Lenacapavir is a gamechanger in the field of global health, signifying a shift from HIV prevention that requires a daily routine to a long-acting and highly effective form of protection. Lenacapavir is expected to support government's efforts to reduce and ultimately prevent new HIV infections in South Africa, advancing the country's goal of achieving zero new HIV infections and ending AIDS as a public health threat by 2030.
Figures from 2025 show that 8.15 million people in South Africa are living with HIV, accounting for approximately 12.9% of the total population. The most affected group is adults aged 15 to 49, and in this cohort, HIV prevalence is about 18.1%, and it remains worrying that young people aged 15 to 24, continue to face heightened vulnerability to HIV.
Recognising the need for further efforts to tackle this challenge, President Cyril Ramaphosa announced in his 2026 State of the Nation Address that government is committed to strengthening the country's HIV treatment programme through the rollout of Lenacapavir.
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Lenacapavir is a revolutionary HIV prevention medication administered through an injection only twice a year. Less than four months after announcing government's intention to introduce this groundbreaking innovation, President Cyril Ramaphosa delivered on that commitment by officially launching the rollout of Lenacapavir in Secunda, Mpumalanga, on 5 June 2026. The launch marked a significant milestone in South Africa's HIV response, bringing the country one step closer to expanding access to cutting-edge prevention tools and reducing new HIV infections.
This rollout represents important development in South Africa's ongoing efforts in reducing new infections while improving the public health response to HIV and AIDS.
The first phase of Lenacapavir is being rolled out to approximately 360 public clinics and health facilities located in high-burdened districts across six of South Africa's provinces. Government's immediate target is to reach one million people by the end of 2027 and three million in three years.
The introduction of this long-acting HIV prevention medicine aligns with South Africa's commitment to strengthening prevention as a key pillar of the national HIV response. While significant progress has been made in expanding access to antiretroviral treatment, reducing the number of new infections remains critical to achieving long-term epidemic control.
The availability of Lenacapavir provides an opportunity to reach individuals and communities who may face challenges in consistently accessing or using existing prevention methods. By offering protection through a twice-yearly injection, it has the potential to improve uptake and continuity of HIV prevention services, particularly among populations that remain disproportionately affected by new infections. This could contribute to reducing transmission rates, lowering the future burden on the healthcare system, and improving health outcomes across communities.
Furthermore, the introduction of Lenacapavir reinforces government's broader public health objective of shifting from a predominantly treatment-focused approach towards a more balanced model that prioritises early intervention and long-term sustainability.
Every new HIV infection prevented reduces the need for lifelong treatment and associated healthcare costs, enabling resources to be directed towards other pressing health and development priorities. In this regard, Lenacapavir represents not only a medical breakthrough, but also a strategic policy tool that can help accelerate South Africa's progress towards a healthier, more equitable and HIV-free future.
Although Lenacapavir is developed by the United States pharmaceutical company, Gilead Sciences, South Africa has applied for inclusion among the African countries to be granted the rights to manufacture the medicine.
This development will not only strengthen the country's capacity to respond to HIV, but also position South Africa as an important contributor to expanding access to life-saving health innovations across the continent.
For South Africa, this moment carries profound significance. It stands as a testament to the remarkable progress the country has made since the darkest days of the HIV epidemic, when communities were devastated by the height of this illness and loss of loved ones. Over the years, the country has improved its response towards HIV and AIDS, such as through the roll-out of antiretroviral medicines and awareness campaigns driven to minimise the spread of the disease while working towards the goal to eliminate it.
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The manufacturing of Lenacapavir builds on the decades of South Africa's fight against this epidemic, representing a significant step forward in the country's ongoing efforts to prevent new infections and improve public health outcomes.
Moreover, through the innovation of this medicine, the country is no longer only a recipient of medical innovation but is increasingly becoming a participant in shaping it. The opportunity that will be given if a company is found with adequate capacity to manufacture Lenacapavir reflects growing confidence in South Africa's capabilities and offers renewed hope that future generations may live in a country where HIV is no longer a defining public health challenge.
It is a milestone that speaks not only to scientific advancement, but also to the resilience, determination and collective efforts of all those who have contributed to the fight against HIV over the past decades. It is now in our hands to prevent new HIV infections in South Africa. Protect yourself, protect your future!
*Crisp is the Acting Director-General for the National Department of Health, and the Deputy Director-General for National Health Insurance in the Department of Health.
