Uganda is set to receive nearly 20,000 additional doses of a long-acting injectable drug that protects against HIV, as health authorities scramble to meet demand that has already exhausted stocks at clinics across the country.
The shipment of 19,200 doses of lenacapavir – a twice-yearly injection that has been described as a breakthrough in HIV prevention – is expected to arrive next month, funded by the Global Fund.
“This is a continuation batch to cover the second dose of the individuals who have received their first injection,” said Dr Herbert Kadama, the pre-exposure prophylaxis (PrEP) coordinator at Uganda’s Ministry of Health, in comments to New Vision.
The drug, administered as a small injection under the skin that slowly releases medication into the body for months at a time, is being hailed by health workers as a potential turning point for a country still recording tens of thousands of new HIV infections each year.
But the rollout, launched in April at Lira Regional Referral Hospital, has run into a familiar problem: not enough supply to match demand.
A drug in high demand, in short supply
Since the national launch, 103 public health facilities have begun offering the injectable. By the end of next year, that number is expected to rise to 300, according to Dr Kadama.
At several of those facilities, doses have run out within weeks of arriving.
Lule Mugagga, who led the clinical study that paved the way for the national rollout, said Mbarara had received just 40 doses in its first batch, which was used up almost immediately. A further 80 doses have since arrived, but officials say they are still struggling to keep pace.
In Fort Portal, Titus Tumwine, who runs Bukuku Health Centre IV, said his facility exhausted its first delivery within a week and was still waiting for new stock.
At Mbarara Hospital, HIV focal person Dorcas Twinabaitu described a similar scramble: 40 doses delivered in early May were gone before the month was out, prompting a request for 60 more. The facility had distributed 100 doses by early June, she said, with patients regularly asking if any were left.
At Lira Regional Referral Hospital, where the drug was first introduced, administrator Peter Odeke said the hospital received 80 doses on 17 April but no further deliveries that month. By early June, only a handful remained.
To stretch limited supplies, some facilities have prioritised pregnant and breastfeeding women, in an effort to prevent mother-to-child transmission of the virus.
The scale of the crisis
The shortages come as Uganda continues to battle a significant HIV burden. National prevalence stands at 4.9 percent, according to 2025 government estimates, with 37,000 new infections recorded in 2024 alone – or roughly 711 people newly infected every week, about five every hour.
Adolescent girls and young women aged 15 to 24 bore a disproportionate share of those infections, accounting for 14,000 cases. Within that group, adolescent girls alone made up 11,000 infections, nearly four times the 3,000 recorded among young men of the same age.
Geographically, Fort Portal city recorded the country’s highest HIV prevalence at 14.3 percent, followed by Soroti city at 11.6 percent and Mbarara city at 9.9 percent.
The toll has also been measured in lives lost: Uganda recorded 20,000 HIV-related deaths last year, an average of 54 people dying each day. Of the estimated 1.5 million people living with HIV in the country, only 1.3 million are currently receiving treatment.
Who is benefiting
Health officials say the injectable is being targeted at those considered most at risk, including adolescent girls and young women, pregnant and breastfeeding mothers, sex workers and their clients, fishing communities, long-distance truck drivers, and people with multiple sexual partners. The drug is provided free of charge; recipients only need to cover the cost of transport to reach a facility.
Dr Flavia Matovu Kiweewa, who led the Ugandan arm of the trial that tested the drug’s safety and effectiveness, said pregnant and breastfeeding women face heightened vulnerability to HIV due to hormonal changes during pregnancy that increase susceptibility to infection. But protecting mothers, she said, carries benefits beyond the individual.
“If you prevent one HIV infection in a baby, then you save the nation lots of resources. If you protect the women, their partners are safeguarded as well,” she said.
Uptake among men has been particularly strong, according to health workers, in part because the drug requires no daily routine and minimal contact with health services once administered – a significant advantage in a context where men are often harder to reach with health messaging due to economic and social pressures.
Odeke said most requests for the injectable came from men, while women in low-income and rural settings often struggled to access the facility or lacked timely health information, leaving them more reliant on other prevention approaches such as abstinence or mutual faithfulness.
A personal journey through prevention options
For Saidi Katende, a peer coordinator working with the Most At Risk Populations Initiative across Kampala, Mukono and Wakiso districts, lenacapavir is the latest chapter in a years-long effort to protect himself from HIV.
“It is now two months since I received my first injection. I have not experienced any side effects,” Katende said.
He had previously used daily oral PrEP pills before switching to cabotegravir, an injectable taken every two months, through participation in clinical trials. The move to lenacapavir, he said, offers a longer-acting option requiring far fewer injections each year.
Katende is now encouraging others he considers at risk – including sex workers and truck drivers – to consider the drug, urging people to trust health workers’ assessments of individual risk. “If a person feels at risk of contracting HIV, they can walk in and get the injection in line with the screening guidelines,” he said.
No single solution
Despite the optimism surrounding lenacapavir, officials caution against viewing it as a cure-all. Dr Vincent Bagambe, senior manager for policy planning and strategic information at the Uganda AIDS Commission, said the injectable “will not be a magic bullet” in efforts to curb new infections.
He said those unable to access the drug should continue relying on other proven prevention methods, including condom use, abstinence and faithfulness within relationships – a reminder that, even as new tools emerge, Uganda’s fight against HIV will likely depend on a combination of strategies rather than any single intervention.
Lenacapavir belongs to a newer class of drugs known as capsid inhibitors, which work by disrupting the protein shell that protects HIV’s genetic material, preventing the virus from replicating. It has already been rolled out in several other African countries, including Eswatini, Kenya, Lesotho, Mozambique, Nigeria, Zambia and Zimbabwe.
