Science has done something extraordinary: it has shown us what is possible in HIV prevention.

Lenacapavir (LEN), a twice-yearly injectable PrEP option, was one of the clearest examples at AIDS 2026 in Rio de Janeiro of how HIV prevention is evolving. It offers another prevention choice and could change how and where prevention is delivered.

But as I listened to country teams, providers and partners in Rio, I found myself thinking less about the product itself and more about what has to happen around it.

Through my work with the South-to-South HIV Prevention Learning Network (SSLN), I have been close to countries working through these questions. Kenya, Eswatini, Zambia and South Africa are already generating experience as early adopters. Others, including Botswana and Rwanda, are preparing for introduction or considering how LEN fits within their prevention systems.

What struck me is that this difference in timing can be an asset. Countries moving first can generate lessons that help those coming next make better decisions and make them earlier

At AIDS 2026, I saw this first-hand when SSLN and FHI 360 convened a session where Malawi and Lesotho shared emerging LEN experience with stakeholders from the Philippines, which is preparing for introduction. The conversation quickly moved beyond the product itself to practical questions of demand, delivery models, provider readiness and community engagement. 

What stayed with me was how quickly experience from one setting could become useful to another.

One country’s implementation experience can become another country’s preparation.

But its value depends on timing. A lesson received after procurement can explain a problem; received early enough, it can help prevent one. An insight received after rollout can inform course correction; received while delivery models are still being designed, it can shape them.

This is why I have come to see learning and adaptation as part of prevention delivery itself. Countries will introduce new technologies at different speeds and in different health-system contexts. That is not necessarily a problem. The bigger risk is when countries learn the same lessons separately or when learning arrives too late to influence decisions.

Perhaps the capability we need to invest in is not simply the ability to introduce innovation, but the ability to learn and adapt while innovation is being introduced.

We went to Rio looking for the next HIV prevention breakthrough.

I left thinking it may be less visible than a new product: the ability of health systems to learn from what works, respond to what does not, and adapt before problems become entrenched.

The most valuable lesson may not be the one discovered first. It may be the one that reaches the next decision in time to change it.

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