South Africa has taken delivery of its first two shipments of Lenacapavir, the revolutionary twice-yearly injectable designed to prevent HIV transmission in high-risk populations. The medication, supplied from Ireland, arrives at a critical time as the country continues to carry one of the world’s largest HIV burdens. Health Minister Aaron Motsoaledi confirmed the consignment will be distributed to 350 public health facilities in the coming weeks, offering a powerful new tool in the national prevention arsenal.
After years of anticipation, South Africa has officially received its first consignments of Lenacapavir, the long-acting injectable that has the potential to transform HIV prevention. The two shipments arrived from Ireland this week and will be distributed through the public health system starting in the coming days. Health Minister Aaron Motsoaledi described the arrival as “a game-changing moment” in the country’s decades-long battle against HIV.
Lenacapavir, marketed as Sunlenca, is administered as a subcutaneous injection just twice a year. Clinical trials have shown it to be more than 99 percent effective at preventing HIV infection in high-risk individuals when used as pre-exposure prophylaxis (PrEP). Unlike daily oral PrEP pills that many people struggle to take consistently, this long-acting option removes the burden of daily adherence.
Why This Matters for South Africa
South Africa remains the country with the largest number of people living with HIV in the world — an estimated 7.8 million. While antiretroviral treatment (ART) programmes have saved millions of lives, prevention efforts have lagged, particularly among young women and key populations. Daily PrEP uptake has been hampered by stigma, side effects and the challenge of remembering to take a pill every day.
The arrival of Lenacapavir offers a powerful new weapon. By requiring only two injections per year, it dramatically simplifies prevention for people at substantial risk. The initial rollout to 350 public health facilities will focus on high-prevalence districts and key populations, including adolescent girls and young women, sex workers, men who have sex with men and people in serodiscordant relationships.
A Global First for Africa
South Africa is one of the first countries in Africa — and among the first globally outside high-income settings — to roll out Lenacapavir for prevention at scale. The medication was originally developed for treatment of multidrug-resistant HIV but has shown extraordinary promise as PrEP. Gilead Sciences, the manufacturer, worked with international partners and generic manufacturers to make the drug more accessible to low- and middle-income countries.
Minister Motsoaledi emphasised that this is not just about receiving medicine — it is about building a sustainable prevention ecosystem. “We are not only importing a drug,” he said during a briefing. “We are importing hope and a new way of protecting our people from HIV.”
Implementation Challenges Ahead
While the arrival of the first shipments is cause for celebration, the real work begins now. Health workers will need training on administration and monitoring. Cold-chain logistics must be strengthened in rural facilities. Most importantly, communities must be engaged so that people understand the benefits and feel confident accessing the injection.
Cost remains a critical factor. The government has negotiated access pricing with Gilead and partners, but scaling up to hundreds of thousands of users will require sustained funding. The Department of Health is already working with international donors and the Global Fund to ensure the programme can expand beyond the initial 350 facilities.
A Broader Shift in HIV Prevention
Lenacapavir joins a growing arsenal of long-acting HIV prevention tools. South Africa is already piloting the six-monthly injectable cabotegravir (CAB-LA) in selected provinces. The arrival of Lenacapavir adds another option that requires even less frequent dosing. Experts hope the combination will finally bend the curve on new infections, especially among young people who have traditionally struggled with daily pill regimens.
For many young South Africans, a twice-yearly injection could be life-changing. It offers discreet, highly effective protection without the daily reminder of HIV risk that some find stigmatising.
What Comes Next
The first facilities to receive Lenacapavir will begin administering the injection within weeks. Monitoring and evaluation systems are already in place to track uptake, adherence and real-world effectiveness. If the initial phase succeeds, the programme will expand rapidly across all provinces.
Minister Motsoaledi has made it clear that this is only the beginning. “Today we celebrate the arrival of the medicine,” he said. “Tomorrow we must ensure every person who needs it can access it.”
For a country that has lost so many to HIV over the past four decades, the arrival of Lenacapavir represents more than a new drug. It represents a new chapter — one where prevention is simpler, more effective and, crucially, within reach.