South Africa has made history as the first African country to approve a long-acting injection to prevent HIV. The South African Health Products Regulatory Authority (SAHPRA) announced on 27 October that it had registered lenacapavir, developed by global pharmaceutical company Gilead Sciences.

Unlike daily tablets, the injection is given only twice a year. It begins with an initial jab and two tablets, followed by six-monthly injections. It is intended for HIV-negative adults and adolescents weighing at least 35 kg who are considered at high risk. Authorities emphasise that it should still be used alongside safe sex practices, as it does not guard against other sexually transmitted infections.

Health Minister Dr Aaron Motsoaledi said government plans to roll out the injection in March 2026. With one of the world’s highest HIV rates, South Africa hopes the new option will fill critical gaps in prevention for people who struggle with daily medication.

SAHPRA chief executive Boitumelo Semete Makokotlela described the development as a “game-changer.”

A key breakthrough is cost. Originally priced at $28 000, the treatment will now be made available for about $40 (roughly R730) per person per year through partnerships with local and international manufacturers. Government also plans to integrate it into national health funding.

Preparations are underway to train health workers, secure supply chains and run awareness campaigns. For communities, especially those facing stigma or barriers to consistent pill use, a discreet six-monthly injection offers new hope in the fight against HIV.

high-priority medicines. 

Crucially, costs have been drastically reduced. Gilead and six partnering pharmaceutical companies, including one in Egypt, aim to produce the injection at a cost of around US $40 per person per year — a steep drop from the original US $28 000. 

Furthermore, the government plans to integrate lenacapavir into its domestic financing mechanisms and move towards routine funding within two years. Local manufacturing capacity is also being pursued. 

What this means for local communities

For communities across South Africa — urban, rural and peri-urban — this development offers hope. A six-monthly injection could provide a more manageable and discreet prevention option for individuals who struggle with daily medication, or who face social or structural barriers to consistent adherence.