South Africa has begun introducing Lenacapavir, a long-acting injection administered just twice a year to prevent HIV infection — and the rollout confirms the country’s standing as a global leader in HIV prevention innovation.
According to the National Department of Health, writing in SAnews, the introduction of Lenacapavir is not a stand-alone intervention but the culmination of more than a decade of strategic health system strengthening.
Built on a Decade of Leadership
South Africa has been one of the few countries globally to make antiretroviral-based pre-exposure prophylaxis (PrEP) available on its Essential Medicines List and integrate it into public primary healthcare.
The department adopted a pioneering approach in 2016 when it introduced oral PrEP, and by 2021 the country had scaled it across the public health sector — at a time when many countries were still debating whether it was feasible at all. Today, more than 2.2 million South Africans have been initiated on oral PrEP through public sector programmes.
That early investment built the platform — trained healthcare workers, supply chains, monitoring systems and community networks — that now allows South Africa to move quickly on the next generation of prevention technology.
A Scientific Breakthrough, Made Practical
Lenacapavir represents a major advance in HIV prevention. Unlike daily oral PrEP, it is administered as two injections every six months, offering a highly effective long-acting option that removes the burden of daily pill-taking. Clinical trials demonstrated unprecedented effectiveness in preventing HIV infection, leading to global recognition of Lenacapavir as one of the most important advances in HIV prevention in recent years.
The department stressed that Lenacapavir is an additional choice rather than a replacement for existing methods — part of South Africa’s philosophy of informed choice and combination prevention, which recognises that different people need different options at different stages of their lives.
Long-acting technologies are expected to be especially valuable for people who find daily prevention methods difficult to sustain, including adolescent girls and young women, and pregnant and breastfeeding women.
Owning the Future
The rollout reflects a balanced model of domestic ownership and catalytic international support. While development partners assisted with the early introduction, government has committed to long-term sustainability and future domestic financing as more affordable generic products become available.
“By building on the strong foundation established through the national oral PrEP programme, South Africa is undoubtedly positioned to once again lead globally in expanding equitable access to life-saving HIV prevention technologies and accelerating progress towards ending new HIV infections,” the department said.
For a country that has carried one of the world’s heaviest HIV burdens, the symbolism is powerful: South Africa is no longer simply fighting the epidemic — it is showing the world how to end it. Government said it will continue to mobilise resources and strengthen partnerships to support the rollout of what it calls a “game-changer” in the national response.
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