By Amos Ssemuwemba
In a groundbreaking step for HIV prevention, Uganda’s Ministry of Health has administered the first dose of Cabotegravir (Cab-LA), marking the official rollout of a long-acting injectable as part of the country’s enhanced HIV prevention strategy. The first recipient, a walk-in patient, was treated at a health facility in Mbarara, a region experiencing rising HIV infection rates.
Dr. Herbert Kadama, the ministry’s Pre-Exposure Prophylaxis (PrEP) coordinator, shared that the patient, though unnamed, was the first to receive Cabotegravir in the country. The drug, available to anyone at high risk of contracting HIV, offers a much-needed alternative to daily oral PrEP. Cabotegravir is administered in an initial two-dose series, spaced four weeks apart, followed by maintenance doses every eight weeks. This new regimen significantly reduces the burden of daily pill-taking, providing users with greater convenience and encouraging adherence.
“Cabotegravir represents a breakthrough in HIV prevention. It’s a solution to the challenges we’ve faced with adherence to daily PrEP,” Dr. Kadama said.
However, the promising intervention comes with supply constraints. Currently, Uganda has 7,500 doses, largely from donations by the US President’s Emergency Plan for AIDS Relief (PEPFAR). The Ministry of Health expects to receive an additional 3,500 doses by February next year, funded by the Global Fund. Despite these challenges, Cabotegravir’s entry into Uganda’s healthcare system is a crucial move toward curbing new infections.
Civil Society Organizations (CSOs) have consistently advocated for equitable access to HIV prevention tools like PrEP, particularly in developing countries facing high infection rates but limited resources. While the number of people using oral PrEP in Uganda has surged from 800 users in 2017 to nearly 700,000 today, health workers have noted that many struggle to maintain daily adherence, leading to reduced effectiveness over time.
Once prohibitively expensive, Cabotegravir has been subsidized to around $35 (Shs 130,000) per dose, making it more accessible. In addition to Cabotegravir, another breakthrough drug, Lenacapavir, has demonstrated 100% effectiveness in preventing HIV during clinical trials. Lenacapavir, administered only twice a year, could revolutionize HIV prevention due to its ultra-long-acting nature.
Dr. Flavia Matovu Kiweewa, a senior research scientist at Makerere University – John Hopkins University Research Collaboration (MUJHU), highlighted the significance of Lenacapavir in ongoing clinical trials conducted in Mityana, Kalangala, and Masaka. Trial participants will continue to receive the drug until it becomes publicly available in Uganda’s healthcare facilities.
With these advancements, Uganda’s fight against HIV is moving toward more sustainable and accessible preventive measures, promising hope for those at risk. The rollout of Cabotegravir is a significant step, but ensuring continued supply and equitable access remains a critical challenge for the Ministry of Health and its partners.
