Healthcare Update: HIV Prevention Rollout in South Africa

Planned Rollout of HIV Prevention Injection

South Africa’s Ministry of Health has announced the initiation of a new HIV-prevention injection, lenacapavir (LEN), projected to be distributed to approximately half a million individuals throughout the country. This initiative targets the nation’s significant HIV prevalence rate.

Technical Specifications and Implementation Plan

The LEN injection is administered biannually and aims to significantly reduce HIV/AIDS incidence over the next 14 to 18 years, contingent upon widespread adoption. Clinical trials have demonstrated its efficacy in preventing HIV transmission, particularly among young women.

The initial rollout, scheduled for April 2026, is supported by a $29.2 million grant from the Global Fund, with an additional $5 million from the Networking HIV and AIDS Community of Southern Africa. The rollout will begin in 23 high-incidence districts across six provinces, targeting approximately 360 public clinics for the first phase.

Funding and Pricing

The initiative is partially facilitated by a price reduction from Gilead, setting the annual cost per person at $40, down from the initial $28,000. Long-term funding strategies will focus on integrating LEN into local healthcare systems, including the essential medicines list.

Policy and Operational Considerations

Minister of Health Aaron Motsoaledi highlighted the importance of prioritizing vulnerable populations in high-burden areas to maximize the prevention of new infections. However, he noted potential funding challenges due to reductions from international sources such as USAID.

Global and Local Approvals

The World Health Organization has endorsed the six-month HIV prevention injection as part of a comprehensive prevention approach. Gilead is actively pursuing registration in 18 high-incidence countries, including South Africa, to ensure access to LEN until generic alternatives are projected to be available in 2027.