Zambia's medicines regulator approved the HIV prevention drug lenacapavir in 12 days, a stark contrast to typical four- to seven-year delays in sub-Saharan Africa. Lenacapavir, a twice-yearly injection developed by Gilead Sciences, showed over 99.9% efficacy in trials and addresses adherence and stigma issues with daily oral PrEP. Gilead employed regulatory reliance, allowing Zambia to leverage assessments from better-resourced regulators rather than conducting independent reviews.