South Africa is taking a giant step in its fight against HIV. The Department of Health announced plans to make a new, twice-yearly anti-HIV injection available in public clinics.
The drug, lenacapavir, represents a potential turning point for HIV prevention. It could significantly curb new infections across the nation. Introducing lenacapavir for HIV prevention could change the landscape of health outcomes in South Africa.
Hasina Subedar, the department’s senior technical adviser for HIV prevention, said the department will introduce the jab between April 2026 and March 2028. They will provide it at more than 300 government clinics located in health districts with the highest rates of new HIV infections. This emphasises the importance of using lenacapavir for HIV prevention in areas most affected.
What is Lenacapavir?
Lenacapavir, also known as LEN, is a long-acting form of pre-exposure prophylaxis (PrEP). While users must take oral PrEP as a daily pill, they receive LEN as an injection just once every six months. It works by disrupting the protective shell of the HIV virus and preventing it from infecting a person's immune cells and replicating. This makes lenacapavir for HIV prevention a promising option.
Recent studies have shown the jab offers near-complete protection. This has sparked hope among scientists that, with sufficient uptake, it could halt South Africa’s HIV epidemic.
Health officials expect that the convenience of a bi-annual injection will overcome the adherence challenges of daily medication. This has been a significant barrier to the success of oral PrEP programmes. Therefore, lenacapavir for HIV prevention not only increases convenience but also addresses adherence issues.
R513m Funding to Kickstart Rollout of Lenacapavir in South Africa
A R513 million allocation from South Africa’s R7.1 billion Global Fund grant will bankroll the initial phase of the programme. This funding will provide the branded version of lenacapavir from Gilead Sciences to approximately 456,396 individuals over a two-year period. This funding will provide the branded version of lenacapavir from Gilead Sciences to an estimated 456,396 individuals over a two-year period.
The department will strategically select "high-performing" clinics to pioneer the rollout. These are facilities that have demonstrated success in distributing daily oral PrEP, particularly in districts within Gauteng, KwaZulu-Natal, and Mpumalanga.
Clinics in other provinces, which have seen a decline in PrEP uptake following recent US funding cuts, will first receive support to strengthen their existing services. The Department of Health will include these clinics in the lenacapavir programme afterwards.
Registration and Generic Access
Before the rollout can begin, several critical steps must be completed. The first is regulatory approval. The South African Health Products Regulatory Authority (SAHPRA) is conducting an expedited review of lenacapavir. They are expected to register the drug by November 2025, if not sooner. The Health Department aims to place its first order through the Global Fund by 30 September 2025.
While the initial rollout is a significant milestone, the long-term goal of ending AIDS as a public health threat hinges on wider, more affordable access. The current price being offered to the Global Fund is subsidised and confidential.
However, the department anticipates the arrival of cheaper generic versions in early 2027. This will enable the government to utilise its own funds to purchase the medicine. It will also increase its availability to more of the country’s 3,400-plus primary healthcare facilities. This will bring this revolutionary prevention tool to millions more South Africans, thanks to lenacapavir for HIV prevention.