Johannesburg – South Africa has launched Lenacapavir, a long-acting HIV prevention injection, as part of efforts to reduce new infections, Health Minister Aaron Motsoaledi announced at an event in Johannesburg on Tuesday. The injectable drug will be administered twice a year and aims to protect high-risk groups including adolescent girls, pregnant and breastfeeding women, female sex workers, and men who have sex with men.
The minister said South Africa has secured an initial allocation of Lenacapavir through a Global Fund grant worth around 29 million U.S. dollars. This will cover roughly 456,000 initiations over two years, translating to 912,000 doses, but only meets a fraction of the total need during the early rollout. The first deliveries are expected in December 2025, with the national campaign beginning in March or April 2026, following registration by the South African Health Products Regulatory Authority (SAHPRA).
Clinical trials showed that Lenacapavir is 100 percent effective in preventing HIV in young women and 96 percent effective for men who have sex with men. Unlike daily oral pre-exposure prophylaxis (PrEP), the six-monthly injection reduces the risk of missed doses and is expected to improve adherence among high-risk populations.
Motsoaledi said the government’s goal is to reduce HIV infections to below 0.1 percent by 2032. He stressed that while the injection is for prevention, individuals already living with HIV will continue with existing antiretroviral therapy, including single-pill combination regimens introduced in 2012.
The minister also noted ongoing efforts to explore local production of Lenacapavir generics. Currently, the U.S.-based manufacturer, Gilead, holds the patent and has issued voluntary licenses to six pharmaceutical companies, with only one located in Africa, in Egypt. South Africa is negotiating for local production to meet domestic demand, given the country’s high HIV burden.
In 2023, about 149,000 people were diagnosed with HIV in South Africa, with women and adolescent girls being most affected. Motsoaledi said persistent challenges in prevention and adherence make the injectable an important addition to existing HIV strategies. The government plans a massive education and mobilization campaign to ensure uptake, once SAHPRA registration is completed.
Motsoaledi also addressed concerns over illegal export of antiretrovirals, referencing a recent bus incident where large quantities of ARVs were discovered, noting that such actions are illegal and undermine local treatment programs.
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