“OPINION” The HIV Free Injectable Drug for Uganda, A true implications of free things are very expensive

On April 17, 2026, the Government of Uganda officially launched Lenacapavir, a revolutionary long-acting injectable drug for HIV pre-exposure prophylaxis (PrEP), to prevent HIV infection. With a 99% effectiveness in trials, this injection is being rolled out to high-risk groups to enhance the fight against new HIV infections. 

The introduction of Lenacapavir has prompted discussions regarding its impact on sexual behavior. Public health officials, have actively addressed these concerns to ensure the drug is used correctly to achieve its purpose. During the rollout in Lira City in April, 2026, Health Minister Dr. Jane Ruth Aceng cautioned the public against misconceptions saying Lenacapavir is a Pre-Exposure Prophylaxis injection and not a vaccine.

The Minister also emphasized that the twice a year injectable drug does not protect against other sexually transmitted infections such as syphilis, gonorrhea, chlamydia, trichomoniasis, herpes simplex virus, Hepatitis B, and human papillomavirus among others. It is designed to expand the HIV prevention toolbox “rather than replace existing methods”. 

Upon launching the drug, an HIV positive friend asked me to help him secure the “wonder” injectable drug. His argument was that he was tired of the daily pills that had pushed him into a state of depression. However, when I consulted, I was told that the injectable drug is a preventive measure and not an alternative HIV drug.

The next question from him was whether the drug capable of preventing HIV infection can also cure it if taken in the right quantities. Guess the makers of the Lenacapavir drug only intended it for prevention. It is hoped that once injected, Lenacapavir will help the body’s immune system to fight off the HIV virus. Once you are already sick, the drug is useless because the immune system would have been compromised.

Please note that in developed countries like the United States of America, their equivalent of Lenacapavir is called Sunlenca. It was approved for treatment of multi-drug-resistant HIV-1 in 2022 and subsequently for HIV pre-exposure prophylaxis in 2025. Do these two drugs serve the same purpose, do they have same components, why market it in African under a different brand name, what is the difference between the two drugs?

The truth is that Uganda being what it is, there is a very high likelihood that some HIV positive patients may take the injection thinking it will cure the disease. Others may take the injection out of ignorance although I believe the injection will be given after a testing. All in all, there may be a need to sensitize the public of the dangers of taking this injection whether one is living positively or negatively.

The injection is typically administered in the abdomen or thigh, offering a convenient alternative to daily pills. We are told the drug is available at regional referral hospitals and selected high-volume health acidities targeting high-risk groups, including adolescent girls, young women, and discordant couples.

Through partnerships with PEPFAR and the Global Fund, the drug is being provided free of charge to beneficiaries. It is said that trials in Uganda and South Africa demonstrated over 99% effectiveness in preventing HIV acquisition among women. This therefore means that Lenacapavir is seen as a key tool to reduce Uganda’s approximately 37,000 new annual HIV infections that have been reported in the recent years.

I will not question whether or not the Ministry of Health is phasing out the ;ABC strategy of abstinence, Be Faithful, and use Condoms but maybe it has outlived its purpose. There is no doubt that the ABC strategy was more associated with behavior and has been praised as having helped in the reduction of new HIV infections. So, what shortcomings did ABC encounter for health experts to find an alternative strategy?

Why does Gilead Sciences, an American based biopharmaceutical company believe Lenacapavir drug is the best deal moving forward. What has prompted them to consider giving out free Lenacapavir drug to Uganda. Is this gesture being done out of love for Uganda or there is a sinister motive behind their “big heart”

Why do I think that the introduction of this injectable drug will create a fertile ground for HIV negative people to get involved with those who are already infected, are they not promoting promiscuity in the long run? Promiscuity refers to engaging in frequent, casual sexual activity with multiple partners often characterized by a lack of selectivity.

Where did the Global Fund, Gilead Sciences and PEPFAR get the love for us aware that Trump had frozen aid to Uganda. The late Idd Amin once remarked that he was tired of free items donated to Uganda as he did not believe the offers were in good faith. His view was that free things come with conditions and are very expensive in the long run.

I can’t agree more, it is not possible that a country advocating for small populations is the same country providing drugs to increase our life span. Why hasn’t Gilead Sciences in partnership with PAPFAR and Global Fund come up with a drug that stops an infected person from infecting those who are negative instead of making injectable drugs to help HIV negative persons from catching the disease from an HIV positive patient?

My lay man’s thinking is that health expert should have come up with a 20-year plan and to manufacture drugs that keep the HIV positive persons positive but unable to infect those who are negative. as time goes by, they wait for that generation to be wiped out and in so doing HIV will be wiped out with time and by default. Why do I feel that we could end up creating a problem in an attempt to solve one. Why is the innovation targeting women and adolescent girls, why is Lenacapavir not a vaccine yet it serves the same purpose as a vaccine, if it is not a vaccine, then what is it, how do we know? Already, the initial consignment of 19,200 doses of the drug are due for distribution.

Finally, who will take the bullet in case an HIV negative person gets infected after taking the injection as prescribed? Is the government of Uganda ready to take the blame over the use of a drug the Government of Uganda did not manufacture or there is a disclaimer to sign before taking the injection. Who will take the blame in case of side effects?

Wadada Rogers is a commentator on political, legal and social issues.

wadroger@yahoo.ca