Inside the ‘miracle’ drug rollout that could end Aids

The closest the world has to an HIV vaccine is being rolled out in some of the worst-hit countries in the world. Bel Trew in Eswatini, southern Africa, meets those at the sharp end

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Lianne was just 13 when she lost her parents to Aids.

Newly orphaned, she had to find a way to keep herself and her younger sister alive. With no money to finish school, unable to find a job and struggling to put food on the table, there was only one option - sex work.

Now 24, she knows the dangers in Eswatini, a kingdom in southern Africa once described as the epicentre of the HIV epidemic and a country still struggling with some of the highest infection rates in the world.

‘‘Both my parents passed away. Hunger led me to join this work although I know it’s risky,’’ Lianne says, explaining that she earns under #25 a week. She is unable to acquire HIV preventative medication - known as PrEP - on her own.

But there is now hope in the form of lenacapavir - dubbed the ‘‘miracle’’ drug - which the United Nations hopes can protect millions of people like Lianne and even end the Aids epidemic altogether.

The twice-yearly injection - described by the head of the UN Aids agency as ‘‘the closest thing we have to a vaccine’’ - provides near complete protection against infection.

Lenacapavir is being introduced for the first time in nine of the most at-risk countries, including Eswatini, meaning Lianne was among the first people in the world to get the injection.

While it is a big step forward in HIV care, concerns have been raised about the extent of the rollout, with fears it will be ineffective if it is not introduced on a global scale.

The positive news about lenacapavir comes after last year’s devastating cuts to foreign aid spending by US president Donald Trump, which had previously funded around half of Eswatini’s HIV response.