South Africa Adds Revolutionary HIV Prevention Drug Lenacapavir to Essential Medicines List
Pretoria – The Department of Health’s National Essential Medicines List Committee has given the green light to include the newly registered injectable lenacapavir on the Essential Medicines List. This step fits with the department’s goal to provide safe, effective, high-quality, and affordable medicines to everyone in the public sector. By adding treatments like lenacapavir to the list, it helps push for the making of cheaper generic versions, which can make them easier to get and less costly, especially in countries like South Africa with limited resources.
This choice is seen as key to filling big gaps in current ways to prevent HIV. Last month, the local drug watchdog approved lenacapavir, making South Africa the first nation on the continent to do so. Plans are in place to roll out this game-changing twice-a-year shot against HIV as soon as March 2026.
What is Lenacapavir and How Does It Work?
Lenacapavir is a long-acting medicine taken as a shot every six months to stop HIV infection before it starts. Made by a US-based company, it belongs to a group of drugs that block the virus from copying itself inside the body. Unlike daily pills or monthly shots for prevention, this one offers longer protection with fewer doses, making it easier for people to stick with it.
Tests in big studies showed it works very well. In one trial with women and girls, it cut HIV risk by 100%, with no one getting the virus. Another study with men and transgender people found it lowered risk by 96%. These results make it a strong tool against HIV, especially where sticking to daily meds is hard due to stigma, forgetfulness, or access issues.
South Africa, with about 7.8 million people living with HIV – the highest number in the world – stands to gain a lot. The drug could help reach groups like young women, who face high infection rates, and key populations often left out of health services.
The Approval Process and Role of the Essential Medicines List
The committee that picks essential medicines is a group chosen by the health minister. It works under the country’s drug policy to create and update a list of must-have medicines for public clinics and hospitals, along with care guidelines for basic, mid-level, and advanced health services.
Adding lenacapavir follows its okay from the local health products watchdog in October 2025. The company behind it applied in March that year, and the review worked with global health bodies to speed things up. This makes South Africa a leader in Africa for getting this new prevention option.
The list acts as a guide for buying and sharing medicines in the public system. It helps make sure people get what they need at low costs. Around the world, such lists are tools for fair health access, picking cost-effective options that meet main health needs while keeping quality high.
In a place with tight budgets and many health problems, this list is vital for fair access to care. It pushes for generics, which can drop prices a lot once patents end or deals are made.
Benefits for HIV Prevention in South Africa
This drug tackles weak spots in current prevention ways, like daily pills that people sometimes skip. A shot twice a year could boost sticking to treatment, cutting new infections. Health leaders see it as a way to hit goals like ending HIV as a public threat by 2030.
For women and girls, who make up over half of new cases here, it offers more choice and control. It also helps in places with high stigma or limited clinics. By adding it to the list, the department aims to make it part of standard care, reaching those who need it most.
The world health body gave it a thumbs up in October 2025, calling for quick rollout in hard-hit areas. This backs South Africa’s move and could draw more funding from global partners.
Challenges: High Costs and Access Issues
One big hurdle is the price. In richer countries, it costs about R700 000 a year, way out of reach for most here. But the maker has deals to let generic versions in poorer nations, which could bring costs down to around R700 a year. Talks are on to make sure generics hit the market soon.
Even with lower prices, rolling it out needs strong supply chains, trained health workers, and community education. The health system, already stretched by HIV care for millions, must plan well to avoid shortages.
Some worry about side effects, like reactions at the shot site or rare drug resistance. But studies show it is safe, with benefits outweighing risks for high-risk groups.
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