EDITORIAL | Lenacapavir rollout a crucial moment in fight against HIV/Aids

South Africa stands at a crucial moment in its decades-long fight against HIV/Aids. The rollout of the new six-monthly HIV prevention injection, lenacapavir (LEN), brings with it a renewed sense of hope and a powerful tool to curb new infections.

This breakthrough could not have arrived at a more critical time as new HIV infections continue to rise, underscoring the urgent need for effective, accessible prevention strategies.

The facts are clear and compelling. LEN, taken just twice a year, offers near-complete protection against HIV infection through sex. Today, it is available free of charge at 360 government clinics across Gauteng, KwaZulu-Natal, the Eastern Cape, Mpumalanga, North West and the Western Cape.

Soon, as affordable generic versions become available, the Northern Cape, Limpopo and the Free State will join this life-changing initiative, expanding access nationwide.

We commend the South African government, the department of health and their partners for their vision and resolve in making this revolutionary medication accessible to so many, so swiftly. Their commitment not only saves lives but also restores dignity and hope to communities hardest hit by HIV.

The phased rollout, supported by the Global Fund and bolstered by forthcoming generic options, ensures this intervention will be sustainable and reach those who need it most.

Every South African who is HIV-negative and meets the criteria should consider taking this injection — not only for individual protection but to help protect our communities and future generations.

LEN’s impact could be transformative. If between 1- and 2-million HIV-negative people use the jab each year between now and 2043, researchers at Wits University predict a dramatic drop in new infections. The annual number could be slashed from approximately 140,000 in 2025 to just 65,000 within two decades, potentially ending Aids as a major public health threat in South Africa.

But to make this vision a reality, widespread uptake is essential. The injection is safe, highly effective and suited for anyone at risk, including young women, sex workers, gay and bisexual men, transgender people and pregnant or breastfeeding women.

Every South African who is HIV-negative and meets the criteria should consider taking this injection — not only for individual protection but to help protect our communities and future generations.

While logistical challenges remain, such as the need for local quality testing and the wait for expanded private sector access, the determination to overcome these hurdles is evident. Plans to manufacture LEN locally and the prioritisation of generic registration will further accelerate progress, reduce costs and empower our health system.

As South Africa leads the way, we urge all eligible citizens to seek out this opportunity. Visit your nearest participating clinic, learn about LEN, get tested and take your health into your hands. In doing so, you are not only protecting yourself but joining a national movement to end new HIV infections for good.