South Africa Launches New HIV Prevention Drug Amid Funding Concerns

JOHANNESBURG — On Friday, South Africa began distributing a new injectable HIV prevention drug known as Lenacapavir. This biannual treatment could significantly reduce infection rates, though U.S. funding cuts might limit its accessibility.

Lenacapavir, an innovative form of Pre-exposure Prophylaxis (PrEP), is administered via injection every six months and has proven highly effective for individuals at high risk of contracting HIV.

Interestingly, South Africa isn’t the first on the continent to implement Lenacapavir; it’s the ninth African country to do so. The rollout is aimed at combating the highest HIV rates in the world. At the launch, South African President Cyril Ramaphosa described Lenacapavir as not merely a medication but a pivotal moment in the nation’s fight against HIV.

The drug is being introduced in 360 health facilities situated in areas hit hardest by the epidemic. With around 8 million people living with HIV in South Africa, UNAIDS reports important advances in treatment, yet new infections remain a major concern, with approximately 160,000 new cases annually.

A youth demographic, especially adolescent girls and young women aged 15 to 24, experiences a disproportionate number of new infections. Many face challenges linked to power imbalances in their relationships, often involving older men.

Currently, South Africa does employ daily PrEP pills, but adherence has been tricky for many. Experts are optimistic that this new injection could enhance prevention efforts. Dr. Saiqa Mullick mentions that Lenacapavir presents a unique biannual option that may better fit people’s lives.

However, for the rollout to truly impact the epidemic, extensive support beyond what’s currently available from the Global Fund is necessary. Mullick notes that ideally, around 456,000 individuals would be put on the drug within the next two years to make a real difference.

Access to Lenacapavir is facing challenges, particularly due to cuts in the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) funding last year. These cuts have triggered significant gaps in HIV prevention services and community programs at a time when South Africa needs them most.

Linda-Gail Bekker, an expert from the Desmond Tutu Health Foundation, commented on the implications of reduced U.S. funding. She believes that had PEPFAR funding remained intact, South Africa could have secured more doses of Lenacapavir, ultimately facilitating a better response to the crisis.

The cost of Lenacapavir, produced by Gilead, is currently steep—nearly $28,000 annually in the U.S. Nonetheless, there are plans for generics to be available by 2027, priced around $40 per year, specifically aimed at low and middle-income countries. This could open up broader access for South Africa’s population.

Scientific predictions suggest that if one to two million HIV-negative individuals receive Lenacapavir by 2043, it could effectively render AIDS a minor public health challenge in South Africa.