South Africa is preparing to introduce a new HIV‑prevention jab, lenacapavir, which has demonstrated a 100 % success rate in preventing HIV transmission among young women. With the world’s highest HIV prevalence, the country plans to distribute the drug to roughly 456,000 people over two years, using an initial supply funded by a $29.2 million Global Fund grant.
Health Minister Aaron Motsoaledi said the drug, taken only twice a year, could potentially eradicate HIV/AIDS in South Africa within 14 to 18 years if adoption is widespread. The rollout, slated to begin in April 2026, will first target 23 high‑incident districts across six provinces, focusing on about 360 high‑performing public clinics. Motsoaledi stressed the need to prioritize vulnerable populations in high‑burden districts to maximise the impact of prevented infections.
Research shows lenacapavir is especially effective for young women, who account for over a quarter of the approximately 400 new infections recorded daily in South Africa. The World Health Organization has recommended the six‑month prevention jab as an additional option within combination prevention strategies.
Although the initial supply is donated, Motsoaledi expressed concern about long‑term financing, noting recent cuts from USAID and other donors. He highlighted that the drug’s price, originally $28,000 per person annually, has been reduced to $40 by manufacturer Gilead. South Africa aims to fund the programme independently, with sustained financing dependent on integrating lenacapavir into local systems such as the essential medicines list.
The introduction of lenacapavir marks a significant development in the fight against HIV/AIDS, and its rollout in South Africa is expected to substantially bolster the country’s response to the epidemic. Gilead is accelerating registration in 18 high‑incidence countries, including South Africa, and generic versions are anticipated by 2027, further expanding access. As the rollout proceeds, South Africa will be closely watched as a model for implementing lenacapavir in other nations with high HIV prevalence.
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