Thokozile Mnguni
The United Nations Programme on HIV/AIDS (UNAIDS) has praised South Africa’s introduction of Lenacapavir into its public health system, calling it a significant development in HIV prevention efforts.
The organisation said the rollout is the first of its kind at this scale globally.
South Africa joins Eswatini, Kenya, Lesotho, Nigeria, Zambia and Zimbabwe in making the injectable prevention drug available.
Lenacapavir is administered twice a year, and research indicates strong effectiveness in preventing HIV infection.
The drug is currently offered at 360 public health facilities across six provinces and in 24 districts with high HIV burdens.
Government plans to reach nearly one million people by the end of 2027, with a broader target of three million within three years.
UNAIDS said the rollout is supported by a combined R1.3 billion contribution from the Global Fund to Fight AIDS, Tuberculosis and Malaria and the Children’s Investment Fund Foundation, alongside government funding.
UNAIDS Executive Director Winnie Byanyima said the development reflects strong political commitment.
“President Cyril Ramaphosa has demonstrated commitment and political will to continue on a path to transform the HIV response. We welcome the prioritisation of adolescent girls and young women, men who have sex with men, sex workers and people who use drugs,” she said.
Byanyima also backed the scale of the government’s rollout plan.
“We welcome the ambition to reach three million people over the next three years and the discussions between Gilead Sciences and the government to explore local generic production,” she added.
At the launch, UNAIDS Eastern and Southern Africa Director Anne Githuku-Shongwe described the moment as historic for HIV response efforts.
“This is a moment many of us here in South Africa have waited for. For many of us who have worked in the HIV response, this moment feels almost unimaginable. And yet here we are,” she said.
She noted earlier concerns around affordability, saying the treatment previously cost tens of thousands of dollars per person annually in high-income countries.
UNAIDS has urged governments, donors and health partners to accelerate access across eastern and southern Africa.
It also called on pharmaceutical companies to expand licensing agreements and speed up generic production to ensure wider access.
Meanwhile, the Gauteng Department of Health says it will roll out Lenacapavir (LEN) this week as part of a national HIV prevention programme aimed at reducing new infections and advancing efforts to end AIDS as a public health threat by 2030.
The department has been identified as a key implementation province due to its high HIV burden. The rollout will take place at 133 health facilities across Johannesburg, Tshwane, Ekurhuleni, Sedibeng and the West Rand, targeting people at the highest risk of infection.
Spokesperson Steve Mabona said Gauteng, as the country’s most populous province and one of the areas most affected by HIV, is a critical site for the first phase of implementation.
He said the province has been allocated sufficient stock to initiate 56,079 eligible clients between June 2026 and March 2027. An initial batch of 18,809 doses has already been distributed to districts to prepare facilities for rollout, with additional stock to follow quarterly.
Lenacapavir is a long-acting injectable form of pre-exposure prophylaxis (PrEP). It adds to existing HIV prevention methods, including oral PrEP, condoms, HIV testing, voluntary medical male circumcision and post-exposure prophylaxis.
Phase one will prioritise adolescent girls and boys, young women and men, key populations including sex workers, men who have sex with men, transgender people and people who inject drugs, as well as pregnant and breastfeeding women at higher risk.
Health officials stress that Lenacapavir is part of a combination prevention strategy and does not replace other HIV prevention and treatment services.