South Africa has received its first consignment of lenacapavir, a long-acting injectable medicine that prevents HIV infection with near-perfect efficacy. The 37,920 doses arrived at OR Tambo International Airport in two shipments from Dublin on 30 March and 2 April.

Why it matters: South Africa has the world’s largest HIV epidemic. Lenacapavir requires just two injections per year, removing the daily adherence burden that undermines existing prevention options such as oral PrEP.

How it works

The drug is injected into the fatty tissue of the abdomen once every six months. Clinical trials showed it was nearly 100% effective at preventing HIV transmission through sexual contact. It works by blocking the virus at multiple stages of its replication cycle.

The Department of Health confirmed that the rollout will target groups at highest risk of infection first. These include adolescent girls and young women aged 15 to 24, sex workers, and men who have sex with men.

Funding and supply

The doses are funded through South Africa’s grant from the Global Fund to Fight AIDS, TB and Malaria. This first batch is part of a larger order of nearly one million doses financed for 2026 and 2027.

The original plan was to begin administering the drug on 1 April. Shipping delays pushed the rollout to mid to late May. The Department said it will announce the official launch date and phased implementation plan in the coming weeks.

Scale of the challenge

According to UNAIDS, approximately 7.7 million South Africans live with HIV. The country records more than 150,000 new infections annually. Oral PrEP, the existing prevention medicine, requires daily tablets. Adherence rates have been low, particularly among young women.

Lenacapavir addresses this gap directly. Two clinic visits per year replace 365 daily pills. Health officials describe it as the most significant advance in HIV prevention since the introduction of PrEP.

The medicine has already received regulatory approval from the South African Health Products Regulatory Authority. Quality checks on the batch are being completed before distribution begins.