A PUBLIC health physician has outlined the conditions under which Lenacapavir, a new HIV drug, could be expanded beyond its current pilot states, saying scale-up will depend on uptake, programme performance and future procurement under upcoming funding cycles.
“The mechanisms to ensure equity and transparency… are assured through standard eligibility criteria, risk assessment and clinical screening, availability across designated facilities, and transparent communication on service locations,” said Dr. Adebayo Opeyemi, Senior Program Manager at the Institute of Human Virology Nigeria and HIV Programme Lead for the Global Fund GC7 Nigeria TB-HIV Reach Integration and Impact Project.
He disclosed that current supplies are limited to pilot-phase quantities, meaning access cannot yet meet potential demand nationwide. “The quantity of the products that have been brought into the country may not be enough to serve everyone,” Opeyemi said. “But there will be no preferential services… there is product traceability across the various chains of command – from the national warehouse in Lagos to the last-mile delivery at facilities.”
According to him, tracking systems have been put in place to ensure accountability and prevent diversion as the product moves through the supply chain. He added that some facilities may introduce enrolment caps within specific timeframes due to supply constraints. “This is a pilot,” he said, noting that implementation is still being tested and refined.
Opeyemi said preparations for the next funding phase are already underway, with Nigeria currently in the Global Fund’s seventh grant cycle and transitioning to the eighth. “The outcome of these current pilots is going to significantly inform the quantities of the products that will be brought into the new grant,” he said, adding that a combination of donor funding and possible government procurement could support broader national expansion.
He also projected shifts in user preference as more prevention options become available. “One of the things we will likely see… is people switching from one type of prevention service to another,” he said. “Some who are on oral medication may move to injectables, and some may switch back.”
The rollout is currently limited to eight states, with IHVN directly implementing in Anambra, Ebonyi, Gombe and Kwara. “It is not taken to scale immediately,” Opeyemi said. “With increased acceptance and experience in the field, we can then expand access to other Nigerians in need.”
With the strong progress Nigeria is making toward epidemic control, the rollout of Lenacapavir will contribute by expanding prevention choices, improving adherence for some populations, and increasing coverage among those at highest risk, he said, emphasizing that the drug is part of a broader prevention strategy. “Lenacapavir will not replace existing methods but will strengthen the prevention toolbox, which is critical to reducing new infections.”
According to Dr. Opeyemi, the introduction of the drug marks a significant step forward in giving individuals more control over their health. “People across different high-risk groups will be able to make informed choices to remain HIV-negative. Those on prevention are protecting themselves – whether from known HIV-positive partners or partners whose status they may not know,” he said, adding that “persons who are on treatment and achieve viral suppression are able to take charge of their health and avoid putting others at risk.”
Dr. Opeyemi highlighted that Lenacapavir’s six-month dosing schedule addresses a longstanding challenge with daily medication. “Pill burden has always been an issue,” he said, drawing a comparison with family planning. “There is no single magic option – some people prefer daily pills, others injections, and some long-term methods. HIV prevention is evolving in the same way.”
While longer-acting solutions, including vaccines, remain a future goal, he described Lenacapavir as the most advanced option currently available. “With these expanded options and continued collaboration among stakeholders, we are on the right track to ending HIV by 2030,” Dr. Opeyemi added.
