Demand for Nigeria’s newly introduced long-acting HIV prevention injection, Lenacapavir, has outpaced supplies in several states, with health officials reporting stock-outs only months after the Federal Government began its pilot rollout.
The shortage has been reported in Benue, Kwara, Gombe and Cross River, while Lagos still has supplies but is struggling with low uptake, according to findings by Saturday PUNCH.
Lenacapavir is a pre-exposure prophylaxis (PrEP) drug given every six months to HIV-negative people at substantial risk of infection. It is designed to provide an alternative to daily oral PrEP.
The World Health Organisation recommended twice-yearly injectable lenacapavir as an additional HIV-prevention option in July 2025. WHO said the drug could increase PrEP uptake because it gives people more choice, particularly those who face difficulties with daily pills because of adherence, stigma or access to healthcare.
Supplies exhausted in some states
Nigeria received its first batch of 11,520 doses on March 19, 2026, as part of a larger plan to secure about 52,000 doses for the initial programme. The first doses were distributed to eight pilot locations: Benue, Kwara, Gombe, Anambra, Ebonyi, Akwa Ibom, Cross River and the Federal Capital Territory.
In Benue, Commissioner for Health and Human Services Paul Ogwuche said more than 2,000 HIV-negative people had received the injection since its introduction in May.
“The initial allocation has been exhausted at the participating health facilities, and the commodity is currently out of stock at the service-delivery level,” Ogwuche told PUNCH.
He, however, said the shortage was temporary and that the Federal Government was processing additional supplies.
Kwara has also exhausted its initial allocation. The state AIDS Programme Coordinator, Muhammed Rasheed, said more than 800 doses had been used and additional doses were expected.
“People are responding so well to the doses. We are going to extend the doses to more facilities as more comes into the state,” Rasheed said.
Sex workers among those seeking the injection
Health workers in Cross River said demand increased after awareness campaigns, particularly among sex workers.
One health worker told PUNCH that people were increasingly requesting the injection instead of 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,” the worker said.
The worker said clients were being advised to continue with oral PrEP while waiting for new supplies.
The situation is different in Lagos, where officials said the state has enough doses but needs more eligible people to come forward.
“We have more than enough doses to the point that we are begging people to come and take it,” an official of the Lagos State Ministry of Health’s HIV Unit told PUNCH.
NACA blames logistics and funding constraints
The National Agency for the Control of AIDS said stock-outs in individual states should not be interpreted as a nationwide shortage.
NACA’s North-East Zonal Coordinator, John Tobias, said the pilot programme was designed to identify problems involving demand, storage, healthcare workers, logistics and distribution before a wider rollout.
“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,” Tobias said.
He also linked some distribution problems to funding constraints, saying reductions in programme funding had affected several HIV interventions.
“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.
WHO says twice-yearly dosing could improve access
WHO said Nigeria’s introduction of lenacapavir gives people another prevention choice and could help address some of the difficulties associated with daily oral PrEP.
Nigeria is among nine early-adopter countries for the drug, and WHO says the country is expected to receive about 180,000 doses by 2028. More than 70 health facilities across 10 states were assessed for readiness, including training, supply management and counselling.
WHO’s Africa office said Nigeria has about 1.9 million people living with HIV, with young women and key populations carrying a significant share of the burden.
Internationally, the drug has generated strong interest because of its dosing schedule and trial results. WHO reported that the PURPOSE 2 trial found a 96 per cent reduction in the risk of acquiring HIV, with 99.9 per cent of participants receiving lenacapavir remaining HIV-negative.
UNAIDS has also called for faster and more equitable access. In April 2026, UNAIDS said the Global Fund and the United States had increased their ambition from reaching two million people with lenacapavir to three million by 2028.
“This expanded commitment is an important step forward, and we applaud the Global Fund and the United States for accelerating access to lenacapavir,” UNAIDS Executive Director Winnie Byanyima said.
