Civil society pushes for Lenacapavir rollout to include people who use drugs

Rumbidzayi Zinyuke

Senior Health Reporter

Civil society organisations are pushing for Zimbabwe’s rollout of long-acting HIV prevention drug lenacapavir to include people who use and inject drugs to ensure that no population at heightened risk of HIV infection is left behind.

Zimbabwe began rolling out lenacapavir early this year as part of efforts to expand HIV prevention options, with the initial programme targeting priority populations at substantial risk of HIV infection, including adolescent girls and young women, sex workers and pregnant women, among others.

Zimbabwe Civil Liberties and Drugs Network (ZCLDN) executive director Mr Wilson Box said the rollout of the new HIV prevention technology should be guided by equity and deliberately reach key and vulnerable populations who often face barriers to accessing health services.

He made the remarks during a media advocacy dialogue on equitable access, domestic financing and inclusive rollout of lenacapavir for key and vulnerable populations.

Mr Box said people who use and inject drugs should also be considered as the programme expands, particularly given the growing drug and substance abuse challenge facing the country and the health risks associated with drug use.

“Scientific innovation only becomes a public health success when the people who need it most can actually access it. For key and vulnerable populations, including people who use and inject drugs, sex workers, men who have sex with men, transgender people and other communities that experience barriers to health services, the challenge has never simply been the absence of effective interventions. The challenge too often is whether services are accessible, affordable, acceptable and delivered without discrimination,” he said.

Zimbabwe has been grappling with a growing drug and substance abuse problem, with the Government describing it as a public health and national security concern.

The country’s Multisectoral Drug and Substance Abuse Plan 2024–2030 identifies demand reduction, supply reduction, harm reduction, treatment and rehabilitation, community reintegration, media and communication, legal and policy enforcement, and resource mobilisation as key areas of intervention.

The Government has also stepped up its response through the Zimbabwe National Committee on Drug and Substance Abuse, which coordinates interventions across ministries, law enforcement agencies and other sectors.

Mr Box said these existing efforts should be complemented by ensuring that people who use and inject drugs are not overlooked when new HIV prevention technologies are introduced.

Lenacapavir is regarded as an important development in HIV prevention because its long-acting nature could help overcome some of the adherence challenges associated with daily oral prevention.

He challenged policymakers and stakeholders to consider whether domestic resources would be sufficient to sustain access as donor funding for HIV programmes comes under increasing pressure.

“Will domestic financing be sufficient to sustain access beyond donor-supported programmes?” Mr Box said.

He also called for meaningful participation of affected communities in decisions around the rollout, saying programmes should not simply be designed for communities without their involvement.

Mr Box said domestic financing would be critical to ensuring that innovations such as lenacapavir remain available beyond donor-supported programmes.

He also urged the media to play a greater role in scrutinising financing commitments, implementation plans and the extent to which communities are included in national HIV programmes.

“Equity must be at the centre of the rollout. No person should be excluded because of their identity, occupation, behaviour, social status or circumstances,” he said.

Mr Box said the success of the lenacapavir programme should ultimately be measured not simply by whether the drug was introduced, but by whether those who need it most could access it.

“Our success should be measured by whether those who need it most can access it safely, equitably, affordably, and without stigma or discrimination,” he said.