A Landmark Step in South Africa's HIV Response
President Cyril Ramaphosa officially launched the national rollout of Lenacapavir, a long-acting injectable form of pre-exposure prophylaxis for HIV prevention, on 5 June 2026 at the Lilian Ngoyi Stadium in Secunda, Mpumalanga. The event brought together government leaders, health officials, and community representatives to mark what the President described as a major turning point in the country's fight against HIV. Lenacapavir offers protection through just two injections per year, providing a new option for people at substantial risk of acquiring HIV through sexual contact.
The launch aligns with broader national efforts to reduce new infections and move toward ending AIDS as a public health threat by 2030. South Africa carries one of the largest HIV burdens globally, and this initiative expands prevention choices beyond daily oral pills or other methods that require more frequent adherence.
Understanding Lenacapavir and Its Mechanism
Lenacapavir belongs to a class of medications known as capsid inhibitors. It works by interfering with the HIV capsid, a protein shell that protects the virus's genetic material and is essential for its replication cycle. When administered as an injection, the drug maintains protective levels in the body for six months, eliminating the need for daily dosing. This long-acting formulation has shown high efficacy in clinical studies, with trials demonstrating near-complete prevention of HIV acquisition in key populations when used consistently.
Unlike traditional daily PrEP regimens that rely on consistent pill-taking, the twice-yearly schedule addresses common barriers such as forgetfulness, stigma associated with daily medication, or challenges in accessing refills regularly. Health authorities emphasize that Lenacapavir is not a vaccine and does not cure HIV; it is strictly a preventive tool for individuals who test negative for the virus.
The Scale of the Initial Rollout
The programme begins with 360 public health facilities prepared across six provinces and 24 high-burden districts. These sites are equipped to offer the injection alongside existing HIV testing, counselling, and other prevention services. Government targets aim to reach close to one million people by the end of 2027, scaling up to three million individuals over the subsequent three years. Priority groups include adolescent girls and young women, sex workers, men who have sex with men, and other populations facing elevated risk.
Early shipments included an initial batch of approximately 37,920 doses that arrived in the country earlier in 2026. Distribution will expand as more supply becomes available through partnerships and local manufacturing agreements.
Partnerships Driving Access and Production
South Africa has secured agreements with Gilead Sciences, the developer of Lenacapavir, to support both immediate supply and future local production. This collaboration includes provisions for technology transfer aimed at building regional manufacturing capacity. Additional support comes from international partners such as Unitaid and the Global Fund, which have facilitated early studies and initial deliveries in several African countries.
The national Department of Health has developed implementation guidelines to ensure safe, equitable, and effective integration of the new option into existing programmes. These guidelines cover clinical protocols, training for healthcare workers, and monitoring systems to track uptake and outcomes.
Read the full presidential address on the launchEffectiveness and Clinical Evidence
Clinical trials, including studies involving participants in South Africa and Uganda, have demonstrated strong protective effects. In one key trial focused on cisgender women, Lenacapavir showed 100 percent efficacy in preventing HIV acquisition compared to background incidence rates. Broader data indicate effectiveness exceeding 99 percent when the injection schedule is maintained.
Real-world implementation will combine the injection with comprehensive services such as regular HIV testing, sexually transmitted infection screening, and support for adherence to the six-month schedule. Officials stress that the drug complements rather than replaces other proven strategies like consistent condom use and treatment for those living with HIV.
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Addressing Implementation Challenges
While the launch represents significant progress, several practical considerations remain. Supply constraints, influenced in part by shifts in international funding, may initially limit the pace of expansion. Healthcare worker training and infrastructure upgrades at primary care facilities will be essential to handle increased demand.
Community engagement plays a central role in success. Stigma surrounding HIV prevention methods can deter uptake, particularly in rural areas or among young people. Targeted communication campaigns are planned to provide accurate information and build trust in the new option.
Coverage of the historic launch eventPerspectives from Government and Health Leaders
President Ramaphosa highlighted the intervention's potential to strengthen dignity and empower individuals to take control of their health. Health Minister Dr Aaron Motsoaledi has noted expectations that South Africa could become one of the largest users of the medication globally, reflecting both the scale of need and the country's commitment to innovative solutions.
Provincial health departments in high-burden areas are coordinating with national structures to ensure smooth rollout. Early feedback from pilot sites and related studies has informed adjustments to service delivery models, focusing on convenience and confidentiality for recipients.
Broader Public Health Implications
Reducing new HIV infections carries wide-ranging benefits for individuals, families, and the national economy. Fewer acquisitions mean lower long-term treatment costs and reduced strain on the healthcare system. The programme supports South Africa's National Strategic Plan on HIV, TB, and STIs, which emphasizes combination prevention approaches tailored to local contexts.
By offering a discreet, low-frequency option, Lenacapavir may particularly benefit groups that have faced barriers with daily regimens. Integration with existing services at clinics and community outreach points aims to make prevention more accessible across diverse settings.
Future Outlook and Sustainability
Plans include scaling production through local partnerships to ensure long-term supply security. Continued monitoring will track coverage rates, adherence patterns, and any emerging safety signals. International collaboration through bodies such as the African Medicines Agency and regional health organisations will support regulatory harmonisation and knowledge sharing.
The initiative forms part of a continental push, with South Africa becoming the ninth African nation to introduce the option. Lessons from this rollout are expected to inform similar programmes elsewhere on the continent.
Official government announcement on the rollout launchCommunity and Stakeholder Reactions
Public discussion on social media and in community forums reflects a mix of optimism and questions about access. Many express hope that the twice-yearly option will reach those most in need, while others highlight the importance of addressing underlying social and economic factors that influence HIV risk.
Advocacy groups have welcomed the development as a step toward more person-centred prevention. They continue to call for sustained investment to match the ambition of the targets set by national leadership.
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Supporting a Comprehensive HIV Response
Lenacapavir joins a suite of tools that includes oral PrEP, post-exposure prophylaxis, voluntary medical male circumcision, and universal access to antiretroviral treatment. The government continues to promote regular testing and linkage to care for those who test positive, ensuring a balanced approach that addresses both prevention and treatment.
Resources for further information are available through provincial health departments and the National Department of Health website, where updates on facility availability and eligibility will be posted as the programme expands.
Additional details on the game-changing launch
