Starting in September 2024, Uganda will roll out injectable Pre-Exposure Prophylaxis (PrEP), marking a significant milestone in the nation’s ongoing battle against HIV.
This innovative approach will be introduced at select health facilities, offering a powerful alternative to daily oral PrEP, with the potential to greatly enhance HIV prevention efforts across the country.
In a statement issued on Thursday by Dr. Diana Atwiine, the Permanent Secretary of the Ministry of Health, she emphasized the importance of this development: “Globally, there are significant advancements in HIV prevention that promise to strengthen the fight against the epidemic. The Ministry of Health is committed to bringing these innovations to the country as part of our ongoing National HIV Combination Prevention Strategy. These developments are crucial as we strive to end AIDS as a public health threat by 2030.”
She noted that Uganda has made commendable progress in reducing the spread of HIV, but the challenge remains significant. The HIV prevalence among adults aged 15-49 years is currently 5.5 percent, with an estimated 38,000 new infections reported in 2023, according to UNAIDS. To combat these numbers, the Ministry of Health has prioritized the introduction of more effective prevention strategies, such as injectable PrEP.
One of the most promising new PrEP products is Lenacapavir, an injectable option currently under review. According to Dr Atwine, Lenacapavir has shown tremendous potential, particularly in the Gilead Sciences’ PURPOSE 1 trial, which involved over 5,000 participants from Uganda and South Africa. The trial demonstrated that injectable Lenacapavir was 100 percent effective in preventing HIV transmission among women and adolescent girls.
Dr. Atwiine also highlighted the significance of this breakthrough: “Once approved, Lenacapavir will be a game-changer, reducing the burden of daily pills, minimizing stigma, and easing the pressure on our healthcare systems. However, it will take time before Lenacapavir is widely available in Uganda. In the meantime, we continue to provide oral PrEP to people at significant risk of HIV infection.”
Currently, oral PrEP is available to over 700,000 individuals across 635 health facilities in Uganda. In addition to this, the Ministry has introduced the dapivirine vaginal ring, a flexible, long-acting device that offers month-long protection against HIV during vaginal sex. The PrEP ring is accessible at seven public health facilities, including Mbarara Municipal Health Centre IV and Gulu Regional Referral Hospital, with plans to expand its availability by the end of August 2024.
Dr. Atwiine also noted the upcoming introduction of another injectable PrEP option, cabotegravir (CAB-LA), which is set to be rolled out by September 2024. “Uganda is in the final stages of introducing the 2-monthly injectable cabotegravir (CAB-LA/ CAB PrEP) in the same facilities offering the PrEP ring. By the end of September 2024, CAB-LA will be available in seven PEPFAR/USAID-supported facilities, and by February 2025, four more facilities will begin offering CAB-LA, with support from Global Fund.”
The rollout of injectable PrEP, including both Lenacapavir and CAB-LA, is a testament to Uganda’s commitment to staying at the forefront of HIV prevention. The Ministry of Health remains dedicated to expanding access to these products, particularly for marginalized populations, ensuring that everyone who needs protection from HIV can access it.
As Dr. Atwiine stated, “We are committed to expanding access to these HIV prevention products, particularly for marginalized populations, ensuring that everyone who needs protection from HIV can access it, and ending HIV as a public health threat by the year 2030.”
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