January 2026 marks a somber milestone: one year since the devastating cuts to U.S. foreign aid reshaped the global health landscape. For those of us working to end the HIV epidemic, 2025 was a year of profound disruption. Jobs were lost. Clinics closed. Outreach programs stalled. Decades of hard-won momentum were suddenly at risk. Yet even amid that uncertainty, one thing remained clear to all of us: progress against HIV depends on continuity, partnership, and community leadership.

At a pivotal moment during the evolution of global health, the Elton John AIDS Foundation stepped in as an early partner for Root to Rise, building a bridge between their longstanding expertise and urgent current needs in HIV prevention. Together, Root to Rise and the Foundation are ensuring that disruption does not translate into delay and that community voices remain central as the field enters a new era.

A new era in HIV prevention

Despite the challenges of the past year, this is also a transformative moment in HIV prevention.

Lenacapavir (LEN) – a subcutaneous injection administered just once every six months – has the potential to reshape the HIV epidemic. With the U.S. FDA’s approval in mid-2025 and new WHO guidelines in place, countries are now racing toward rollout in several low- and middle-income settings in early 2026.

Photo: Associated Press / Alamy Stock Photo

We know from decades of experience that availability does not guarantee access, and approval does not guarantee uptake. For new HIV prevention tools like LEN to deliver real impact, they must be introduced in ways that are trusted, understood, and shaped by the communities they are meant to serve.

That requires more than clinical guidelines and supply chains. It requires informed, confident community leaders who can talk about LEN in relatable ways, answer tough questions, and support people as they navigate their HIV prevention choices.

Adaobi and Lilian in Nigeria and Uganda break down why this moment matters.

Updating a peer-led PrEP resource for LEN

Through support from the Elton John AIDS Foundation, Root to Rise is updating the HIV Prevention Ambassadors Training Package and Toolkit (HPAT).

The HPAT prepares potential and current PrEP users to be leaders – or “ambassadors” – in the rollout of PrEP in their communities (including young people and other priority populations). The training equips ambassadors to share information with their peers about PrEP methods, support peers who are interested in using PrEP, and build community support for PrEP use. Since 2019, the HPAT has been a cornerstone of peer-led community mobilization and demand generation for PrEP in at least ten countries.

With the Foundation’s partnership, this toolkit update is going to support LEN rollout. Current work includes:

  • Integrating new content on LEN
    Updating both editions of the HPAT (for adolescent girls and young women, and for diverse priority populations) to include everything an ambassador needs to know about LEN – how it works, its benefits, how it is different from other PrEP products, and how to support peers in choosing the HIV prevention option that is best for them. LEN is presented as part of a menu of choices, reinforcing that people deserve options that fit their lives.
  • Grounding the updates in community input
    Engaging youth leaders and key population networks to review and refine the LEN content so that it reflects their realities and the questions they are already hearing. Their feedback is shaping the language we use, the scenarios we include, and the concerns we address.
  • National advocacy for community-led rollout
    Working with partners in Kenya, Nigeria, South Africa, and Uganda to advocate for the HPAT to be integrated into national LEN rollout plans. Our goal is for community mobilization to launch in lockstep with the product, so that as clinics prepare to offer LEN, ambassadors are already talking about it in youth groups, community meetings, and peer networks.

Why this first grant matters

For Root to Rise, this grant from the Elton John AIDS Foundation was more than early funding. It was a tangible example of resourcefulness in an era of funding disruption. Most importantly, it was an affirmation that communities most affected by HIV must continue to help shape how new tools are introduced, discussed, and used. The partnership allowed Root to Rise to build directly on technical expertise developed through decades of experience in HIV prevention programming while continuing work rooted in equity, access, and community leadership.

For the Foundation, this collaboration reflects a long-standing commitment to ensuring that innovation in HIV prevention translates into real-world impact, especially in moments when global systems falter and community leadership becomes even more critical.

Looking ahead 

As LEN rollout approaches, regulatory approvals and policy decisions are only the beginning. The true measure of success will be found in everyday moments: peer-to-peer conversation, a first clinic visit, and a decision to stay protected.

In a year marked by uncertainty and loss, this partnership represents continuity and hope. The Elton John AIDS Foundation is proud to stand with Root to Rise, and with communities around the world, to ensure that the next chapter of HIV prevention is led not only by science, but also by the people whose lives it is meant to protect.