Ramaphosa hails Lenacapavir roll out as turning point in HIV fight

A twice-yearly injectable HIV prevention drug has arrived in South Africa. The rollout of the drug, lenacapavir, is underway in the country that needs it the most, about a-year-and-a-half after US aid cuts hit some of its HIV programmes. South African President Cyril Ramaphosa told crowds gathered for its launch at Lilian Ngoyi stadium in Secunda, Mpumalanga province, that the introduction of lenacapavir was a turning point in South Africa’s fight against HIV.

“Now we have definitely moved away from denialism to treatment and now to elimination,” he said. South Africa carries the highest burden of HIV globally, with over 8 million people living with the virus. It is hoped that lenacapavir will help curb new infections, which range from 140,000 to 170,000 annually.

The first batch of 37,920 doses is being distributed across 360 health facilities in six provinces that have high HIV rates. Some South African civil society organizations, however, call the rollout plan inadequate, asserting that at least 2 million doses are necessary to significantly affect new infection rates.

The government has acquired 912,000 doses, sufficient for 456,000 people, funded by a $29 million Global Fund grant. Lenacapavir is also expected to significantly lower pill fatigue and missed doses, typical challenges for traditional oral prevention drug users. Growing up witnessing the devastating effects of HIV in her family and community in South Africa pushed Olwam Plaatjie to start using preventive HIV medications at 16.

The 19-year-old is one of the thousands of South Africans who signed up for clinical trials of lenacapavir. “I’ve seen people default on their medication and get very sick,” she said. “That made me realise that one day it could be me, so I decided to prevent that and protect myself because people don’t disclose their status. So that’s why I made the decision to take preventative measures.” South Africa is initially targeting high-risk groups, including injectable drug users, sex workers, transgender people, adolescent women aged 15-24 and pregnant or nursing women with the new drug.