A major HIV prevention breakthrough is transforming the global fight against new infections. For the first time, a twice-yearly injection called lenacapavir is being made available in 120 low- and middle-income countries, including South Africa. Experts are calling it a game-changer, as the treatment offers a powerful tool for ending HIV transmission.
Why This Breakthrough Matters
In 2024 alone, 1.3 million people worldwide acquired HIV. Traditional methods of prevention, such as daily oral pills or condoms, have faced barriers including stigma, adherence, and accessibility.
Lenacapavir changes this picture. With just two injections per year, it offers discreet and long-lasting protection. This could remove the obstacles that have slowed down the uptake of other prevention methods.
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The Science Behind Lenacapavir
Lenacapavir is a long-acting injectable pre-exposure prophylaxis (PrEP) drug. Clinical trials under the PURPOSE programme demonstrated nearly 100% effectiveness in preventing HIV infection.
The drug works by blocking the HIV virus from replicating in the body. Unlike daily pills, lenacapavir requires only one injection every six months, making it more user-friendly.
Global Rollout Across 120 Countries
The rollout covers 120 resource-limited countries, where HIV incidence remains high. According to Gilead Sciences, the company has committed to providing the branded drug at no profit until generic production begins.
Six generic manufacturers have been licensed to produce the medicine. The plan is to reach millions of people by 2027 with an affordable option.
South Africa’s Role in the Rollout
South Africa has one of the world’s largest HIV epidemics. The country reports over 7.8 million people living with HIV, according to Statistics South Africa.
The South African Health Products Regulatory Authority (SAHPRA) is currently reviewing lenacapavir. The Department of Health has already called the drug a “game changer in preventing HIV transmission.”
Local researchers at Wits Reproductive Health and HIV Institute (Wits RHI) played a central role in the trials. Their leadership ensures that South Africa is at the forefront of introducing this breakthrough.
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Accessibility and Affordability
One of the biggest barriers to new HIV prevention tools has been cost. In the United States, lenacapavir costs more than $28,000 per year.
However, through partnerships with Unitaid, The Global Fund, and the Bill & Melinda Gates Foundation, generic versions will be priced at around US$40 per person per year from 2027.
Early shipments of the branded version are expected in Africa by end of 2025.
Expert Opinions on the Breakthrough
International and local experts have emphasised the significance of this rollout.
- Peter Sands, Global Fund Executive Director: “This is not just a scientific breakthrough — it’s a turning point for HIV/AIDS.”
- Dr Meg Doherty, WHO Director of HIV, Hepatitis and STIs: “This regulatory milestone brings us one step closer to expanding access to lenacapavir.”
- Winnie Byanyima, UNAIDS Executive Director: “We have new, long-acting HIV prevention tools that could fundamentally reshape the HIV response.”
Timeline of Availability in South Africa
The first step is regulatory approval from SAHPRA. Once approved, the drug will be integrated into national HIV prevention programmes.
Partnerships with Unitaid and the Global Fund aim to ensure early access in South Africa by late 2025 or early 2026. This will make South Africa one of the first countries in Africa to adopt lenacapavir.
Addressing Challenges in HIV Prevention
Even with powerful new tools, challenges remain. Funding shortages, healthcare worker training, and community acceptance are key issues.
Civil society groups emphasise that stigma and misinformation must be addressed alongside medical rollouts. Without community trust, even the most effective drugs will not reach those who need them.
What This Means for Young Women in South Africa
Young women in South Africa face disproportionately high HIV infection rates. According to UNAIDS, adolescent girls and young women account for nearly 30% of new infections in the region.
Lenacapavir could significantly reduce these numbers by offering a discreet and effective prevention method. It allows women to take control of their health without fear of stigma.
Next Steps in HIV Prevention
The rollout of lenacapavir does not mean that other prevention methods will disappear. Condoms, oral PrEP, and voluntary medical male circumcision remain important tools.
However, lenacapavir adds a new dimension. Its long-acting nature makes it easier for people to stay protected. As WHO highlights, this combination prevention approach is the most effective way to reduce HIV transmission.
The Path Towards Ending HIV Infections
Experts believe the new HIV prevention breakthrough could accelerate progress towards ending AIDS as a public health threat by 2030, a target set by the United Nations.
With scientific innovation, strong partnerships, and adequate funding, countries like South Africa can lead the way in turning this goal into reality.
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The rollout of lenacapavir in 120 countries marks a historic moment in the fight against HIV. For South Africa, it represents hope, progress, and the possibility of drastically reducing new infections.
By combining scientific breakthroughs with community engagement and equitable access, the world moves closer to an HIV-free future.
