Health Minister Aaron Motsoaledi has defended the limited rollout of the six-monthly injectable lenacapavir (LEN) – this as Gauteng Health last week announced that it had already exceeded its initial target, recording more than 6 100 provincial initiations in its first month of implementation, reports IOL.
The rollout of the new anti-HIV treatment programme was launched by President Cyril Ramaphosa in Secunda last month, with Motsoaledi saying before the launch that the jab had been delivered to 99 of 360 facilities in high-burden districts across six provinces.
On Thursday, the Gauteng Department of Health said that since the state of the rollout, 6 130 “eligible clients have been initiated on lenacapavir across Gauteng, representing 131% of the provincial monthly target of 4 672 initiations”.
However, EFF MP Moshome Motubatse said 8.15m South Africans are infected with HIV, and that 170 000 new infections were reported annually.
“So why did the rollout start with only 37 920 doses and why does the government rely on charity-scale supply when the country already funds 74% of its HIV response domestically?” he asked.
He also wanted to know when the National Department of Health planned to scale up provision of the injection beyond the initial 456 000 persons covered.
In response, Motsoaledi said the 37 920 doses were those supplied by Gilead Sciences, and “it was not what had been ordered for the country”.
The drug is paid for with a grant from the Global Fund.
Motsoaledi maintained that South Africa was not relying on “charity-scale supply” for its HIV response. “Lenacapavir is expensive – the current price is $28 218 per person per year.”
Motsoaledi said the $29.2m from the Global Fund enables South Africa to accelerate early access to LEN, while maintaining fiscal sustainability during a period when the product remains under patent protection and global prices remain high.
This will also enable South Africa to establish the systems, service delivery platforms, healthcare worker training, supply chain capacity, and monitoring systems needed to support future full-scale implementation once affordable generics are available.
The department has a plan to scale up distribution of the jab – in phase 2 – to all primary healthcare facilities and community-based platforms through partnerships, the Minister added.
“The preparation of the facilities starts in the 2026/27 financial year, and actual delivery of lenacapavir is expected in the 2027/28 financial year, dependent on the availability of generics.”
More affordable generic formulations will be available once registered with the South African Health Products Regulatory Authority.
See more from MedicalBrief archives:
Minister promises SA-made generic as LEN rollout begins
Demand for new HIV jab outstrips supply in African rollout
Africa’s HIV response must pivot from aid dependency to ownership