HARARE, Zimbabwe (AP) — Eswatini on Tuesday became the first African country to receive lenacapavir, the first twice-yearly HIV prevention injection hailed by global health officials as a game-changer in the fight against a virus that has killed tens of millions of people across the continent.
Developed by Gilead Sciences, lenacapavir has demonstrated near-total protection in clinical studies. Its rollout, initially planned for 10 high-risk African countries, is part of the U.S. President’s Emergency Plan for AIDS Relief, or PEPFAR, in partnership with the Global Fund. By 2027, the initiative aims to benefit at least 2 million people in those countries.
Daniel O’Day, chair and CEO of Gilead Sciences, described the Eswatini rollout as “extraordinary” because “it’s the first time in history that a new HIV medicine is reaching a country in sub-Saharan Africa in the same year as approval of the United States” and because Eswatini “is the country with the highest incidence of HIV in the world.” The U.S. approved the drug in June.
The United States, whose deep cuts to foreign aid this year under President Donald Trump have severely impacted Africa’s health programs, initially planned to distribute 250,000 doses this year to the 10 countries. Zambia also received its first shipment Tuesday, while Gilead seeks regulatory authority in Botswana, Kenya, Malawi, Namibia, Rwanda, Tanzania, Uganda and Zimbabwe.
That was increased to 325,000 due to “early demand signs,” Brad Smith, senior advisor for the Bureau of Global Health Security and Diplomacy, told journalists.
The U.S. government has noted that over 25 million people across Africa are living with HIV.
In Eswatini, a tiny kingdom in southern Africa, about 6,000 high-risk people are set to benefit from the drug's initial rollout, primarily to prevent HIV transmission from mothers to newborns. Home to roughly 1.2 million people, Eswatini currently has over 200,000 people living with HIV, with most receiving treatment funded by PEPFAR, Smith said.
Eswatini, the world’s last absolute monarchy with a documented record of human rights violations, is also among the African countries participating in Trump’s third-country deportation program, which has faced protests from rights groups.
In July, the World Health Organization approved lenacapavir as an additional HIV prevention option. UNAIDS has called long-acting injectables a “fresh option” amid concerns that foreign funding cuts could worsen infections.
South Africa’s health minister, Aaron Motsoaledi, recently called lenacapavir “groundbreaking” but raised concerns over limited supplies when South Africa begins its own rollout in April 2026.
Motsoaledi also welcomed Gilead’s steep price reduction from over $28,000 per person annually in the U.S. to approximately $40 for lower-income countries.
The rollout has fueled debate over access and manufacturing rights. Civil society groups in South Africa, sub-Saharan Africa’s most advanced economy, have criticized Gilead for excluding local manufacturers from voluntary licensing agreements despite the country’s role in clinical trials.
For more on Africa and development: https://apnews.com/hub/africa-pulse
The Associated Press receives financial support for global health and development coverage in Africa from the Gates Foundation. The AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.
FILE - A pharmacist holds a vial of lenacapavir, an injectable HIV prevention drug, at the Desmond Tutu Health Foundation's Masiphumelele Research Site, in Cape Town, South Africa, July 23, 2024. (AP Photo/Nardus Engelbrecht, File)
MADISON, Wis. (AP) — Democrats across the country are proposing state law changes to rein in federal immigration officers and protect the public following the shooting death of a protester in Minneapolis and the wounding of two people in Portland, Oregon.
Many of the measures have been proposed in some form for years in Democratic-led states, but their momentum is growing as legislatures return to work amid President Donald Trump’s national immigration crackdown following the killing of Renee Good by an Immigration and Customs Enforcement agent in Minneapolis. Republicans are pushing back, blaming protesters for impeding enforcement of immigration laws.
Democratic Gov. Kathy Hochul wants New York to allow people to sue federal officers alleging violations of their constitutional rights. Another measure aims to keep immigration agents lacking judicial warrants out of schools, hospitals and houses of worship.
Oregon Democrats plan to introduce a bill to allow residents to sue federal agents for violating their Fourth Amendment rights against unlawful search and seizure.
New Jersey’s Democrat-led Legislature passed three bills on Monday that immigrant rights groups have long pushed for, including a measure prohibiting state law enforcement officers from cooperating with federal immigration enforcement. Democratic Gov. Phil Murphy has until his last day in office Tuesday to sign or veto them.
California lawmakers are proposing to ban local and state law enforcement from taking second jobs with the Department of Homeland Security and make it a violation of state law when ICE officers make “indiscriminate” arrests around court appearances. Other measures are pending.
“Where you have government actions with no accountability, that is not true democracy,” Democratic state Sen. Scott Wiener of San Francisco said at a news conference.
Democrats in Georgia introduced four Senate bills designed to limit immigration enforcement — a package unlikely to become law because Georgia’s conservative upper chamber is led by Lt. Gov. Burt Jones, a close Trump ally. Democrats said it's still important to take a stand.
“Donald Trump has unleashed brutal aggression on our families and our communities across our country,” said state Sen. Sheikh Rahman, an immigrant from Bangladesh whose district in suburban Atlanta’s Gwinnett County is home to many immigrants.
Democrats in New Hampshire have proposed numerous measures seeking to limit federal immigration enforcement, but the state's Republican majorities passed a new law taking effect this month that bans “sanctuary cities.”
In Tennessee, instead of considering a Democratic measure that would limit civil immigration enforcement at schools and churches, Republican House Speaker Cameron Sexton said he was working with the White House on a separate package of immigration-related bills. He hasn't said what they would do.
The Trump administration has opposed any effort to blunt ICE, including suing local governments whose “sanctuary” policies limit police interactions with federal officers.
States have broad power to regulate within their borders unless the U.S. Constitution bars it, but many of these laws raise novel issues that courts will have to sort out, said Harrison Stark, senior counsel with the State Democracy Research Initiative at the University of Wisconsin Law School.
“There’s not a super clear, concrete legal answer to a lot of these questions,” he said. “It’s almost guaranteed there will be federal litigation over a lot of these policies.”
That's already happening.
California in September was the first to ban most law enforcement officers, including federal immigration agents, from covering their faces on duty. The Justice Department said its agents won't comply and sued California, arguing that the laws threaten the safety of officers who are facing “unprecedented” harassment, doxing and violence.
The Justice Department also sued Illinois last month, challenging a law that bars federal civil arrests near courthouses, protects medical records and regulates how universities and day care centers manage information about immigration status. The Justice Department claims the law is unconstitutional and also threatens federal officers’ safety.
Minnesota and Illinois, joined by their largest cities, sued the Trump administration this week. Minneapolis and Minnesota accuse the Republican administration of violating free speech rights by punishing a progressive state that favors Democrats and welcomes immigrants. Illinois and Chicago claim “Operation Midway Blitz” made residents afraid to leave their homes.
Homeland Security spokesperson Tricia McLaughlin accused Minnesota officials of ignoring public safety and called the Illinois lawsuit “baseless.”
Associated Press writers John O’Connor in Springfield, Illinois; Sophie Austin in Sacramento, California; Mike Catalini in Trenton, New Jersey; Jonathan Mattise in Nashville, Tennessee; Anthony Izaguirre in Albany, New York; Claire Rush in Portland, Oregon; and Jeff Amy in Atlanta contributed.
Protesters confront federal immigration officers outside the Bishop Henry Whipple Federal Building, Tuesday, Jan. 13, 2026, in Minneapolis. (AP Photo/Adam Gray)
