Global Fund Executive Director Peter Sands inspects boxes with lenacapavir during a visit to Eswatini’s Central Medical Stores. The Global Fund/Brian Otieno

When I walked into Eswatini’s Central Medical Stores that morning, the first thing I saw were the boxes.

They were stacked neatly in tall, orderly columns on pallet racks in the middle of the warehouse — plain cardboard, carefully labelled, indistinguishable from any other medical shipment. Warehouse staff moved around them with quiet purpose, entering data, conducting routine checks, doing the work that keeps a health system running. Nothing suggested these boxes held something historic and that they were the first of their kind in Africa.

But inside those unremarkable boxes was something extraordinary: the first delivery of lena

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