Botswana is reinforcing its position as a leader in the global HIV response by expanding its prevention toolkit following the approval of a new long-acting antiretroviral drug.
The Botswana Medicines Regulatory Authority (BOMRA) has officially registered Lenacapavir, marking a significant step in the country’s evolving public health strategy to curb new infections and sustain epidemic control.
In an interview, Dr. Christopher Nyanga from the Ministry of Health stated that the approval aligns with Botswana’s broader shift toward combination prevention—an approach that integrates multiple, complementary interventions rather than relying on a single solution.
“Lenacapavir will be an important addition to our HIV prevention strategy, expanding the range of antiretroviral-based PrEP options,” Nyanga said.
Nyanga shared that the current framework already combines several interventions, including oral pre-exposure prophylaxis (PrEP), condom programming, voluntary medical male circumcision, and targeted outreach to high-risk populations. The country also introduced long-acting injectable PrEP using Cabotegravir in February 2025, reflecting a growing emphasis on alternatives to daily pill regimens.
The addition of Lenacapavir is part of a deliberate strategy to address persistent gaps in prevention, particularly challenges around uptake, adherence, and long-term use. Unlike daily oral PrEP, long-acting options offer protection over extended periods, reducing the burden of frequent dosing. This is especially critical for populations facing barriers such as stigma or difficulty maintaining daily routines.
Nyanga noted that the strategy is guided by data from population-based surveys and bio-behavioural studies to identify high-risk groups, including adolescent girls, young women, and sero-discordant couples. Importantly, the Ministry is also incorporating self-perceived risk into its approach, allowing individuals to access services even if they fall outside traditional risk categories.
To further strengthen delivery, the Ministry is exploring differentiated service models and community-led initiatives designed to reach underserved populations and reduce structural barriers like distance and healthcare access.
Although Lenacapavir is now approved, Nyanga indicated that its rollout will depend on product availability. In the meantime, Botswana will continue to rely on existing measures while preparing to integrate the new drug.
“There are currently no clinical trials or partnerships exploring Lenacapavir locally,” Nyanga said, adding that monitoring of the drug’s performance will be conducted through post-marketing surveillance led by BOMRA.
