South Africa’s health department is preparing to introduce the world’s first long-acting injectable HIV prevention medicine, lenacapavir (LEN), at more than 300 public clinics starting April 2026. The twice-yearly jab is seen as a game-changer in efforts to curb the country’s high HIV infection rates, especially among young people and women.
According to senior technical advisor Hasina Subedar, the government has allocated R513 million from a Global Fund grant to buy the branded version of LEN from Gilead Sciences. This funding could support nearly half a million people on the jab over the next two years. Scientists say widespread uptake could significantly reduce new infections, following 2024 studies that showed near-complete protection for HIV-negative people.
LEN works as a PrEP (pre-exposure prophylaxis) by blocking HIV from entering immune cells, offering protection for six months with a single injection. In April 2027, South Africa expects to switch to cheaper generic versions, licensed to six global manufacturers, allowing expansion beyond the initial 300 facilities to thousands of public clinics nationwide.
The first districts to receive LEN include high-performing clinics in Johannesburg, Tshwane, Ekurhuleni, eThekwini, and Mpumalanga’s Gert Sibande, where daily oral PrEP distribution has been most effective. Facilities in provinces hit hard by US funding cuts, like the Western Cape and Free State, will need support to strengthen services before being considered.
The roll-out depends on timely approval by the South African Health Products Regulatory Authority (Sahpra), which may register the drug as early as October 2025. If successful, the programme could mark a turning point in South Africa’s HIV epidemic and serve as a model for other high-prevalence countries.
