Justicia Shipena
The cost of a new twice-a-year HIV prevention and treatment injection, Lenacapavir, is too high for immediate rollout in Namibia’s public health system.
Health minister Dr Esperance Luvindao announced this during the World AIDS Day commemoration in Otjiwarongo on Monday, saying the long-acting injectable has the potential to change HIV treatment but remains out of reach for most public patients.
She said the ministry has begun the regulatory approval process so that people who can afford the medication in the private sector may access it sooner.
“Our ultimate goal is equity. No one should be denied the future because of their income,” Luvindao said.
This comes as Namibia was listed in October as one of 120 countries included in Gilead Sciences’ global licensing and access plan for Lenacapavir.
The drug has been approved in the United States and Europe and will be submitted for regulatory approval in 18 priority countries, including Namibia, by the end of 2025. It is part of a wider effort to expand HIV prevention options in countries with high HIV incidence.
The Ministry of Health said two months ago that Namibia has not approved the drug because of its high global price.
At that time, the ministry’s spokesperson, Walters Kamaya, said the medication’s US list price of more than 28 218 dollars, which is about N$528 000 per person per year, is far above what Namibia can sustain.
Research published in The Lancet HIV estimates that a future generic version could cost $35 (about N$655) to $46 (about N$861) per person per year, and as low as $25 (about N$468) with large-scale demand.
Rollout plans for lenacapavir are underway in Kenya, Eswatini, Lesotho, Mozambique, Nigeria, South Africa, Uganda, Zambia and Zimbabwe, with distribution expected to begin in 2026.
Call for equity and storage readiness
VIALWA Foundation founder Lazarus Ndiilenga urged the government to ensure fairness in access.
“One thing that I think the government should consider is the equity in it for everybody, the access to it,” he said.
He added that storage requirements for the long-acting injection must be considered.
“We need to look at the storage versus the cost that it involves. Are health facilities capable of having these drugs?” he asked. He said remote areas must not be left behind.
Ndiilenga also said the ministry must prepare the public through strong awareness campaigns.
He said Namibia should learn from past challenges with misinformation during Covid-19 and the HPV vaccine rollout. “People need to feel safe, and it must be safe for the end user,” he said.
The World Health Organization (WHO) said on Monday that countries must urgently expand access to new HIV prevention tools such as lenacapavir.
WHO said funding cuts to global HIV programmes have disrupted essential services and increased risks for vulnerable groups.
New WHO guidelines released in July recommend lenacapavir as an additional option for HIV prevention.
Namibia has made progress in the HIV response. The country has surpassed the UNAIDS 95 95 95 targets, with 96% of people living with HIV knowing their status, 98% of those diagnosed on treatment and 98% virally suppressed.
Luvindao said Namibia must now reach men, children and adolescents who remain behind.
She also acknowledged that global HIV funding is changing.
She said the government now fully procures antiretroviral medicines and is increasing domestic financing to cover gaps caused by donor reductions.
During the commemoration, Luvindao launched two national documents to strengthen treatment and prevention.
The 2025 ART Guidelines update treatment options, improve care for advanced HIV and link HIV services with care for non-communicable diseases.
The 2025 PMTCT Guidelines support Namibia’s work to eliminate mother-to-child transmission of HIV, syphilis and hepatitis B.
They include PrEP for pregnant women at risk, better viral load monitoring and improved follow-up for infants.
She said these guidelines are a promise to the next generation.
Global HIV burden remains high
United Nations resident coordinator in Namibia Hopolang Phororo said the global HIV response faces a serious funding crisis.
She said 40.8 million people are living with HIV globally and 9.2 million still do not have access to treatment.
According to data, Namibia recorded 4 500 new infections last year and 3 200 AIDS-related deaths.
Of the new infections, 24% were among young people aged 15 to 24.
Phororo warned that global gains are fragile.
“Historic declines in donor funding have severely disrupted HIV services,” she said.
Phororo added that community-led services are under pressure and must be protected. Phororo said Namibia’s pilot of social contracting is one way the country is working to sustain essential HIV, TB and malaria services.
World AIDS Day is observed annually on 1 December and is dedicated to raising awareness about HIV and the impact of AIDS worldwide.
This year’s theme was “Overcoming disruption, transforming the AIDS response.”
