HIV activists slam South Africa’s lenacapavir rollout as too slow and too small
HIV activists in South Africa criticized the government’s planned rollout of lenacapavir, calling it too slow and limited in scope, with only 37,920 doses received so far. The coalition of organizations argues the allocation of 480,000 doses annually falls far short of the two-million doses needed to significantly reduce new HIV infections in the country, which recorded 149,000 new cases in 2023 despite existing PrEP programs.
A coalition of civil society organizations, including the African Budget and Information Advocacy (ABIA), Health Justice Initiative (HJI), and Treatment Action Campaign (TAC), condemned South Africa’s lenacapavir rollout as insufficient to combat its HIV epidemic. The groups warned that the initial allocation of 37,920 doses—delayed by mandatory post-importation testing—and the planned annual distribution of 480,000 doses are far below the two-million doses needed to make an impact. Lenacapavir, a twice-yearly injectable pre-exposure prophylaxis (PrEP) drug, has shown high effectiveness in preventing HIV infection in global trials. However, activists argue that South Africa’s rollout, set to launch on Friday by President Cyril Ramaphosa and Health Minister Dr. Aaron Motsoaledi, lacks urgency and fails to prioritize high-risk populations like sex workers. The delay stems from global supply shortages and Gilead Sciences’ patent monopoly, which restricts access. The first shipment arrived in March-April 2026, nearly two years after efficacy results were announced, pushing back the original April 2026 launch date. South Africa, home to the world’s largest HIV epidemic with eight million infected, recorded 149,000 new infections in 2023 despite its existing oral PrEP program serving over two million people. The coalition cited modeling by HE²RO, suggesting two million people in South Africa need lenacapavir to curb infections. Activists emphasized that the country’s role in advancing HIV research—including trials and community participation—contrasts with its limited access to lenacapavir, which is controlled by pharmaceutical decisions outside its borders. Katlego Rasebitse of the Sisonke Movement warned that excluding key populations, like sex workers outside clinics, will leave vulnerable groups unprotected. The groups urged expanded allocation and faster scaling of production to address the crisis effectively.
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