Zambia HIV Leader Calls Long-Acting PrEP a Big Step, But Warns Funding Cuts Could Slow Progress | IAS 2025

We asked experts attending the International AIDS Society meeting in Kigali, Rwanda, about their opinions on long-acting injectable HIV preexposure prophylaxis and its implications for the future of HIV prevention.

Lloyd Mulenga, M.Sc., M.B., Ch.B., Ph.D., an infectious disease and internal medicine specialist at the University Teaching Hospital in Lusaka, Zambia, and Director of Infectious Diseases for the Zambian Ministry of Health, described long-acting injectable PrEP as a major step forward.

“This is a really big deal for us in Zambia,” he said. “We have to make sure from the beginning that the community is at the centerpiece of what we are doing.”

Mulenga emphasized the need for rollout strategies that prioritize sustainability and accessibility. He said Zambia aims to use community health workers rather than high-skilled clinical staff to deliver the treatment. However, he raised concerns about limited funding, particularly the reduced U.S. government support.

“If the American government was on board, I think we’d get more volumes,” he said.

On the World Health Organization's (WHO) updated treatment guidelines, Mulenga expressed support, noting they align with Zambia’s direction, especially regarding newer drug alternatives and expanding pediatric care.