South Africa begins historic twice-yearly injectable HIV prevention rollout

SOUTH AFRICA—South Africa has introduced a new phase in its HIV prevention strategy with the official launch of Lenacapavir, a long-acting injectable, in Mpumalanga.

President Cyril Ramaphosa and Health Minister Dr Aaron Motsoaledi led the rollout at Lilian Ngoyi Stadium in Secunda, marking the start of a national programme to strengthen HIV prevention efforts.

The government positioned the rollout as part of its broader commitment to reduce new HIV infections, following earlier pledges made during the State of the Nation Address in February.

Speaking at the time, President Ramaphosa highlighted that the country would scale up access to Lenacapavir, describing it as a highly effective six-monthly injection designed to prevent HIV transmission.

The Presidency later confirmed that the initiative reflects collaboration between government, civil society, private sector partners, and global development agencies working toward ending HIV as a public health threat.

National rollout strategy and priority groups

The Department of Health has begun distributing the injectable through an initial network of 360 health facilities located in high-burden districts.

Officials confirmed that the first shipment includes 37,920 doses, delivered to depots and clinics ahead of the launch.

The rollout targets adolescent girls and young women up to 24 years old, pregnant and breastfeeding women, female sex workers, men who have sex with men, transgender people, and people who inject drugs.

Health authorities described Lenacapavir as a long-acting antiretroviral capsid inhibitor that offers an alternative to daily oral PrEP.

They noted that its twice-yearly dosing schedule could improve adherence, especially for individuals who face challenges with daily medication or frequent clinic visits.

HIV burden and public health progress

According to Statistics South Africa, about 8.15 million people were living with HIV in 2025, representing roughly 12.9% of the population.

Among adults aged 15 to 49, prevalence stood at about 18.1%.

Despite these figures, the country has recorded notable improvements in health outcomes over the past decade, including an increase in life expectancy from 54 years in 2010 to 66.9 years by 2025.

Maternal mortality also declined significantly over the same period, reflecting expanded access to treatment and care.

Regulatory approval and global guidance

The South African Health Products Regulatory Authority approved Lenacapavir in October 2025, making South Africa the first country in Africa to authorize its use for HIV prevention.

The World Health Organisation has since recommended it as an additional prevention option, noting that it can be used safely, including during pregnancy and breastfeeding for individuals at high risk of HIV exposure.

Broader prevention efforts and global context

The rollout comes shortly after South Africa intensified its “Close the Gap” campaign, which focuses on high-burden communities and vulnerable populations.

At the same time, preparations are underway for the United Nations High-Level Meeting on AIDS scheduled in New York, where member states are expected to review global progress and negotiate a new political declaration on HIV response priorities.

Health officials also noted that South Africa continues to expand testing, treatment, and prevention programmes as part of its long-term strategy to reduce new infections and improve health system outcomes nationwide.