Samson Mutua, 27, feels “lucky, empowered and safe” after becoming one of the first people in Kenya to receive lenacapavir, a twice-yearly injection offering near-total protection against HIV. He had taken daily PrEP pills since 2017, but says the new jab is transformative.
Last month, Kenya became one of the first countries to distribute lenacapavir, hailed as the closest thing to an HIV vaccine. The rollout targets 21,000 doses across 152 health facilities in 15 high-burden counties, aiming to reduce new infections by 2030. However, Kibera, one of Africa’s largest informal settlements, has been excluded from the first phase despite an HIV prevalence of around 12 per cent—more than double the rate in non-slum urban areas.
Jeffrey Okoro, chief executive of CFK Africa, which runs the Tabitha Medical Clinic in Kibera, says they have received no explanation for the exclusion. “In communities like Kibera, lenacapavir could be a game-changer. Right now, it's not reaching the people who would benefit most,” he said.
Residents can travel to designated facilities 1.5 to 3.5 miles away, but a return journey costs up to 380 Kenyan shillings (£2.20)—a prohibitive sum for those living on less than £1.50 a day. “People prefer to go to clinics they know and trust,” Okoro said. “If you push everything into national hospitals, you exclude the very people you say you are targeting.”
While the drug is free during the initial rollout, future costs remain uncertain. Subsidised prices could reach 7,800 Kenyan shillings per year, though generic versions expected from 2027 may reduce costs to around £30 per patient. Antonio Flores, a senior HIV adviser at Médecins Sans Frontières, warned: “Without deliberate policy choices, access will remain uneven.”
Kenya’s health authorities insist this is just the beginning, but structural barriers persist. A recent trial in Kibera found that small incentives failed to improve HIV treatment retention, with transport costs and travel time remaining major issues. Okoro argues for a community-rooted approach using local networks to deliver the jab. “The issue isn't motivation, people want to stay healthy. But the system doesn't meet them where they are,” he said.
