South Africa’s health authorities have announced the rollout of a revolutionary HIV prevention injection that promises to reshape the fight against one of the country’s most persistent public health challenges.
The new drug, lenacapavir is a long-acting injectable that protects against HIV infection for up to six months with a single dose. Health Minister Aaron Motsoaledi hailed the development as a “historic step forward” in reducing new infections, particularly among young women and vulnerable communities.
“For the first time, we have a preventive tool that doesn’t rely on daily adherence,” Motsoaledi said at a briefing in Pretoria. “This innovation brings us closer to controlling HIV transmission in our lifetime.”
Limited Supply and Equity Concerns
Despite the optimism, officials caution that access will be limited in the early stages. South Africa has secured only a few hundred thousand doses—far short of what’s needed to meet national demand
Health experts say the limited rollout could exacerbate inequality between urban and rural populations. Major cities such as Johannesburg, Cape Town, and Durban are expected to receive the first batches, while smaller clinics may have to wait until mid-2026.
Dr. Nomvula Sithole, a public health researcher at the University of the Witwatersrand, emphasized the importance of equitable distribution.
“If this becomes a privilege for a few, we will miss a major opportunity to curb infections where they are rising fastest,” she said.
A New Phase in HIV Prevention
Lenacapavir belongs to a new class of drugs known as capsid inhibitors, which block the virus’s ability to replicate. Unlike previous oral preventive treatments—commonly known as PrEP—the injectable form dramatically reduces the burden of adherence, one of the biggest barriers to success.
South Africa remains home to the world’s largest population of people living with HIV, with an estimated 7.8 million infections. While the country has made steady progress in treatment and awareness, prevention efforts have struggled to keep pace, especially among youth.
Partnerships and Production
The rollout forms part of a public-private partnership between the South African government, the Global Fund, and the drug’s manufacturer, Gilead Sciences. Talks are reportedly underway with local pharmaceutical firm Aspen Pharmacare to explore domestic manufacturing, which could reduce costs and ensure a steady supply.
Motsoaledi confirmed that negotiations are “at an advanced stage,” adding that local production could begin by late 2026.
Looking Ahead
Public health officials are optimistic that the lenacapavir program will complement existing prevention measures, such as condom use, voluntary medical male circumcision, and awareness campaigns.
“We can’t rely on a single solution,” said Dr. Sithole. “But this injection could be the game-changer we’ve been waiting for.