Panic as HIV Prevention Drug Runs Out In Four States

By Opeyemi Adelakun

Nigeria’s six-monthly injectable HIV prevention drug, Lenacapavir, is facing supply shortages in some states as growing demand, particularly among sex workers, puts pressure on the Federal Government’s pilot programme.

Benue, Kwara, Gombe and Cross River states have recorded stock-outs barely months after the rollout of the drug.

The shortages have occurred alongside a different situation in Lagos, where health officials said adequate doses were available but uptake among eligible residents remained low.

Lenacapavir is a long-acting HIV pre-exposure prophylaxis drug developed by Gilead Sciences for eligible HIV-negative people. Unlike daily oral PrEP, the injection is administered once every six months.

The World Health Organisation endorsed the drug as an additional HIV prevention option in July 2025.

The Federal Government received 11,520 doses of the drug on March 19, 2026, and distributed them five days later to 10 pilot locations across the country.

The states and the Federal Capital Territory selected for the initial rollout were Benue, Kwara, Akwa Ibom, Cross River, Gombe, Anambra, Ebonyi, Kano, Lagos and the FCT.

In Benue, the state Commissioner for Health and Human Services, Dr Paul Ogwuche, said more than 2,000 HIV-negative people had received Lenacapavir since its introduction in May.

“Benue State has recorded strong early uptake of Lenacapavir. Since its introduction in May 2026, more than 2,000 HIV-negative persons have received the injection through the state’s HIV-prevention programme,” Ogwuche said.

He said the initial allocation had now been exhausted.

“The initial allocation has been exhausted at the participating health facilities, and the commodity is currently out of stock at the service-delivery level,” he said.

Ogwuche, however, said the shortage was temporary.

“However, this is a temporary stock situation, not a discontinuation of the programme. The Federal Government is already processing additional supplies, while the State Ministry of Health is working with the relevant national programme and partners to facilitate replenishment and minimise any interruption in access,” he added.

The commissioner also disclosed that some beneficiaries had reported mostly mild side effects.

“As with any medicine, Lenacapavir can have side effects. Some clients have reported mostly mild side effects, which are being monitored through the programme’s clinical and pharmacovigilance mechanisms,” he said.

“Clients are counselled before receiving the injection and advised to report anything unusual or concerning symptoms to their healthcare providers.”

Kwara has similarly exhausted its initial allocation.

The state AIDS Programme Coordinator, Muhammed Rasheed, said more than 800 doses had been administered before the supply ran out.

“Above 800 doses received in the initial phase were exhausted about two weeks ago,” Rasheed said.

“People are responding so well to the doses. We are going to extend the doses to more facilities as more comes into the state.”

He said more than 1,000 additional doses were expected, while only eligible HIV-negative people were being allowed to receive the injection after screening.

At Sobi Specialist Hospital, Ilorin, an official identified as Madam Sambo confirmed the shortage.

“Although we have run out of stock for a while now, we can’t tell you more than that. You will need to bring a letter from the ministry to be able to obtain any information from us,” she said.

NACA’s Zonal Coordinator for the North-East, Dr John Tobias, confirmed that Gombe had also experienced a stock-out but stressed that the situation did not amount to a nationwide shortage.

Tobias said the pilot was designed to allow authorities to identify and address challenges before expanding the programme nationwide.

“These states started with Lenacapavir as pilots. It is yet to be rolled out as a national programme for the entire country. It is a learning process to be able to see how we can build capacity around healthcare workers, storage, people understanding the prevention commodity, picking it up and all of that,” he said.

According to him, logistics remained a major challenge in moving health commodities from the national pool to states.

“There are instances, like in condoms, for example, where we could have condoms in Lagos, but the logistics to move those condoms to the states can be a challenge, and this has to do much with some funding issues,” Tobias said.

He also linked the problem to cuts in programme funding.

“Global Fund has been funding most of these interventions. The problem we currently have is that as of the first quarter of this year, there has been a lot of cutting down of programme costs. And that has affected a lot of interventions, and Lenacapavir won’t be out of it,” he said.

In Cross River, the shortage has emerged as demand increased, particularly among sex workers.

A health worker at the University of Calabar Teaching Hospital said the facility initially recorded low uptake before increased counselling generated stronger demand.

“We received limited doses at the beginning. Uptake was slow in the first month, but after intensive counselling, demand increased. As we speak, we have people on our waiting list,” the health worker said.

Another health worker at the Infectious Disease Unit of General Hospital, Calabar, said sex workers were increasingly asking for the injection as an alternative to daily oral PrEP.

“People now come to ask for the injection instead of the daily oral PrEP. It is more discreet and convenient, especially for sex workers. But we have to tell them to continue with oral PrEP pending when new supply comes,” the official said.

The initial allocations at the University of Calabar Teaching Hospital and General Hospital, Calabar, were said to have run low since late August.

In contrast, Lagos officials said the state had enough doses but was experiencing low uptake.

An official of the Lagos State Ministry of Health’s HIV Unit said more awareness was needed to encourage eligible residents to use the drug.

“We have more than enough doses to the point that we are begging people to come and take it. We don’t have any problem with consignment. We have enough. We are the ones begging people to come for it. We just need more awareness; we don’t have enough people coming out,” the official said.

The official said the ministry was using its social media platforms to publicise the programme.

In Anambra, the initial allocation had also been exhausted before a fresh batch arrived.

An official of one of the NGOs involved in the programme said demand remained strong.

“People are coming for the drug. The doses were exhausted before, but we got a supply last week. We have four centres, which are the teaching hospitals, two in Awka and two in Oba and Nnewi,” the official said.

The official added that some beneficiaries preferred Key Population centres because they could receive the drug free of charge.

“People prefer to go to the KP (Key Population) side because the drug is actually free of charge there. You don’t have to pay for a card, as opposed to the teaching hospitals, where you have to spend about N4,000 before you can get a dose. Sometimes, during the One-Stop Shop, you will have to spend N4,000 to get a dose,” the official added.