South Africa, the country with the world’s highest HIV prevalence, is on the verge of a major public health breakthrough with the planned rollout of Lenacapavir, a revolutionary, long-acting injectable drug for HIV prevention. The country’s Health Minister, Aaron Motsoaledi, announced that the initial rollout is set to begin as early as April 2026. Lenacapavir is a game-changer as it offers six months of protection with just two doses per year, effectively overcoming the significant adherence challenges associated with daily oral pre-exposure prophylaxis (PrEP) pills.
The rollout will initially target 23 high-incident districts across six provinces, focusing on approximately 360 public clinics. Key populations prioritized for the initial phase include adolescent girls and young women, pregnant and breastfeeding women, female sex workers, and men who have sex with men—groups that face the highest risk of HIV transmission. Scientists are highly optimistic, with mathematical modeling suggesting that a widespread uptake could lead to the near-elimination of new HIV infections in South Africa, marking a potential turning point in the decades-long epidemic.The initiative is backed by a $29.2 million grant from the Global Fund, which will fund approximately 456,000 Lenacapavir initiations over two years. A landmark agreement with generic manufacturers, which includes an Egyptian firm, has secured the drug at an unprecedented affordable price of just $40 per person per year for 120 low- and middle-income countries. This collaboration between scientific innovation, global donors, and domestic health systems is critical as the country balances the high demand for the drug against initial limited supply.
