Accelerating policy approval and uptake of the dual prevention pill in Zambia through early stakeholder engagement.

The Dual Prevention Pill (DPP), a combination of pre-exposure prophylaxis (PrEP) and combined oral contraception (COC), offers a novel, female-controlled option for HIV and unintended pregnancy prevention. However, new technologies like the DPP often face delays in regulatory approval and uptake due to limited stakeholder involvement early in the introduction process. This project, implemented by Copper Rose Zambia with support from AVAC, aimed to demonstrate how early, multisectoral stakeholder engagement could accelerate DPP approval and adoption in Zambia. Throughout 2024, a series of consultations were conducted with policymakers, healthcare providers, community health workers, female sex workers, adolescent girls and young women, and funders. Feedback informed product messaging, policy alignment, and implementation strategies. The DPP was subsequently included in Zambia's revised National PrEP Guidelines and Implementation Plan as an upcoming product. Stakeholders expressed strong interest but also raised concerns around stigma, access barriers, side effects, and supply chain reliability. These findings underscore the critical role of inclusive, context-specific engagement in the introduction of multipurpose prevention technologies (MPTs). Lessons from this initiative may be relevant to similar high-incidence settings considering the DPP or other integrated prevention products.