Now What with Injectable LEN for PrEP?
How to Translate Ambition into Accelerated Delivery and Impact
Since results of the PURPOSE efficacy trials were announced in 2024, injectable lenacapavir for PrEP (LEN) has generated enormous excitement and opportunity – and frustration. By the end of 2024, Gilead Sciences provided six voluntary licenses to generic manufacturers and submitted multiple regulatory filings, and the Global Fund and PEPFAR committed to an ambition to reach two million people over three years, pending regulatory approvals and WHO guidelines. It seemed like bold ambition – and it was, compared to the previous launches of oral PrEP, vaginal ring and CAB.
But this ambition was always defined as a floor, not a ceiling. In April 2026, the collaboration increased the goal to reach three million people over three years with LEN for PrEP.
In July 2025, AVAC published a first edition of Now What with Injectable LEN for PrEP, outlining priorities to ensure introduction moved swiftly. Now, in this update, AVAC is calling for a new minimum floor: reach three million in two years (2026-2027). No less and no slower, with a push for more and faster.
Without speed, scale and equity, LEN is simply exciting science; but, with them, LEN can be a transformational moment in the HIV/AIDS response.
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