By Co-Chairs of the Civil Society Caucus of the Coalition to Accelerate Access to Long-Acting PrEP Chilufya Kasanda, Kenneth Mwehonge, Numan Afifi and AVAC staff supporting the Caucus Navita Jain & Bridget Jjuuko

The landscape of HIV prevention is shifting beneath our feet. We have officially moved from the anticipation of long-acting options to the gritty, urgent work of early implementation, and translating biomedical options into actual choices for people.

The most recent new option is injectable lenacapavir (LEN) for PrEP – a six-monthly subcutaneous injection that offers near perfect protection from HIV. With LEN implementation ongoing in nine African countries as part of Global Fund and PEPFAR support to 24 “Early Adopter” countries, the question is no longer if LEN will arrive, but how fast we can get it to the communities who need it most and build a sustainable, scalable market.

To ensure community leadership sits at the center of this rollout, the Advocates’ Checklist for Lenacapavir for PrEP Introduction was designed as an immediate, actionable blueprint to help civil society organizations (CSOs) and global health advocates pressure-test government commitments, map implementation bottlenecks and demand equitable access. Whether your country is currently on the early adopter list or you are fiercely campaigning for its inclusion, this checklist outlines the essential questions we all need to be asking our Ministries of Health, technical partners and funders.

Why This Checklist? Why Now?

While the field eagerly prepares for the entry of generic LEN supplies into the market in 2027, we cannot afford to simply wait for that eventuality. The demand and need for LEN is immediate – and the sooner we create demand, the sooner generics will make larger volumes at lower prices. Advancing LEN rollout now, as quickly and as large as possible, translates directly into preventable HIV infections and signals strong demand to generic manufacturers as they prepare to enter the market and to donors as they plan for larger-scale procurement. Advocates need to push for speedy and equitable access to LEN right now, while simultaneously preparing national systems for a multi-producer generic market tomorrow.

The checklist breaks down advocacy targets into five critical pillars:

• Regulatory & Policy Alignment: Moving LEN from regulatory approval to formal integration into National HIV Prevention Guidelines alongside oral PrEP, long-acting injectable cabotegravir (CAB-LA) and the Dapivirine Vaginal Ring (DVR).
• Financing & Procurement: Holding funders accountable to the “3 Million in 3 Years” target for providing access to LEN for prevention, and treating that commitment as a floor, not a ceiling. Ensuring robust demand forecasts are developed and financing plans reflect both procurement and program needs.
• Supply Chain & Site Readiness: Using technical tools to track whether orders sitting at the Global Fund are actually reaching central warehouses and frontline clinics.
• Demand Generation & Community Leadership: Fighting back against the “slow rollout” narrative and embedding LEN into comprehensive, integrated choice campaigns rather than letting it be siloed.
• Accountability & Monitoring: Securing dedicated civil society seats on National Technical Working Groups and deploying Community-Led Monitoring (CLM) to track stock-outs and document real-world access barriers.

Working together, partners from Ascend Futures Foundation, APCOM, HEPS Uganda and AVAC, representing members of the Civil Society Caucus of the Coalition to Accelerate Access to Long-Acting PrEP, lent their expertise and localized insights to create this tool for the global community. It is the newest in a suite of resources available on PrEPWatch to support LEN rollout, including the LEN Resource Toolkit and the Long-Acting PrEP Status Dashboard.

With this tool in hand, now is the time to turn high-level commitments into real choices at the clinic level. For questions or comments about the checklist, contact us at [email protected].

Get Involved: Download and Share the Checklist: Access the full PDF tool to start auditing your country’s readiness. 

Track Progress Live: Keep an eye on global efforts and view continuously updated, country-specific progress trackers on PrEPWatch.

“Lenacapavir has the potential to transform HIV prevention, but its true impact will depend on whether it expands choice rather than replaces it. No single prevention method will work for everyone. Ending new HIV infections requires a prevention ecosystem where every individual can choose the option that best fits their needs, preferences and circumstances.”

Chilufya Hampongo

Executive Director of Ascend Futures Foundation and co-chair of the CS Caucus

“Asia and the Pacific account for nearly one in six people living with HIV globally. For us, global access is about ensuring that new prevention tools do not remain available only in a handful of countries but can reach the millions of people across our region who could benefit from them. That’s how scientific innovation translates into public health impact.”

Numan Afifi

Senior Policy and Research Officer at APCOM and co-chair of the CS Caucus

“Lenacapavir has the potential to transform HIV prevention in high-burden countries. For governments, it is more than a new product—it is an opportunity to prevent infections more effectively, expand choice, reach underserved populations, and reduce the long-term social and economic costs of HIV. If introduced equitably and at scale, LEN could become one of the most important tools in accelerating progress towards ending AIDS as a public health threat.”

Kenneth Mwehonge

Executive Director of HEPS Uganda and co-chair of the CS Caucus

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