early 2026.
Kabogo added that future availability of generic versions of Lenacapavir will further reduce prices, and Rwanda should begin preparing to adopt them once they enter the market.
Public health expert Elvis Benimana stressed the drug’s importance, especially for rural and vulnerable populations in Rwanda, where distance and limited resources often restrict access to daily antiretroviral treatments.
“As a low-income country, Rwanda would benefit from a long-acting injectable like Lenacapavir, which reduces the burden of frequent medication,” he noted.
UNAIDS Executive Director Winnie Byanyima also praised the potential of Lenacapavir, stating that it could become a crucial tool in HIV prevention if priced affordably and widely accessible.
According to the most recent Rwanda Population-based HIV Impact Assessment (2018–2019), HIV prevalence among adults aged 15–64 stands at 3%. However, the rate is notably higher in older age groups, with 7.4% among women aged 50–54 and 6.5% among men aged 55–59. Women overall show higher prevalence (3.7%) compared to men (2.0%).