SOUTH AFRICA—As World AIDS Day approaches on December 1, Doctors Without Borders (MSF) is gearing up to introduce long-acting cabotegravir (CAB-LA) for pre-exposure prophylaxis (PrEP) in its projects across southern Africa.

CAB-LA, administered as an injection every two months, is seen as a groundbreaking advancement in the fight against HIV/AIDS.

Often described as one of the closest tools to an HIV vaccine, it offers a discreet and effective alternative to oral PrEP pills. 

PrEP, a preventive medicine for individuals at high risk of contracting HIV, has been a vital tool in curbing the spread of the virus. CAB-LA, however, stands out for its convenience and effectiveness.

Dr. Antonio Flores, an MSF HIV/TB advisor based in South Africa, highlighted the benefits, noting that CAB-LA’s two-month dosing schedule reduces adherence challenges compared to daily pills.

He emphasized that, with no HIV vaccine or cure available, CAB-LA and other long-acting options have the potential to transform HIV prevention, particularly in low- and middle-income countries where the need is greatest. 

In 2024, Zimbabwe, Malawi, Zambia, and eSwatini became the first African nations to offer CAB-LA.

South Africa is also set to receive doses of CAB-LA through the President’s Emergency Plan for AIDS Relief (PEPFAR), with additional doses expected over the next two years.

Meanwhile, MSF has negotiated a limited supply from ViiV, the drug’s manufacturer, to administer in projects in Zimbabwe, Mozambique, Malawi, and eSwatini by year-end. 

The injectable option is especially valuable for vulnerable groups, including women, girls, sex workers, and men who have sex with men, as its discreet nature enhances privacy.

For example, Dr. Gerald Hangaika from MSF’s Mbare project in Zimbabwe noted that CAB-LA not only improves protection but also addresses privacy concerns and simplifies adherence by eliminating daily pill routines. 

To ensure a smooth rollout, MSF recently conducted a four-day training for healthcare workers, covering topics such as clinical eligibility, managing side effects, and patient education.

This initiative aims to equip medical teams with the skills to deliver CAB-LA effectively and expand PrEP access to high-risk populations. 

While progress has been made—HIV infections have decreased by 60% since 1995—new cases continue to emerge, particularly among women and girls in Africa.

MSF has been at the forefront of HIV/AIDS prevention since the 1990s, advocating for equitable access to life-saving treatments.

As CAB-LA scales up globally, MSF calls on manufacturers like ViiV to ensure affordable pricing and increased supply, enabling broader access to this promising intervention.

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