South Africa is set to roll out a new HIV-prevention jab, lenacapavir, which has shown a 100% success rate in preventing HIV transmission among young women. The country, with the world’s highest HIV prevalence rate, aims to distribute the drug to approximately 456,000 people over two years, with the initial supply funded by a $29.2 million Global Fund grant.
According to Health Minister Aaron Motsoaledi, the new drug, taken only twice a year, could potentially eradicate HIV/Aids in South Africa within 14 to 18 years if sufficiently adopted. The rollout, scheduled to begin in April 2026, will initially target 23 high-incident districts across six provinces, focusing on around 360 high-performing public clinics. Motsoaledi emphasized the importance of prioritizing vulnerable populations in high-burden districts to maximize the impact of the new infections prevented.
Research has shown that lenacapavir is highly effective in preventing HIV transmission, particularly among young women, who account for over a quarter of the approximately 400 new infections in South Africa each day. The World Health Organization has recommended the six-month HIV prevention jab as an additional prevention choice as part of combination approaches.
While the initial supply of the drug is donated, Motsoaledi expressed concerns about the long-term funding of the program, citing recent cuts to funding from USAID and other sources. He noted that the price of the drug, initially set at $28,000 per person annually, had been reduced to $40 by the manufacturer, Gilead. South Africa aims to fund its program independently, with long-term funding contingent on the integration of lenacapavir into local systems, such as the essential medicines list.
The introduction of lenacapavir is a significant development in the fight against HIV/Aids, and its rollout in South Africa is expected to have a substantial impact on the country’s efforts to combat the disease. With Gilead expediting registration in 18 high-incidence countries, including South Africa, the eventual availability of generic versions of the drug in 2027 is anticipated to further increase access to this life-saving medication. As the rollout approaches, South Africa will be closely watched as a model for the implementation of lenacapavir in other countries with high HIV prevalence rates.
