South Africa has become the first African country to register the anti-HIV injection lenacapavir, according to what health officials are calling a “game-changer” in the fight against HIV.

The South African Health Products Regulatory Authority (SAHPRA) announced on Monday, 27 October, that it had approved the registration of lenacapavir, the groundbreaking twice-a-year anti-HIV injection.

In March 2025, Gilead, a biopharmaceutical company based in the United States, applied to SAHPRA, the local drug regulatory authority.

Two weeks ago, Health Minister Dr Aaron Motsoaledi announced that South Africa plans to launch lenacapavir as early as March 2026.

The South African National AIDS Council (SANAC) and the Department of Health held a multi-stakeholder roundtable session to discuss the country’s readiness to implement lenacapavir.

Motsoaledi highlighted the drug’s potential to address critical gaps in current HIV prevention methods.

Meanwhile, SAHPRA stated that the review process was done in collaboration with the European Medicines for All Procedure.

“This procedure enables the European Medicines Agency, together with the participating regulatory authorities, to provide scientific opinions on high-priority medicines, such as lenacapavir, intended for markets outside the European Union.

“The benefits of this pathway are to strengthen regulatory systems and accelerate access to essential medicines,” the watchdog explained.

This product, developed to prevent new HIV infections, is a six-monthly injection.

There is an initiation dose of a subcutaneous injection with tablets taken on days one and two.

The antiviral medication works by interfering with the capsid, the protective outer shell of the HIV virus. By disrupting the capsid at multiple stages of the viral life cycle, lenacapavir prevents HIV from replicating and spreading.

“It is used to reduce the risk of HIV in adults and adolescents who weigh at least 35 kg, are HIV negative, and are at risk of getting HIV,” SAHPRA said.

According to the SAHPRA, lenacapavir for pre-exposure prophylaxis (PrEP) should always be used in combination with safer sex practices, such as using condoms, to reduce the risk of getting other sexually transmitted infections.

“The registration of lenacapavir is a game-changer, given the high prevalence rate of HIV in South Africa. This product is the most effective HIV prevention measure thus far,” said SAHPRA CEO, Boitumelo Semete-Makokotlela.

Earlier this month, Motsoaledi announced that the government plans to integrate lenacapavir into domestic financing mechanisms, aiming for routine funding after two years.

He stated that Gilead and six pharmaceutical companies, including one in Egypt, will produce the jab for US$40 per person per year, which is a significant reduction from US$28,000, reducing costs by 700 times.

Motsoaledi says pharmaceutical companies, like Hetero and partnerships with the Gates Foundation, will produce generic versions, while South Africa actively pursues local manufacturing capabilities.