The Western Cape Department of Health and Wellness has launched the rollout of Lenacapavir, a long-acting HIV prevention injection, at 22 healthcare facilities across the Cape Metro.
The rollout is focused on communities carrying some of the province’s highest HIV burdens, including Delft, Khayelitsha, Gugulethu, Mfuleni and Nomzamo. Administered only twice a year, the injection is being hailed as a major breakthrough in HIV prevention.
The Western Cape recorded approximately 24,000 new HIV infections last year. Although the province has the country’s lowest HIV prevalence rate, health officials believe Lenacapavir could significantly strengthen prevention efforts.
Dr Keith Cloete, Head of the Western Cape Department of Health and Wellness, said the initial rollout covers five of the metro’s eight health subdistricts.
“What that brings us up to is five subdistricts in the metro, not all eight,” said Cloete.
He added that the programme will be expanded through a partnership with the Desmond Tutu HIV Foundation, with plans already underway to establish the first rural rollout site outside the metro.
“When ready for implementation, our first rural site outside of the metro will be in the George health subdistrict,” he said.
Researchers say Lenacapavir has demonstrated exceptional results in clinical trials, with studies showing an overall efficacy rate of 99% in preventing HIV infection. The bi-annual injection is widely regarded as one of the most significant advancements in HIV prevention in recent years.
Desmond Tutu HIV Centre Director Prof Linda-Gail Bekker said the new prevention option comes at a critical time for South Africa’s HIV response.
“We still have about 6,500 children who acquire HIV in the country. In my opinion, in 2026 we should have eliminated vertical transmission of HIV,” Bekker said.
To support the rollout, nearly 30,000 initiation doses have been secured for the first two years of the programme, with an additional 33,600 doses allocated for patients returning for follow-up injections.
“The funding comes from the Global Fund that has come into our system, and we have secured and put the funding in place,” Cloete said.
However, civil society organisations have raised concerns about whether available doses and staffing levels will be enough to meet anticipated demand.
Amelia Mfiki, Chairperson of Civil Society and Co-Chair of the Provincial Council on AIDS and TB, called on government to increase staffing at healthcare facilities.
“We are calling on the Department of Health to prioritise the hiring of clinicians and counsellors to make sure that whoever gets into the facility and asks for Lenacapavir is not told to come back the next day,” she said.
South Africa, which has one of the highest HIV infection rates globally, is currently undertaking the world’s largest rollout of Lenacapavir, marking a significant milestone in the fight against new HIV infections.