South Africa launches twice-yearly HIV jab as U.S. aid cuts bite

Lenacapavir, a biannual injectable shown to be nearly 100 percent effective in trials, is rolling out across South Africa — but dose shortages and slashed American funding threaten to cap its reach.

South Africa has begun administering lenacapavir, a twice-yearly injection that showed near-perfect efficacy in late-stage HIV prevention trials.
The rollout faces an immediate supply ceiling, with available doses covering only a fraction of the estimated population at highest risk.
U.S. foreign aid cuts — including reductions tied to PEPFAR funding streams — have removed financial support that would have underwritten broader distribution.
South Africa carries the world's largest HIV burden, with roughly 7.8 million people living with the virus.
Gilead Sciences holds the patent on lenacapavir; generic licensing negotiations are ongoing but no deal has been finalised.

South Africa has begun rolling out lenacapavir, a twice-yearly HIV prevention injection that recorded near-perfect efficacy in clinical trials, in what health officials describe as a potential turning point in the country's decades-long fight against the epidemic.

The injectable pre-exposure prophylaxis drug, manufactured by Gilead Sciences, requires only two doses a year — a significant compliance advantage over daily oral regimens that have driven prevention efforts since the 2000s.

But the launch is constrained from the start. Available supply covers only a portion of the roughly 5.5 million South Africans the government identifies as priority candidates, according to reporting by NPR published June 5, 2026.

Cuts to U.S. foreign assistance, including reductions affecting PEPFAR-linked funding channels, have stripped away financing that health planners had counted on to scale the programme. The United States has historically funded more than 40 percent of South Africa's HIV response.

Generic licensing talks between Gilead and the Medicines Patent Pool remain unresolved. Without a low-cost generic, per-dose costs remain prohibitive for public health budgets operating under austerity.

South African health authorities have not issued a revised distribution timeline. Licensing talks and government procurement negotiations are expected to continue through the second half of 2026.