Uganda rolls out HIV prevention jabs

The ministry of Health has announced the administration of the first dose of Cabotegravir (Cab-LA) as part of Uganda’s rollout of new HIV prevention strategies.

Dr Herbert Kadama, the ministry's Pre-Exposure Prophylaxis (PrEP) coordinator, shared that the first recipient, a walk-in patient, received the injection at a health facility in Mbarara, a region currently grappling with rising HIV infection rates.

While Kadama did not provide specific details about the patient, he confirmed that the drug is available to anyone at risk of contracting HIV. Cabotegravir is administered in two initial doses, spaced four weeks apart, followed by maintenance doses every eight weeks. This long-acting injectable offers a promising alternative to daily oral PrEP, making prevention more convenient for those who are at risk.

Despite the promise of Cabotegravir, Uganda currently faces a shortage of doses. Presently, the available doses are largely donations from the US President's Emergency Plan for AIDS Relief (PEPFAR). The ministry expects an additional 3,500 doses, procured by the Global Fund, to arrive by February. At the moment, there are 7,500 doses in stock.

Civil Society Organizations (CSOs) have long advocated for equitable access to PrEP, emphasizing that many developing countries with high HIV burdens find it difficult to afford such preventive measures. In Uganda, the number of people using oral PrEP has risen sharply from just 800 users in 2017 to nearly 700,000 today. However, health workers report that adherence to daily medication is often a challenge, with many users discontinuing use over time.

Initially inaccessible due to high costs, Cabotegravir is now subsidized to about $35 (Shs 130,000) per dose, making it more affordable. Additionally, another preventive drug, Lenacapavir, has shown 100 per cent effectiveness in preventing HIV infection during clinical trials. Lenacapavir, which requires administration only twice a year, could be a game-changer in HIV prevention.

Dr. Flavia Matovu Kiweewa, a senior research scientist at the Makerere University - John Hopkins University Research Collaboration (MUJHU), mentioned that participants in the Lenacapavir clinical trials in Uganda, conducted in Mityana, Kalangala, and Masaka, will continue receiving the drug until it becomes available in public health facilities.