Western Cape Health Department announces rollout of ‘breakthrough’ HIV prevention drug

“This is not a vaccine. It is antiretroviral-based prevention. The quest for a vaccine is ongoing, even in this province. But in the meantime, we have known since about 2010, 2012, that ARV-based prevention is a highly effective way of administering prevention. So this is, simply put, a pill that protects against HIV.”

These were the words of Professor Linda-Gail Bekker, the director of the Desmond Tutu HIV Centre at the University of Cape Town, during the announcement in Delft on Monday of the rollout of Lenacapavir by the Western Cape Department of Health.

Bekker was the national principal investigator for the PURPOSE trial in which they evaluated the twice-yearly injectable drug as pre-exposure prophylaxis (PrEP). She said Lenacapavir is not meant for people who are living with HIV but is targeted at people who are HIV-negative but at risk of contracting HIV – for example, couples where one partner is HIV-positive and the other HIV-negative, or they are young and having sex.

Lenacapavir is a form of PrEP that helps prevent HIV infection and is administered as an injection every 6 months. It is not a vaccine but a long-acting prevention medicine that offers an alternative to daily oral PrEP for eligible individuals.

“The rollout of Lenacapavir represents a major scientific breakthrough in HIV prevention, one of the most significant advances in the field in recent years, and gives us another opportunity to strengthen HIV prevention in our communities. It expands the choices available to people who may benefit from a long-acting prevention option and brings us one step closer to a future with fewer new infections,” said MEC for Health, Mireille Wenger.

Wenger said the drug expands the choices available to people who may benefit from long-acting prevention. “It will be offered alongside the options already available, including condoms, oral PrEP, and regular HIV testing. We know that different prevention methods work for different people at different stages of their lives. By expanding the choices available, we can help more people find an option that works for them and support them to protect their health with confidence and with dignity.”

Amelia Mfiki, the Provincial Council on AIDS and TB co‑chairperson, welcomed the introduction of Lenacapavir as both a turning point and a remarkable milestone in advancing HIV prevention in the Western Cape.

“We need to prepare our communities and make sure that they understand the benefit of taking the injectable PrEP, and they understand that we are only giving options; we are not saying one is better. It’s better in terms of adherence; otherwise, the same prevention methods still apply. We are also calling for clear access to this medication so that when you go to a facility, you are not asked all the 100 questions. We are calling for clinic preparedness; we are calling for demand creation; we are calling for sponsors to make sure that we invest, not only in hiring staff, but also in making sure that the research is happening and supported in the province,” she said.

Head of department for health and wellness, Dr Keith Cloete, said the phased approach would allow the department to target available supply where it can have the greatest impact. “The Western Cape is implementing Lenacapavir in a responsible and targeted manner. The 22 facilities selected for the first phase serve communities with a high HIV burden and are well-positioned to support the rollout. Clients will receive HIV testing, counselling and clinical assessment before starting the medicine, and ongoing follow-up will be an important part of the programme.”

The facilities participating in the first phase of the rollout are:

Khayelitsha (Site B) CHC

Phumlani Clinic

Weltevreden Valley Clinic

Vuyani Clinic

Delft South Clinic

Matthew Goniwe CDC

Gugulethu Clinic

Nolungile CDC

Symphony Way CDC

Town 2 CDC

Delft CHC

Gugulethu CHC

Mzamomhle Clinic

Dr Abdurahman CDC

Mfuleni CDC

Luvuyo CDC

Michael Mapongwana CDC

Nyanga CDC

Kuyasa CDC

Ikhwezi CDC

Dr Ivan Toms CDC

Nomzamo CDC

The department encouraged residents to speak to healthcare workers at participating facilities for more information about eligibility and available HIV prevention services.