A groundbreaking new form of HIV prevention has been initiated in South Africa, offering a significant step forward in the fight against the epidemic. The first individuals have started receiving lenacapavir, a novel injectable drug that provides six months of protection against HIV with a single shot.
This rollout, coordinated by Wits University and funded by the UN agency Unitaid, marks some of the earliest real-world use of this long-acting prevention in low- and middle-income countries. While the exact number of initial recipients in South Africa was not disclosed, the drug represents a major logistical advance over daily pills.
The initiative is expanding across the region. Neighboring Zambia and Eswatini received 1,000 doses last month via a US-backed program, with launches timed for World AIDS Day.
The effort is made possible by an agreement with the manufacturer, Gilead Sciences, to supply the medication at a no-profit cost for up to two million people in high-burden nations over three years. This is critical for a region—eastern and southern Africa—that bears over half of the global HIV caseload.
Currently priced at $28,000 annually in the US, access is set to improve dramatically. Through deals brokered by Unitaid and the Gates Foundation, generic versions are anticipated by 2027, potentially costing as little as $40 per year in over 100 countries.
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