WHO Announces Game-Changing HIV Prevention Drug: Lenacapavir

The World Health Organization (WHO) has made a major announcement at the 13th International AIDS Society Conference in Kigali, Rwanda, officially recommending injectable lenacapavir as a groundbreaking option for HIV prevention. This long-acting drug, given just twice a year, offers a highly effective alternative to daily oral pills and shorter-acting methods. The WHO’s endorsement could reshape the global fight against HIV, especially for people who struggle with daily adherence, face stigma, or have limited access to healthcare.

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How Lenacapavir Works

Lenacapavir is the first twice-yearly injectable pre-exposure prophylaxis (PrEP) product for HIV prevention. Clinical trials show it provides near-complete protection against HIV infection for those at risk. The drug, developed by Gilead Sciences, works by blocking the virus from replicating in the body. Because it only requires two injections per year, lenacapavir could help people who find daily pills difficult to manage or who worry about the stigma of HIV prevention.

Why This Matters for South Africa and Gauteng

South Africa, including Gauteng, continues to have one of the highest HIV burdens in the world. The WHO’s new guidelines come at a crucial time, as global HIV prevention efforts have stalled, with 1.3 million new infections recorded in 2024. Key populations such as sex workers, men who have sex with men, transgender people, people who inject drugs, those in prisons, and young people remain disproportionately affected.

Lenacapavir now joins other WHO-approved prevention options, including daily oral PrEP, injectable cabotegravir, and the dapivirine vaginal ring. However, access to lenacapavir outside clinical trials is still limited. The WHO urges governments and health partners to begin integrating it into national HIV programs while gathering real-world data on its impact.

Making Prevention More Accessible

To support the rollout of long-acting injectable PrEP like lenacapavir, the WHO also recommends simpler HIV testing using rapid tests. This change removes complex, costly procedures and allows delivery through local clinics, pharmacies, and tele-health services. The goal is to make HIV prevention as easy and accessible as possible, especially for those most at risk.

Broader Updates in HIV Care

In addition to recommending lenacapavir, the WHO has updated its guidance on HIV care integration. The organization now advises combining HIV services with treatment for high blood pressure, diabetes, mental health conditions, and improving adherence to antiretroviral therapy (ART). Routine screening for sexually transmitted infections (STIs) like gonorrhoea and chlamydia is also recommended for key populations, even without symptoms. For people living with HIV who have or are at risk of mpox (formerly monkeypox), the WHO strongly recommends starting ART quickly, especially if they have never begun treatment or have had long interruptions.

Challenges and Next Steps

Despite these advances, funding challenges threaten global HIV programs. The WHO has issued new guidance to help countries maintain essential services, prioritize interventions, manage risks, and keep health systems resilient. Dr Meg Doherty, WHO’s HIV programme director, stresses the urgency of bold, equitable implementation of these recommendations, powered by community engagement.

While lenacapavir is not yet registered for regulatory approval in all countries, its potential to increase PrEP uptake and bolster HIV prevention is clear. For now, many people at highest risk may have to wait longer than others to access this life-saving tool.

The Future of HIV Prevention in Gauteng

The WHO’s endorsement of lenacapavir marks a significant step toward ending AIDS as a public health threat. By offering more choices and simplifying access, the global health community hopes to reach more people, reduce new infections, and save lives. The focus now shifts to ensuring these innovations reach those who need them most quickly, safely, and equitably.