South Africa will begin providing Gilead’s long-acting HIV prevention injection, lenacapavir, on 5 June 2026, Health Minister Aaron Motsoaledi told Parliament during his department’s budget vote. The twice-yearly shot serves as a major new tool for prevention. This follows trial data, which showed near-complete protection against HIV when used as PrEP.
Motsoaledi said the country could “eliminate HIV/Aids as a public health threat by 2030”, but stressed that success would depend on collective effort. South Africa is home to an estimated 8 million people living with HIV. As a result, prevention and incidence reduction remain at the centre of health system planning.
Lenacapavir Rollout Prioritises High-Incidence Districts
The Department of Health plans to start distributing stock to depots and facilities within weeks, beginning with 360 health facilities in high-burden districts. In the first year, the department expects to initiate about 229,360 people on lenacapavir.
Access will be targeted. The initial offer focuses on groups at higher risk of infection and poorer health outcomes. These include pregnant and breastfeeding women, adolescent girls and young women, men who have sex with men, transgender people, and people who inject drugs. This approach reflects an attempt to match limited early supply with the highest prevention impact.
Lenacapavir Rollout Delayed By Post-Import Testing
The first shipment of close to 38,000 doses arrived in early April. According to the Minister and prior Health Department communications, SAHPRA post-importation testing requirements delayed the programme start date.
Healthcare leaders face a clear operational lesson: even after they finalise policy and procurement decisions, regulatory and quality-assurance steps can shift timelines. These shifts will inevitably disrupt planning at the facility level. Specifically, facilities must establish new systems for staff training, patient education, and follow-up to manage the six-month dosing schedule.
Hospital Upgrades Announced As MPs Raise Corruption Fears
Motsoaledi also said the department will submit 11 bids to Treasury’s Budget Facility for Infrastructure to upgrade public hospitals, including five projects in Gauteng. Sites named include George Mukhari Academic Hospital and district hospitals in Shoshanguve, Diepsloot, Thabang, and Eldorado Park.
The budget debate quickly turned political. MPs criticised the poor state of public healthcare and warned that capital projects remain vulnerable to corruption. The EFF’s Naledi Chirwa pointed to Mpumalanga, alleging billions spent on a promised hospital with no delivery. Rise Mzansi’s Makashule Gana called for lifestyle audits for procurement officials.
The DA’s Karl le Roux attacked Motsoaledi over comments questioning the impartiality of Constitutional Court judges hearing challenges to the NHI Act. This followed reports that the Minister argued they faced a conflict of interest because they were members of the Parmed Medical Scheme and benefited from private healthcare. Le Roux urged changes to Section 33, which limits medical schemes to covering services not offered by NHI. Furthermore, the DA said it would question President Cyril Ramaphosa on whether the Minister’s conduct meets the executive ethics code.
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