The World Health Organisation (WHO) has officially recommended injectable lenacapavir (LEN) as a new pre-exposure prophylaxis (PrEP) option, marking a historic milestone in global HIV prevention. Announced at the 13th International AIDS Society Conference in Kigali, Rwanda, LEN is the first PrEP drug requiring only two injections per year, offering a long-acting and highly effective alternative to daily oral pills. This innovation is particularly valuable for individuals facing challenges with daily adherence, stigma, or limited healthcare access.
The new recommendation comes against the backdrop of 1.3 million new HIV infections recorded globally in 2024, disproportionately affecting sex workers, men who have sex with men, transgender people, adolescents, and people who inject drugs. By introducing LEN, WHO aims to expand prevention choices and make HIV protection more accessible. To ease rollout, WHO also endorsed simplified HIV testing using rapid tests, enabling broader delivery of long-acting PrEP through pharmacies, clinics, and telehealth platforms.
Beyond LEN, WHO updated its treatment guidelines to recommend long-acting injectable cabotegravir and rilpivirine (CAB/RPV) for people living with HIV who have achieved viral suppression on oral therapy. This approach provides flexibility for individuals struggling with adherence. Additional service delivery recommendations encourage integration of HIV care with management of noncommunicable diseases such as hypertension, diabetes, and mental health. Updated STI guidelines also call for routine screening of gonorrhoea and chlamydia among key populations, while advising rapid initiation of antiretroviral therapy for people with both HIV and mpox.
With 40.8 million people living with HIV and 630,000 related deaths in 2024, WHO emphasized that the global fight against HIV remains urgent. The organisation is urging governments, donors, and partners to integrate LEN into national programmes while scaling up data collection on its uptake and effectiveness. Coupled with operational guidance on sustaining HIV programmes amid funding challenges, WHO’s roadmap highlights the need for bold implementation to translate scientific advances into lasting public health gains.
