Phaahla: Long-Acting HIV Injectables Like Lenacapavir to Transform Prevention

Deputy Minister of Health Dr Joe Phaahla has hailed long-acting HIV prevention injectables, particularly Lenacapavir, as a groundbreaking development that has the potential to significantly reduce new HIV infections in South Africa. Speaking at the 12th South African National AIDS Conference 2025, Phaahla described the twice-yearly injection as a “game-changer” for prevention, especially among adolescent girls, young women, and key populations most at risk.

South Africa Secures Global Fund Support

South Africa has secured approximately R520 million from the Global Fund to Fight AIDS, Tuberculosis (TB), and Malaria to procure and roll out Lenacapavir. This investment comes at a critical time, as the country works to strengthen its HIV response while addressing challenges posed by shifting international funding patterns.

Phaahla expressed gratitude to the Global Fund and other partners for selecting South Africa as one of the early adopter countries for Lenacapavir’s implementation as a pre-exposure prophylaxis (PrEP) option.

“Prevention technologies such as long-acting injectables, including Lenacapavir, expand the menu of prevention choices available to people at risk of HIV. This ensures that we protect the gains made thus far in our HIV response,” Phaahla said.

HIV Combination Prevention as a Priority

Phaahla emphasised that modelling studies and expert guidance consistently point to combination HIV prevention strategies—which include PrEP, condoms, treatment as prevention, and behavioural interventions—as the most cost-effective and efficient approach to reducing new infections.

He urged stakeholders to ensure that prevention remains a cornerstone of the country’s HIV strategy, even as the health system continues to deal with broader resource constraints.

Resilience Amid Funding Cuts

The Deputy Minister acknowledged the strain caused by the withdrawal of funding from the United States for HIV programmes in South Africa. He praised healthcare workers, researchers, and civil society for their resilience in ensuring minimal service delivery disruptions for those relying on care.

“This became more than a conference, but a platform for renewing our collective commitment to end AIDS as a public health threat by 2030,” he said.

Harnessing Technology in the HIV Response

Phaahla also highlighted the role of technological innovations—including artificial intelligence (AI), digital technologies, and data analytics—in accelerating prevention, treatment, and surveillance. These technologies, he explained, can improve programme management and help optimise the delivery of services.

However, he cautioned that digital systems must be implemented with strong governance and privacy protections to ensure trust and prevent misuse.

“I need to be clear that utilisation of these technologies is never intended to replace the human element in healthcare, but to enhance our response,” he added.

Addressing TB and HIV Co-Infection

Acknowledging that TB and HIV co-infection remains the leading cause of death for people living with HIV, Phaahla outlined government efforts to strengthen the integration of TB and HIV services.

In February 2025, the Department of Health launched the “Close the Gap” campaign, aimed at finding 1.1 million clients who disengaged from treatment. Phaahla called on all stakeholders to ramp up re-engagement efforts and ensure that clients not only restart but also stay on treatment.

Government has also expanded TB preventive therapy, rolled out new rapid molecular diagnostics, and launched the End TB campaign in March 2025. This campaign aims to conduct five million TB tests to identify missing cases and link patients to treatment promptly.

A Shared Journey Toward Health Equity

In his closing remarks, Phaahla urged delegates to unite in purpose, focusing on building an inclusive and just health system.

“Let us redefine health, not as a set of vertical programmes, but as a shared journey toward wellness, inclusion, and justice. The future is not distant. We are building it now, for mothers, fathers, children, and generations to come. Together, we will end AIDS, eliminate its co-travellers, and write a new chapter of health equity in South Africa,” he concluded.

The introduction of long-acting HIV prevention tools such as Lenacapavir, combined with expanded TB interventions and digital health technologies, signals a new phase in South Africa’s fight against HIV and TB—one that balances innovation, resilience, and community-driven solutions.