Health minister hails new HIV prevention jab but warns of limited supply

JOHANNESBURG — JOHANNESBURG (AP) — South Africa’s health minister on Tuesday called lenacapavir, the world’s first biannual HIV prevention vaccine, a “revolutionary” tool to fight the disease, but warned that the initial supply of donations would be limited to nearly half a million people in the African country with the highest prevalence rate.

This comes just weeks after the United States announced plans to purchase 2 million doses of HIV prevention medication for low-income countries.

Initial procurement in South Africa is expected to begin in April 2026, funded by a Global Fund grant of $29.2 million and an additional $5 million allocated by the Networking HIV and AIDS Community of Southern Africa (NACOSA).

Addressing a national healthcare roundtable in Johannesburg, Minister Aaron Motsoaledi said the Global Fund’s catalytic commitment will enable approximately 456,000 lenacapavir initiations to be administered over two years, resulting in 912,000 doses.

“We plan to initially deploy lenacapavir in approximately 23 high-incident districts across six provinces, targeting approximately 360 high-performing public clinics in these areas for the first phase of implementation,” the minister said.

“About half a million people will be able to start using lenacapavir, and with this support, but demand will likely exceed supply initially,” Motsoaledi said, noting that research data suggests that prioritizing vulnerable populations in high-burden districts would have the greatest impact in terms of preventing new infections.

The minister was quick to warn against complacency with the initial investment after South Africa’s health system was significantly impacted by steep funding cuts from USAID and other US government sources in early 2025. These cuts had a severe impact on HIV/AIDS and tuberculosis (TB) treatment, prevention and research programs across the country.

Although Motsoaledi expressed gratitude to Gilead for lowering the price from the initially announced $28,000 to $40 per person per year, he said South Africa aimed to fund its program independently, with long-term funding dependent on lenacapavir’s integration into local systems, such as the essential medicines list.

In July, the World Health Organization recommended the six-month HIV prevention vaccine, already approved in the United States and Europe, as an additional prevention choice in combination approaches. Gilead is accelerating registration in 18 high-incidence countries, including South Africa, to deliver lenacapavir until generic versions are available in 2027.

In early October, Gilead Sciences announced that it had signed voluntary, non-exclusive, royalty-free licensing agreements with six pharmaceutical companies in Egypt, Pakistan and India to produce and market generic lenacapavir. Despite participating in clinical trials of the drug in recent years, South African companies were excluded from Gilead Sciences’ voluntary authorization, angering civil society.

“This is not the principle of Ubuntu,” said Sheila Mbele-Khama, referring to the South African philosophy which values ​​principles such as human dignity and fairness.

Mbele-Khama, speaking on behalf of the South African National AIDS Council (SANAC), told the panel that one in four new HIV infections occurred in the 26 countries to which Gilead had not licensed. “You can’t come into the house and ask us to allow you to learn and then you run away, you don’t include us anymore.”

According to Gilead country manager Wendy Cupido, South African manufacturers assessed in 2024 did not meet the technical specifications for producing sterile injectable products at that time. She added, however, that Gilead was still willing to consider other voluntary licenses if a South African manufacturer could develop the required capabilities and meet quality standards.

Welcoming the investment of more than $34 million in the rollout, UNAIDS South Africa country director Eva Kiwango said that at a time when cuts to foreign aid funding could lead to an additional 6 million HIV infections globally by 2029, long-acting injectable medicines were a “new option for everyone at risk”.

“It is neither a cure nor a vaccine, but it could be a game-changer if it were made available to everyone who could benefit from it,” Kiwango said. “For many, lenacapavir expands choices, strengthens agency and reduces barriers related to stigma, disclosure or daily adherence. »

The roundtable is a two-day event that concludes on Wednesday.

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