By Brenda Kayo:
Malawi’s HIV prevention programme is entering a new phase, with 272,225 people cumulatively initiated on Pre-Exposure Prophylaxis (PrEP) since the country introduced the prevention medication in 2021.
According to the Ministry of Health, 122,488 people were actively on PrEP by the end of June 2026 while 1,392 people had already been initiated on Lenacapavir, a new twice-yearly injectable option for HIV prevention.
The figures mark a significant expansion of Malawi’s PrEP programme, which has moved from relying mainly on daily oral medication to offering clients a wider range of prevention choices.
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The national PrEP programme started with daily oral PrEP in 2021 before Malawi introduced injectable Cabotegravir in 2024.
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In June 2026, the country added Lenacapavir, a long-acting injectable administered twice a year, giving clients three PrEP options.
Ministry of Health spokesperson Benedicto Mbewe said uptake of PrEP has been particularly notable among people aged between 20 and 34 while preliminary data from facilities offering all three options shows growing interest in Lenacapavir.
“We have noted that the majority of clients fall within the 20 to 34 age bracket. Preliminary data from sites offering all three choices indicates that Lenacapavir is emerging as the most preferred option, with 1,392 individuals already initiated on the drug,” Mbewe said.
He, however, said the ministry was continuing to monitor consumption patterns as the new drug is gradually rolled out.
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Lenacapavir is currently available at 14 health facilities in Lilongwe and Blantyre, with the ministry planning to expand access to the services to additional facilities across the country.
The rollout is being implemented in three phases.
The first phase is targeting 48 sites, including all district hospitals, and is expected to be completed by mid-September 2026.
The second phase will expand the service to 100 sites from mid- September while the third phase is scheduled for December.
The expansion is expected to significantly increase access to long-acting HIV prevention services, particularly for people who may find it difficult to adhere to daily oral medication.
By the end of June 2026, 122,488 clients were actively on PrEP.
Oral PrEP is available at 460 facilities while 106 facilities offer both oral PrEP and Cabotegravir.
The 14 facilities currently providing Lenacapavir offer all three prevention choices.
The government is also looking beyond the initial rollout to ensure that the new prevention option does not suffer supply interruptions.
According to the Ministry, PEPFAR will procure Lenacapavir for Malawi over the next three years while the Ministry of Health and Sanitation plans to include the drug in its Global Fund Cycle II application.
Public health advocates say the introduction of Lenacapavir represents an important development in Malawi’s HIV prevention response because it gives people greater choice over how they prevent infection.
Health rights advocate Maziko Matemba said the latest figures should be viewed as evidence of the progress Malawi has made in scaling up PrEP and the opportunities presented by long-acting prevention.
He, however, said the 1,392 people initiated on Lenacapavir should not be interpreted as weak uptake, considering that the drug was only introduced in Malawi in June 2026.
“Instead, the figure represents an early group of users of a new prevention technology that could become increasingly important as availability expands,” Matemba said.
