South Africa launches biannual HIV prevention injection amid funding cuts that could limit access despite high hopes for impact
South Africa has launched a new twice-yearly HIV prevention injection that health officials say could significantly reduce new infections, though limited funding is expected to restrict early access.
The drug, lenacapavir, is a form of pre-exposure prophylaxis (PrEP) that is administered as an injection every six months and is highly effective at preventing HIV infection in high-risk individuals. It is being rolled out in South Africa as part of a broader expansion across the continent, where it is already in use in several other countries. South Africa is the ninth African nation to introduce the treatment.
The launch was described by President Cyril Ramaphosa as a major milestone in the country’s fight against HIV, calling it a potential turning point in the national response to the epidemic. The initial rollout will take place across 360 health facilities in high-burden areas.
South Africa has an estimated 8 million people living with HIV, the highest burden globally, and records roughly 160,000 new infections each year. Health experts say adolescent girls and young women are disproportionately affected, driven in part by socioeconomic vulnerability and unequal relationships.
While daily oral PrEP is already available, adherence challenges have limited its effectiveness. Health specialists say the new long-acting injection could improve prevention efforts by offering a more convenient dosing schedule.
Experts caution, however, that the impact will depend heavily on scale and funding. Current support from international partners is only expected to cover a fraction of those who could benefit, with estimates suggesting capacity for roughly 456,000 users over two years.
Access challenges are compounded by cuts to U.S. HIV/AIDS assistance programs, which have reduced funding for prevention services, outreach, and community health initiatives. Health officials say those cuts have strained existing infrastructure just as countries are preparing to expand rollout of the new drug.
The cost of lenacapavir remains a major barrier, with treatment priced at tens of thousands of dollars per patient annually in high-income markets. However, generic versions are expected to become available in 2027 under licensing agreements covering dozens of low- and middle-income countries, with projected prices dropping significantly.
South African health leaders are also exploring local manufacturing options in hopes of improving long-term supply and affordability.
Researchers say that if between one and two million HIV-negative people receive the injection over the coming decades, it could help push HIV toward being a far less significant public health threat in the country.
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