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TRANSCRIPT
On
the
outskirts
of
Zimbabwe’s
capital
Harare
are
a
group
of
young
women,
some
of
them
mothers
holding
babies.
Zimbabwe
was
once
ravaged
by
the
HIV
epidemic,
with
tens
of
thousands
of
deaths
over
the
past
two
decades.
It
remains
a
problem
–
especially
for
women
–
with
UNAIDS
figures
suggesting
women
and
girls
of
all
ages
accounted
for
63
percent
of
all
new
HIV
infections
in
2024.
Accordingly,
these
women
have
come
to
a
clinic
to
take
advantage
of
a
donor-supported
rollout
of
a
new
HIV
prevention
drug
called
lenacapavir,
among
them
sex
worker
Constance
Mukoloka.
“I
work
in
beer
halls
looking
for
clients.
Sometimes
I
would
get
drunk
and
forget
to
take
my
drugs.
Sometimes
I
would
work
all
night
and
not
have
time
to
take
tablets
but
with
this
vaccine
even
if
I
get
drunk,
I
know
I’m
safe.”
The
introduction
of
lenacapavir
is
happening
in
10
African
countries.
Developed
by
California-based
Gilead
Sciences,
lenacapavir’s
introduction
in
selected
high-risk
countries
is
being
supported
through
the
United
States
President’s
Emergency
Plan
for
AIDS
Relief,
or
PEPFAR,
in
partnership
with
the
Global
Fund.
Zimbabwe
is
one
of
the
first
countries
to
implement
the
roll
out.
Authorities
say
about
46,000
people
across
24
sites
are
expected
to
benefit
in
the
early
phase
of
the
rollout,
a
fraction
of
potential
demand
in
a
country
of
roughly
15
million.
Dr
Ernest
Chikwati
is
the
program
director
at
Aids
Healthcare
Foundation,
and
says
the
drug
only
needs
to
be
taken
twice
a
year.
“When
someone’s
taking
medicines
every
day,
they
tend
to
forget.
But
when
someone
is
injected
6
months,
it’s
very
unlikely
that
they’ll
forget
to
take
their
medicine.
So
Lenacapvir
is
coming
as
an
addition
to
all
the
pre-exposure
prophylaxis
methods.”
The
doctor
says
clinical
studies
have
demonstrated
near-total
protection,
and
accordingly
the
drug
has
been
described
by
some
health
officials
as
a
turning
point
for
high-risk
groups
that
could
slow
the
rate
of
new
infections.
But
he
is
also
advising
caution.
Daily
oral
PrEP
has
long
been
available
in
Zimbabwe
alongside
condoms,
vaginal
rings
and
shorter-acting
injectables,
yet
adherence
has
remained
a
challenge,
particularly
for
people
facing
stigma
or
unpredictable
schedules.
He
says
that
this
suggests
turning
scientific
promise
into
broad
impact
will
require
overcoming
funding
constraints,
infrastructure
gaps
and
the
challenge
of
keeping
patients
engaged.
“Let’s
not
say
this
is
the
silver
bullet
for
HIV
prevention.
There
are
other
methods.
Condoms
remain
key
for
us
as
an
organization,
we’ve
got
two
condom
brands
we
give
freely
in
the
public
sector.
We
also
feel
funding
should
be
given
to
condoms
as
well.
Condoms,
why?
Because
they
are
very
cheap.”
Zimbabwe,
Eswatini
and
Zambia,
once
global
HIV
epicentres,
have
emerged
in
recent
years
as
among
the
world’s
most
successful
models
in
controlling
the
epidemic,
achieving
World
Health
Organisation
testing,
treatment
and
viral
suppression
targets.
The
injection
of
the
new
drug
is
offered
for
free
to
high-risk
people
such
as
sex
workers,
adolescent
girls
and
young
women,
gay
men
and
pregnant
and
breastfeeding
women.
Yet
despite
these
gains,
new
infections
remain
a
concern.
Cesar
Nunez
is
the
director
of
the
UNAIDS
New
York
Office.
“The
HIV
epidemic
is
not
over,
and
our
previous
progress
is
at
risk.”
Just
how
tenuous
the
position
remains
is
laid
bare
by
the
numbers
in
sub-Saharan
Africa.
HIV
prevalence
among
adolescent
girls
and
young
women
aged
10-24
is
persistently
triple
that
of
their
male
counterparts
in
sub-Saharan
Africa,
driven
by
gender
inequality,
poverty
and
uneven
access
to
health
services.
Cesar
Nunez
has
outlined
how
a
lack
of
funding
is
contributing
to
these
numbers.
“Most
of
the
community
response
has
depended
on
foreign
assistance
and
that
has
currently
been
impacted.
Some
national
AIDS
commissions
in
African
countries
have
had
to
invite
or
provide
office
space
to
organisations
that
have
been
left
without
that
kind
of
funding.
And
UNAIDs
anticipates
that
the
impact
of
these
fundings
will
represent
1.4
million
annual
new
infections
by
2030.”
Details
for
the
next
phase
of
the
rollout
in
Zimbabwe
remains
unclear.
The
government
says
it
hopes
the
number
of
beneficiaries
will
increase
as
more
donor-funded
doses
arrive,
and
it
also
hopes
to
acquire
its
own
doses
for
a
mass
rollout
but,
like
many
other
African
governments,
lacks
enough
money.
Overall,
health
officials
and
advocates
in
Zimbabwe
hope
the
drug
will
reshape
HIV
prevention
strategies
if
governments
can
navigate
barriers
of
cost
and
fragile
health
systems.
Meanwhile
for
Ms
Mukoloka,
the
drug
represents
more
than
convenience.
“I
am
safe,
I
can
work
with
confidence
now.
When
we
took
tablets,
customers
would
see
a
container
of
pills
and
leave,
they
would
never
return
due
to
fear.
They
couldn’t
tell
the
difference
between
PrEP
and
treatment
drugs.
With
the
work
we
do,
that
stigma
costs
you
money.”