The International Community of Women Living with HIV Eastern Africa (ICWEA) welcomes Gilead Sciences’ decision to license the production and sale of the generic version of Lenacapavir to six pharmaceutical companies, making it available in 120 low- and middle-income countries. Lenacapavir, a long-acting injectable, has shown high efficacy in preventing HIV infections, particularly among populations most at risk. This move signals a step forward in expanding CHOICES for HIV prevention.
At ICWEA, we celebrate progress in ensuring diverse options for preventing HIV, but we must recognize the gaps and challenges in access to Pre-Exposure Prophylaxis (PrEP). Community-Led Monitoring (CLM) in Uganda findings have consistently shown low uptake of oral PrEP in our region, despite its availability. The evidence reveals several critical barriers: many health facilities are not accredited to offer PrEP, and stigma, discrimination, and gender-based violence remain obstacles to women and young girls accessing HIV services. This has limited access to oral PrEP, leaving many priority populations without the protection they need.
While we applaud the potential of Lenacapavir to revolutionize HIV prevention—particularly with its convenience as a twice-yearly injection—we must also highlight that the issue of CHOICE remains key. HIV prevention should not be one-size-fits-all. We need a broader range of effective, accessible prevention methods. While Lenacapavir represents a significant addition to this toolkit, ICWEA will continue to advocate for accelerated access to other critical options, (especially those discreet for women and girls) such as the Dapivirine Vaginal Ring (DVR) and injectable Cabotegravir (CAB-LA), which have already shown promise in protecting women and girls from HIV.
“Women and girls have long called for more OPTIONS and CHOICES in HIV prevention. The availability of Lenacapavir is a welcome addition, but it must be part of a broader strategy that offers accessible, diverse prevention tools for all. Every woman deserves the right to choose the HIV prevention method that works best for her.”—Lillian Mworeko, Executive Director, ICWEA
Activists have rightly raised concerns about whether Gilead’s voluntary licenses will be sufficient to ensure affordable, widespread access to Lenacapavir. With 1.3 million new HIV infections occurring globally each year—one every 24 seconds—this is no time for complacency. The technology is there, but we must ensure that it reaches everyone, everywhere. Community voices are clear: CHOICE and ACCESS are essential in defeating this pandemic.
The gaps in PrEP access, reflected in low uptake, cannot be ignored. Facilities must be accredited, and investments must be made to reduce structural barriers that prevent priority populations from accessing HIV services. Lenacapavir must be available to all who need it, but it must not come at the expense of failing to accelerate other effective prevention tools. We call on governments, donors, and stakeholders to ensure that women and girls across Eastern Africa can access their prevention method of choice.
As we wait for Lenacapavir to be rolled out, ICWEA remains steadfast in our commitment to advocating for a variety of HIV prevention options that meet the diverse needs of women and girls in our region. We will continue working to ensure that every woman and girl can choose the HIV prevention tool that works best for her, whether it’s oral PrEP, DVR, CAB-LA, or Lenacapavir.
International Community of Women Living with HIV Eastern Africa (ICWEA)
