Gauteng is set to be the first province to rollout lenacapavir
Lenacapavir, a twice-yearly HIV prevention injection, is set for a phased rollout in South Africa starting around April 2026.
Announced by President Cyril Ramaphosa during the State of the Nation Address (Sona) this initiative speaks to South Africa’s commitment to curbing new infections and bringing hope to those at risk.
The initiative, targeting high-risk populations, will begin in over 300 public clinics across six provinces, including Gauteng, supported by a R513-million grant. The drug offers near-complete protection, serving as a vital, discreet, long-acting alternative to daily pills.
The rollout is scheduled to commence between April and June 2026, with initial efforts focusing on bridging the gap in HIV prevention for high-risk individuals.
The injection is aimed at adolescent girls, young women, sex workers, men who have sex with men, and people who use drugs.It will be distributed through public sector, primary healthcare clinics.
“Lenacapavir is for HIV-negative individuals at risk of contracting the virus. It is not a treatment, and it is not a vaccine, it’s an HIV prevention method targeting everyone, including key populations like men who have sex with men, sex workers, and transgender individuals.”
This distinction matters. It’s a shield, not a cure, and it comes at a time when South Africa is making strides in reducing new infections but still faces the daunting reality of 178,000 new cases annually.
Lenacapavir offers a chance to rewrite these narratives. It’s not just an injection; it’s a symbol of progress and hope. By providing a discreet, long-term prevention method, it removes some of the barriers, like the need for daily pills that have previously made prevention difficult for those most at risk.
South Africa is home to 8.15 million people living with HIV, the largest population globally. This number, paradoxically, is a testament to the success of antiretroviral therapy (ART), which keeps people alive longer.
In provinces like Mpumalanga, KwaZulu-Natal, and the Eastern Cape, the numbers reveal the complexities of the epidemic:
Mpumalanga: Now the province with the highest prevalence (17.4%), it’s also seeing a significant rise in its total number of people living with HIV.
KwaZulu-Natal: Home to nearly 2 million people living with HIV, it has shown dramatic drops in new infections but still carries the highest absolute burden.
Eastern Cape: With prevalence at 13%, it faces some of the largest gaps in treatment coverage, with only 73% of those who need ART receiving it.
