Demand for Nigeria’s twice-yearly injectable HIV prevention drug, Lenacapavir, is rising rapidly, with health officials reporting depleted supplies in several states only months after the Federal Government began its pilot rollout.
Findings reported by Saturday PUNCH indicate that Benue, Kwara, Gombe and Cross River have experienced stock-outs, exposing a sharp contrast between growing demand in some locations and low uptake in others.
In Cross River, health workers said interest in the injection had increased particularly among sex workers, some of whom preferred the twice-yearly option because they considered it more discreet and convenient than taking oral HIV pre-exposure prophylaxis (PrEP) every day.
But in Lagos, the situation is almost the reverse. Health officials said the state has sufficient doses but has struggled to attract enough eligible people to take up the prevention option.
The National Agency for the Control of AIDS (NACA) has linked some of the supply difficulties to logistics and funding constraints, while stressing that stock-outs in individual states should not be interpreted as a nationwide shortage.
What Is Lenacapavir?
Lenacapavir is a long-acting injectable HIV pre-exposure prophylaxis drug developed by Gilead Sciences. Unlike daily oral PrEP, the injection is administered once every six months, giving eligible HIV-negative people another option for preventing HIV infection.
The World Health Organisation recommended Lenacapavir as an additional HIV-prevention option in July 2025.
Nigeria’s Federal Government received 11,520 doses of the drug on March 19, 2026, before distributing the initial consignment five days later to 10 pilot locations: Benue, Kwara, Akwa Ibom, Cross River, Gombe, Anambra, Ebonyi, Kano, Lagos and the Federal Capital Territory.
The rollout is being used as a pilot programme through which health authorities can assess demand, healthcare-worker capacity, storage requirements, public awareness and commodity distribution before a possible wider national programme.
Benue Runs Out After More Than 2,000 People Receive Injection
Benue State has recorded strong early demand for Lenacapavir, with more than 2,000 HIV-negative people reportedly receiving the injection since its introduction in May 2026.
The Commissioner for Health and Human Services, Dr Paul Ogwuche, said the state’s initial allocation had been exhausted at participating health facilities.
“Benue State has recorded strong early uptake of Lenacapavir. Since its introduction in May 2026, more than 2,000 HIV-negative persons have received the injection through the state’s HIV-prevention programme,” Ogwuche said.
He said the stock-out was temporary and did not mean the programme had been discontinued.
“The initial allocation has been exhausted at the participating health facilities, and the commodity is currently out of stock at the service-delivery level,” he said.
According to the commissioner, the Federal Government was processing additional supplies while the Benue State Ministry of Health was working with national programmes and partners to replenish stocks and reduce interruptions in access.
Ogwuche also said some recipients had reported mostly mild side effects, which were being monitored through clinical and pharmacovigilance mechanisms.
He said clients were counselled before receiving the injection and encouraged to report unusual or concerning symptoms to healthcare providers.
Kwara Waits for More Than 1,000 Additional Doses
Kwara State has also exhausted its initial allocation, with the state expecting more than 1,000 additional doses, according to the state AIDS Programme Coordinator, Muhammed Rasheed.
Rasheed said more than 800 doses received during the first phase were exhausted about two weeks before his comments were reported.
“People are responding so well to the doses. We are going to extend the doses to more facilities as more comes into the state,” he said.
He said prospective beneficiaries were screened to ensure that the injection was administered only to eligible HIV-negative people.
An assessment at Sobi Specialist Hospital in Ilorin, one of the designated facilities, reportedly found that interested people could not access the drug because supplies had run out.
An official at the facility said the centre had been out of stock for some time and referred enquiries about availability to the state ministry.
NACA Blames Logistics and Funding Pressures
NACA confirmed that Gombe State experienced a Lenacapavir stock-out during the second quarter of 2026 but said the development should not be interpreted as evidence of a nationwide shortage.
Dr John Tobias, NACA’s Zonal Coordinator for the North-East, explained that the pilot was designed partly to identify weaknesses in the distribution and delivery system before any broader national rollout.
“These states started with Lenacapavir as pilots. It is yet to be rolled out as a national programme for the entire country. It is a learning process to be able to see how we can build capacity around healthcare workers, storage, people understanding the prevention commodity, picking it up and all of that,” Tobias said.
He said the pilot had generated lessons around logistics, supply, awareness, uptake and availability.
Tobias also pointed to funding and distribution difficulties that can leave commodities available at the national level while some states experience shortages.
He cited condoms as an example of commodities that could be available in Lagos but difficult to move to other states because of logistical constraints.
According to him, reductions in programme funding have also affected several health interventions supported by development partners.
“Global Fund has been funding most of these interventions. The problem we currently have is that as of the first quarter of this year, there has been a lot of cutting down of programme costs. And that has affected a lot of interventions, and Lenacapavir won’t be out of it,” he said.
Cross River Sees Rising Demand Among Sex Workers
Cross River State has also exhausted its initial allocation, with health workers in Calabar reporting increased demand in recent months.
According to Saturday PUNCH, uptake was initially slow because of limited awareness and stigma but increased following sustained counselling and sensitisation.
Health workers at the University of Calabar Teaching Hospital and General Hospital, Calabar, reportedly said supplies had become depleted since late August.
A health worker at the teaching hospital said the facility received only a limited number of doses initially and later developed a waiting list as demand increased.
At the Infectious Disease Unit of General Hospital, Calabar, another health worker said sustained awareness efforts had contributed to stronger demand, particularly among sex workers.
The official said some people were asking for the injection instead of daily oral PrEP because of its convenience and discreet nature, but advised clients to continue with oral PrEP while waiting for new Lenacapavir supplies.
Lagos Has Doses but Struggles With Low Uptake
While Benue, Kwara, Gombe and Cross River have reported supply pressures, Lagos is facing a different challenge: insufficient demand.
An official of the Lagos State Ministry of Health’s HIV Unit said the state had more than enough doses and was encouraging eligible residents to come forward.
“We have more than enough doses to the point that we are begging people to come and take it. We don’t have any problem with consignment. We have enough. We are the ones begging people to come for it,” the official said.
The official said the major challenge in Lagos was awareness and getting enough eligible people to seek the injection.
Information about Lenacapavir is being disseminated through the ministry’s social media platforms, according to the official.
On possible reactions to the drug, the official said established procedures were in place for documenting and reporting side effects.
Anambra Receives Fresh Supply After Initial Stock Runs Out
Anambra State also exhausted its first allocation before receiving another batch of Lenacapavir.
An official involved in administering the drug through a non-governmental organisation said eligible residents had responded strongly to the available doses.
The official said the state recently received another supply for its four centres, including teaching hospitals in Awka, Oba and Nnewi.
According to the official, some beneficiaries preferred Key Population centres because the drug was available there free of charge, while patients accessing it through some teaching hospitals could incur additional charges.
A Pilot Programme Under Pressure From Uneven Demand
The early experience with Lenacapavir has exposed a challenge that goes beyond the availability of a new HIV-prevention medicine: demand, awareness and supply are not developing at the same pace across Nigeria.
In Benue, Kwara and Cross River, health workers are reporting demand strong enough to exhaust initial allocations. Anambra has already received additional doses after its first supply ran out.
Lagos, meanwhile, has sufficient stock but is seeking more eligible people to come forward.
The contrasting experiences could provide important information for health authorities as they assess how a wider Lenacapavir programme would need to be organised, particularly around forecasting demand, commodity distribution, public education, healthcare-worker capacity and sustainable funding.
The wider issue is consistent with other healthcare-delivery challenges recently examined by The Bureau Journal, including shortages of basic materials at primary healthcare facilities.
Coverage of Kebbi’s sexual and reproductive, maternal, newborn, adolescent and child health strategy has also highlighted the importance of awareness, community engagement and reducing barriers to accessing health services.
As Nigeria continues expanding healthcare capacity, plans for medical simulation centres across the six geopolitical zones are among efforts aimed at strengthening the country’s health workforce.
The Bureau Journal has also reported on the Federal Government’s National Health Technology and Data Analytics Office, part of a broader push to improve coordination and innovation within the health sector.
Recent reporting on large-scale medical outreach programmes and free surgical interventions further illustrates the range of approaches being used to expand access to healthcare across Nigeria.
For Lenacapavir, the next stage of the pilot will show whether supply systems can keep pace with demand in areas where awareness and acceptance are growing, while health authorities work to increase uptake in states where doses remain available.
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