IN the bustling streets of Epworth, 18-year-old Tadiwanashe Moyo, clutches a tattered piece of paper, her eyes scanning it with a mixture of hope and trepidation.
This slip of paper holds the key to her future — a golden ticket to receive the long-awaited Lenacapavir injection, a revolutionary HIV prevention drug that promises to change the trajectory of her life.
But as Moyo walks the narrow, dusty and pot-holed streets of her neighbourhood, she hardly notices similar circumstances surrounding her.
More than 200km away, in the quiet township of Dangamvura, Mutare, 32-year-old Farai Chikukwa stares at the same announcement, his shoulders heavy with the weight of exclusion.
For him, the “miracle” of Lenacapavir remains an elusive dream, locked away by the barriers of geography and the cold hard realities of resource allocation.
While the residents of Epworth and Dangamvura grapple with the uncertainties of the Lenacapavir rollout, some affluent and leafy communities of Harare and Bulawayo, seemingly have already secured private access to the “miracle” injection.
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There, the privileged few eagerly await their twice-yearly doses, confident that this new technology will shield them from the ravages of HIV.
These three stories, playing out across Zimbabwe’s communities, capture the essence of the recent high-staked Lenacapavir rollout — a tale of two worlds, where the promise of scientific progress collides with the enduring inequities of the nation’s healthcare system.
As the rollout marked a revolutionary HIV prevention injection hailed as a “miracle” by many, those living with the constant spectre of the virus, the promise of this twice-a-year shot feels more like a cruel lottery than a universal solution.
Undeterred, still in the same bustling neighbourhood of Epworth, on the outskirts of Harare, Tendai Moyo, a 29-year-old mother of two, has been waited anxiously for that day.
“We’ve heard so much about Lenacapavir, how it can change our lives,” she says, her eyes filled with a mixture of hope and trepidation.
“But when I look around, I can’t help but wonder: who will really get this injection?”
Tendai’s concerns are echoed across communities like Caledonia, Tafara, Mabvuku and Mbare, where the burden of HIV has long weighed heavily.
According to official government data and statements, the initial rollout targets just 46 000 people in a nation where over 1,3 million people live with the virus, a stark reminder that this “miracle” drug seemingly is not yet a panacea.
“The government says they’re prioritising vulnerable groups like us, but how do they decide who gets it?” asks Shingirai Chirenje, a community activist from Luveve, Bulawayo.
“Will it be those with the right connections or those who can afford the transport to clinics?
“This is a high-stakes game, and we're not sure we’ll be the winners.”
The science behind Lenacapavir is undoubtedly revolutionary, offering a level of protection that surpasses traditional daily oral PrEP.
But the very innovation that makes it so promising also presents a significant challenge: the cold chain.
“To keep Lenacapavir viable, we need a stable, controlled temperature environment from the manufacturer to the patient,” explained a senior official in the Health and Child Care ministry.
“That’s a tall order in a country where electricity is still unreliable, especially in rural areas.”
This reliance on a robust medical infrastructure risks exacerbating the existing rural-urban divide, as the initial rollout focuses on well-connected urban centres like low-density areas.
“What about the people in Siabuwa, Binga or Dangamvura, Mutare?” laments Chirenje.
“They’re just as vulnerable, if not more so. Will they be kept abreast or left behind?”
The politics of global pharmaceutical companies further complicates the picture.
While Gilead Sciences, the developer of Lenacapavir, has been praised for its voluntary licensing agreements, the exclusion of several middle-income countries raises concerns about the role of profit in public health.
“We shouldn’t have to beg for access to life-saving drugs,” says Rumbidzai Dube, a member of the Parliamentary Portfolio Committee on Health.
“These companies hold the power to determine who lives and who dies. That’s not acceptable.”
For organisations representing persons with disabilities, the rollout of Lenacapavir raises additional challenges.
“Accessibility is a major concern,” says a senior official in the National Association of Societies for the Care of the Handicapped.
“Will the clinics and virtual platforms be designed with our members in mind? Or will they be an afterthought, once again?” she asked rhetorically, during an online discussion and debate.
As the first injections were administered in Epworth recently, the voices of the concerned, the unassured, and the vulnerable echo across Zimbabwe’s communities.
They know that the success of this rollout will not be measured by the number of shots given, but by the equity of access and the lasting impact on those most exposed.
“Lenacapavir is a game-changer, no doubt,” reflects Moyo.
“But for us, it’s not just about the drug — it’s about the fundamental right to health.
“We can’t let this be another missed opportunity, another broken promise. We need to fight for a future where no one is left behind.”
As the nation holds its breath, the story of Lenacapavir is not just about a medication, but about the very soul of Zimbabwe’s healthcare system.
The choice available is clear: will there be an embrace of the promise of true equity or will people simply resign to the cruel lottery of birth and geography?
The answer, in the end, will merely define the true legacy of this “miracle” drug.