SA to Roll Out Groundbreaking HIV Prevention Jab Lenacapavir by 2026

Health Minister Dr Aaron Motsoaledi announced that the national rollout is expected to begin by March or April 2026, depending on coordination and preparedness among stakeholders.

South Africa is preparing to launch one of the most transformative HIV prevention tools in recent history — lenacapavir, a revolutionary long-acting injectable drug that could significantly reduce new HIV infections and reshape the country’s fight against the epidemic. Health Minister Dr Aaron Motsoaledi announced that the national rollout is expected to begin by March or April 2026, depending on coordination and preparedness among stakeholders.

A Game-Changer in HIV Prevention

Speaking at the National Roundtable on Lenacapavir Access and Sustainability on Tuesday, Dr Motsoaledi emphasized that lenacapavir represents a breakthrough in HIV prevention — a biannual injection offering six months of protection per dose. The drug, already endorsed by the World Health Organization (WHO), provides a practical and empowering alternative for individuals for whom daily or monthly prevention methods are difficult to maintain.

“We need prevention methods that fit into people’s lives, that address the gaps left by existing tools,” Motsoaledi said. “This is where lenacapavir comes in — as a timely and much-needed innovation to help us overcome persistent challenges in HIV/AIDS prevention. It expands choices within our combination prevention strategy.”

The Minister stressed that the initiative is not merely about introducing a new medical tool, but about transforming public health systems and ensuring inclusivity. “No one should be left behind simply because existing tools do not fit into their lives,” he noted.

Targeting the Most Vulnerable

The initial rollout will prioritize 23 high-incidence districts across six provinces, encompassing around 360 high-performing public clinics. These regions have been identified as having the highest new infection rates and will serve as pilot zones for the nationwide implementation.

Target populations include pregnant and breastfeeding women, adolescent girls, female sex workers, and men who have sex with men — communities historically at the highest risk of HIV transmission. This focus aligns with the government’s broader HIV strategy of ensuring equity and addressing social determinants of health.

Clinical trials have shown outstanding efficacy, with 100% protection among women and 96% protection among men who have sex with men and transgender women — statistics that, according to the Minister, “represent hope and science working hand in hand.”

Funding and Affordability Breakthroughs

In a major financing milestone, the Global Fund has allocated US$29 million to support about 456,000 initiations over two years, equating to 912,000 doses. The U.S. Centers for Disease Control and Prevention (CDC) has also pledged R2 billion to sustain ongoing HIV and AIDS programs for the next six months, ensuring the continuity of existing interventions during the transition phase.

Equally significant is the sharp reduction in cost — from US$28,000 to just US$40 per person per year — made possible through voluntary licensing agreements by Gilead Sciences. This partnership enables six pharmaceutical manufacturers, including one based in Egypt, to produce lenacapavir at an affordable rate. Generic production agreements with Hetero and support from the Bill & Melinda Gates Foundation will further drive affordability and local manufacturing capacity.

“What revolutions are made of is reducing costs 700 times,” Motsoaledi remarked, emphasizing the historic nature of this price breakthrough. He added that the government is already exploring options to integrate lenacapavir into domestic health financing systems, ensuring routine access beyond the initial two-year period.

Towards Ending HIV as a Public Health Threat

Dr Motsoaledi reaffirmed the government’s vision of ending AIDS as a public health threat by 2032, setting an ambitious goal of reducing new infections to below 0.1%. Mathematical models suggest that if two to four million South Africans adopt lenacapavir within two years of rollout, the country could achieve near-elimination of new infections — a feat that would mark a historic turning point in its decades-long battle against HIV.

“This is not just a dream. We have no choice — we must and will end AIDS in our lifetime,” he declared to applause from health officials and civil society representatives.

Collaboration for Sustainability

The rollout plan emphasizes multi-sectoral collaboration, involving the Department of Health, South African National AIDS Council (SANAC), community organizations, and international partners. The strategy also includes community engagement campaigns to combat misinformation, promote adherence, and integrate lenacapavir with broader sexual and reproductive health services.

The Health Minister underscored that the success of lenacapavir will depend not only on scientific innovation but on collective commitment, sustainable financing, and inclusive access: “This is how we move from promises to progress — together, across every sector and community.”

If successful, South Africa’s lenacapavir rollout could serve as a global model for HIV prevention, signaling a new era in the fight against one of the world’s most enduring public health challenges.