Sex workers and other Nigerians eligible for HIV prevention are facing difficulties accessing the newly introduced twice-yearly injectable HIV prevention drug, Lenacapavir, following stock-outs in several states participating in the Federal Government’s pilot programme.
Investigations by Saturday PUNCH found that Benue, Kwara, Gombe and Cross River had experienced shortages only months after the long-acting HIV prevention injection was introduced, with health workers reporting increased demand in some locations.
The situation has been particularly noticeable in Cross River, where health workers said demand had increased among sex workers who considered the injection more convenient and discreet than taking oral pre-exposure prophylaxis, commonly known as PrEP, every day. Some facilities reportedly have waiting lists for people seeking the injectable option.
Lenacapavir is a long-acting medicine used as pre-exposure prophylaxis to help prevent HIV infection. Unlike daily oral PrEP, it is administered once every six months, providing an alternative for people who face challenges with adherence, stigma or access to daily medication. The World Health Organisation recommended injectable lenacapavir as an additional HIV prevention option in July 2025.
Nigeria introduced the drug in 2026 as part of efforts to expand HIV prevention options. The WHO said the first phase of implementation involved eight states and the Federal Capital Territory, while preparations had been carried out across more than 70 health facilities in 10 states.
According to Saturday PUNCH, the Federal Government received 11,520 doses on March 19 and distributed them five days later to 10 pilot locations: Benue, Kwara, Akwa Ibom, Cross River, Gombe, Anambra, Ebonyi, Kano, Lagos and the FCT.
In Benue, Commissioner for Health and Human Services, Dr Paul Ogwuche, said more than 2,000 HIV-negative people had received the injection since its introduction in May. He confirmed that the initial allocation had been exhausted at participating facilities but said additional supplies were being processed.
“This is a temporary stock situation, not a discontinuation of the programme,” Ogwuche said, according to Saturday PUNCH, adding that the state was working with the relevant national programme and partners to facilitate replenishment.
Kwara has also exhausted its initial allocation. The state AIDS Programme Coordinator, Muhammed Rasheed, said more than 800 doses supplied during the initial phase were used up about two weeks earlier, with more than 1,000 additional doses expected.
Health officials in Cross River similarly reported that the initial supply had run out amid growing interest in the injection. According to one health worker, continued counselling and sensitisation contributed to increased uptake, particularly among sex workers.
The health worker said some clients had been advised to continue using oral PrEP while awaiting fresh supplies.
However, the shortages do not appear to represent a nationwide stock-out.
The National Agency for the Control of AIDS said some states were experiencing supply challenges but cautioned that this should not be interpreted as a nationwide shortage. Dr John Tobias, the agency’s North-East Zonal Coordinator, attributed some of the difficulties to logistics and funding constraints affecting the movement of health commodities from the national pool to individual states.
He also stressed that the Lenacapavir programme remained a pilot intended to help authorities assess demand, storage, healthcare-worker capacity, distribution and other operational requirements before a wider national rollout.
Lagos presents a contrasting picture. While states such as Benue and Cross River are struggling with depleted supplies, health officials in Lagos said the state had sufficient doses but was experiencing low uptake because of inadequate awareness.
An official of the Lagos State Ministry of Health’s HIV Unit urged eligible residents to come forward and take advantage of the available prevention option.
The supply challenge comes as international demand for Lenacapavir grows. The Global Fund said on September 24 that demand from countries had been strong and that additional generic versions were expected to become available in the coming months. Initial generic supplies are anticipated by late 2026, with broader availability expected during 2027.
The Global Fund said expanding the supplier base would help create more resilient supply chains and enable countries to reach more people who could benefit from the twice-yearly prevention option.
For Nigeria, the immediate challenge is ensuring that demand generated by the pilot programme can be matched with reliable supplies. The experience across the participating states is also providing health authorities with information that could shape any future expansion of Lenacapavir access across the country.
