Dar es Salaam. The introduction of the injectable drug Lenacapavir, alongside major reforms in the health service delivery system, marks a new phase in Tanzania’s fight against HIV, with the government also planning to phase out specialised Care and Treatment Clinics (CTCs) to reduce stigma and improve access to services.
The government has begun preparations to introduce Lenacapavir, a long-acting injectable medicine expected to serve as an alternative to antiretroviral drugs (ARVs) for some patients, particularly those who struggle with daily medication or have developed resistance to existing treatment.
Unlike most ARVs, which must be taken every day, Lenacapavir is administered as an injection twice a year, a development expected to improve adherence and reduce the risk of patients missing doses.
Speaking in an interview in Dodoma, Chief Government Pharmacist Daudi Msasi said the drug will mainly be used for patients who have developed resistance to other ARVs, those who fail to follow daily treatment schedules, and people at high risk of infection who require preventive treatment (PrEP).
“This is a major transformation. We are talking about a person receiving one injection that protects or treats them for six months. This completely changes the approach to HIV treatment,” said Mr Msasi.
He said the drug showed high effectiveness in early trials, including studies conducted in Uganda in 2025, and has already been approved internationally by the World Health Organisation (WHO).
Through the Tanzania Medicines and Medical Devices Authority (TMDA), the drug has been officially registered in the country, allowing importation once other procedures are completed.
“At present, anyone with the capacity to import the drug can do so by following the required procedures, but the government is going further to ensure it becomes part of the national health service system,” he said.
Mr Msasi added that national treatment guidelines have already been updated and are expected to be signed before June this year, after which Lenacapavir will be formally included in HIV treatment and prevention services.
How the drug works
HIV cannot survive without entering immune cells known as CD4 cells. Lenacapavir belongs to a group of medicines called capsid inhibitors, which block the virus from attaching to and entering these cells, preventing it from multiplying.
For prevention, a person receives two injections every six months. Because the medicine is released slowly, the first dose must be supported by a short course of tablets to ensure full protection within the first few days.
Minor side effects include pain, redness or swelling at the injection site, as well as small skin nodules in some cases.
Mr Msasi said the drug can be used both as prevention for people at high risk and as treatment for patients who have developed resistance to other medicines.
“Even if the virus enters the body, the drug prevents it from multiplying. It is not a cure, but it allows patients to live long and healthy lives,” he said.
Talks on government supply system
Despite registration, the government is still in discussions to include Lenacapavir in the national supply chain, as Tanzania continues to rely heavily on donor funding for HIV medicines through the Global Fund.
Mr Msasi said the drug is expected to be considered under the next funding cycle, known as GC8.
“We believe these discussions will allow Lenacapavir to be included as part of HIV prevention medicines, as recommended by WHO,” he said.
End of specialised HIV clinics
In another major reform, the government plans to abolish the system of separate CTC clinics, which were created specifically for HIV services.
Under the new approach, all patients will receive treatment within the general hospital system.
“There will no longer be a special section for HIV patients. A patient with malaria, pneumonia or HIV will be treated in the same place by the same doctor,” said Mr Msasi.
He added that medicines will also be dispensed from the same pharmacy windows, a move aimed at reducing stigma that has discouraged some people from seeking treatment.
According to him, the reforms, together with the introduction of long-acting medicines, are expected to improve adherence and reduce drug resistance.
“The fewer times a patient needs to take medicine, the better the adherence. This will also reduce resistance because patients will not miss doses frequently,” he said.
The government is also continuing public education campaigns to reduce stigma, which remains one of the biggest barriers to treatment and prevention.
Cost still a challenge
Chairperson of the Association of Private Health Facilities in Tanzania (APHFTA), Dr Egina Makwabe, welcomed the introduction of Lenacapavir but warned that its high cost could limit access.
He said the medicine is estimated to cost between Sh40 million and Sh50 million for six months of treatment per patient, making it unaffordable for many people.
Dr Makwabe urged the government to explore ways of reducing the price so that more Tanzanians, especially those in high-risk groups, can benefit.
He said private health providers have been encouraged to begin the process of importing the medicine while following all regulations set by TMDA, including registration, quality testing and inspection of manufacturing plants.
“We commend the government for allowing this medicine to enter the country, but its use must strictly follow guidelines to avoid misuse that could lead to drug resistance,” he said.
