Lenacapavir Rollout Marks New Chapter in South Africa's HIV Fight

The introduction of Lenacapavir supports the government's commitment to ending AIDS as a public health threat by 2030 and achieving the long-term goal of zero new HIV infections.

South Africa is entering a new phase in its fight against HIV with the rollout of Lenacapavir, a long-acting HIV prevention medicine that health experts believe could transform efforts to reduce new infections. Writing on the significance of the breakthrough, Professor Nicholas Crisp said the medicine represents a major shift from prevention methods that rely on daily medication to a highly effective injection that provides protection for six months at a time.

The introduction of Lenacapavir supports the government's commitment to ending AIDS as a public health threat by 2030 and achieving the long-term goal of zero new HIV infections. With millions of South Africans still living with HIV, health officials believe the innovation could play a critical role in strengthening prevention while reducing the future burden on the healthcare system.

Twice-Yearly Injection Offers New Prevention Option

South Africa remains one of the countries most affected by HIV. According to 2025 figures, around 8.15 million people are living with HIV, representing approximately 12.9% of the country's population. Among adults aged 15 to 49 years, HIV prevalence stands at about 18.1%, while young people between 15 and 24 years continue to face a particularly high risk of new infections.

Recognising the need to strengthen prevention, President Cyril Ramaphosa announced during the 2026 State of the Nation Address that South Africa would introduce Lenacapavir as part of the country's HIV response. Less than four months later, the President officially launched the rollout of the medicine in Secunda, Mpumalanga, on 5 June 2026, fulfilling that commitment.

Unlike existing HIV prevention medicines that often require daily use, Lenacapavir is administered through a single injection every six months. This long-acting approach is expected to make HIV prevention easier for many people, particularly those who face challenges in consistently accessing healthcare services or maintaining daily treatment routines.

The first phase of the rollout will cover approximately 360 public clinics and healthcare facilities across high HIV-burden districts in six provinces. Government has set an ambitious target of reaching one million people by the end of 2027 and expanding access to three million people within three years.

Prevention Strategy Could Ease Long-Term Health Burden

Professor Crisp said the introduction of Lenacapavir strengthens South Africa's commitment to making prevention a central pillar of the national HIV programme. Although the country has achieved significant success in expanding access to antiretroviral treatment over the past two decades, reducing the number of new infections remains essential for controlling the epidemic in the long term.

The twice-yearly injection offers an opportunity to reach communities that may struggle to use existing prevention methods consistently. Improved uptake of HIV prevention services could reduce transmission rates while lowering the future demand for lifelong HIV treatment, creating long-term benefits for both patients and the healthcare system.

He said every HIV infection prevented reduces future healthcare costs and allows government to direct more resources towards other health and development priorities. From this perspective, Lenacapavir is not only a medical innovation but also an important policy tool that supports sustainable public health planning.

The rollout also reflects a broader shift in government policy from focusing primarily on treatment towards balancing treatment with stronger prevention measures. Health authorities believe this integrated approach will improve health outcomes while supporting South Africa's goal of eliminating HIV as a major public health challenge.

Local Manufacturing Could Strengthen Africa's HIV Response

Although Lenacapavir was developed by the United States pharmaceutical company Gilead Sciences, South Africa has applied to join the group of African countries that may receive rights to manufacture the medicine locally.

If approved, local production would strengthen the country's capacity to respond to HIV while positioning South Africa as an important supplier of advanced HIV prevention medicines across the continent. It would also contribute to developing the country's pharmaceutical manufacturing sector and expanding access to life-saving innovations throughout Africa.

Professor Crisp said this opportunity reflects how South Africa has evolved during decades of responding to the HIV epidemic. The country has moved from confronting one of the world's most severe public health crises to becoming an increasingly active contributor to global medical innovation.

He noted that local manufacturing of Lenacapavir would build upon decades of progress achieved through antiretroviral treatment programmes, public awareness campaigns and sustained efforts to reduce HIV transmission. Beyond the scientific achievement, he described the development as a symbol of resilience, determination and the collective work of healthcare professionals, researchers, government and communities.

Professor Crisp concluded that the availability of Lenacapavir places a powerful new prevention tool in the hands of South Africans. By embracing the innovation and expanding access across vulnerable communities, the country has an opportunity to protect future generations and move closer to a future where HIV is no longer one of South Africa's defining public health challenges.