Existing Users Prioritised as Uganda Manages Limited Lenacapavir Stock

Uganda is prioritising people already receiving Lenacapavir as it manages limited supplies of the six-monthly HIV prevention injection.

Dr Flavia Matovu Kiweewa of the Makerere University-Johns Hopkins University Research Collaboration (MU-JHU) says some of the 103 facilities providing the drug can go for one or two weeks without stock.

“Stock is short, maybe a week or two you go there and it is not there,” Matovu said.

Uganda has received 36,000 doses through the Global Fund, including 19,200 doses delivered in March and another consignment of about 15,000 doses recently.

However, the latest stock is being divided between people who have already started Lenacapavir and new users, with about 7,000 doses expected to support new initiations.

“When we say we are not initiating new people, we don’t mean we don’t have LEN. It is there, but it is reserved for those who have already started,” she said.

Matovu says the priority is to ensure that people already on the programme receive their next injection on time, since protection depends on returning every six months.

“Once you go to LEN, Ministry is obliged to ensure you continue. No one should get then stock out,” she said.

The situation comes as Uganda prepares to expand Lenacapavir access from the current 103 facilities to about 300 by the end of the year. The Ministry of Health has previously said the expansion is intended to bring the drug closer to people at substantial risk of HIV infection.

Lenacapavir is a long-acting form of pre-exposure prophylaxis, or PrEP, administered beneath the skin every six months. It provides an alternative to daily oral PrEP, particularly for people who struggle to consistently take tablets.

“We need interventions that are more convenient,” Matovu said.

The injection was tested in the PURPOSE-1 study among adolescent girls and young women aged 16 to 25 in Uganda and South Africa. In Uganda, the study was conducted at MU-JHU, AMBSO Masaka and a Makerere University site in Kalangala.

The study recorded no HIV infections among participants receiving Lenacapavir, while five infections occurred among women assigned to the oral PrEP groups, with researchers linking the difference largely to adherence to daily tablets.

Unlike a vaccine, Lenacapavir does not provide permanent protection. Users must return for another injection after six months, with a two-week window before or after their scheduled appointment.

The medicine has also moved rapidly through the regulatory process. Results from PURPOSE-1 were available in June 2024, the US Food and Drug Administration approved Lenacapavir in 2025, and Uganda’s National Drug Authority registered it in January 2026.

The current supply is provided free through the Ministry of Health with support from the Global Fund. Uganda is also awaiting generic versions of Lenacapavir, which are expected to improve availability and reduce the cost.

The manufacturer, Gilead Sciences, has agreements with generic manufacturers to produce the drug, with generic access expected at about 40 US dollars per person per year.

Researchers say the challenge now is to maintain uninterrupted supplies for existing users while expanding access to new users across the country.