By Faith MazibukoÂ
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When we introduced Lenacapavir in Gauteng in June, we knew we were introducing something new. However, we did not fully comprehend on how quickly our communities would respond.
Within weeks, thousands of people visited our identified facilities to access this new HIV prevention option. By the end of July, 17 937 eligible clients had already been initiated on Lenacapavir. Gauteng has since received an additional 28 593 initiation packs, bringing the total received to 57 231. The province has been allocated enough stock to initiate 114 160 eligible clients between June 2026 and March 2027.
For me, this is more than a statistic. It conveys an important message about people of Gauteng. They are eager to protect themselves against HIV, and willing to adapt and use new prevention options when such are made available.
There has been some public discussion about facilities that temporarily ran out of Lenacapavir, which intervention was quickly sort to make it available to those who couldn’t access during the said shortage period. We acknowledge the frustration experienced by clients who could not immediately access the service. However, we should also look at what caused these shortages.
In some facilities, demand was higher than our initial projections. That is not a story of people being turned away from healthcare. It is a story of people coming forward in numbers that exceeded expectations.
Our responsibility as government is to take note to that demand, strengthen our planning and make sure that the health system responds. The new stock is already being distributed to facilities that have experienced temporary shortages, while stock monitoring and programme management have been strengthened across the province.
The bigger story is that Gauteng is embracing prevention. Lenacapavir gives eligible HIV-negative people another prevention choice. It is administered twice a year and complements existing HIV prevention methods. It does not replace condoms, HIV testing, STI screening or other prevention services.
This distinction is particularly important as we speak to our young people. Accordingly, making Lenacapavir available does not mean that we are encouraging young people to have sex.
Our message to young people must always begin with protecting themselves and their future. Abstinence remains an important choice. But we must also be honest about the realities facing young people in our communities. According to information at our disposal, we are aware that some are experimenting because of peer pressure. Some live in communities that exposes them to sexual violence. Sadly some enter relationships before they are emotionally ready. Others are exposed to sexual exploitation, including situations where older people use poverty and material needs to target young people.
These realities can expose young people to teenage pregnancy, HIV and other sexually transmitted infections. That is why silence cannot be our strategy.
Young people need accurate sexual and reproductive health information. They need parents and guardians who are prepared to have difficult conversations with them. They need schools and communities that support them, and they need youth-friendly health services where they can ask questions and receive appropriate care without fear or judgement.
We must also remember that teenage pregnancy is not only a girls’ issue. The boy child is part of this conversation. Boys and young men must understand responsibility, consent, contraception and the consequences of their choices.
And while we celebrate the strong response to Lenacapavir, I want to remind everyone that prevention must remain comprehensive. Lenacapavir prevents HIV but does not prevent pregnancy or other sexually transmitted infections. Condoms therefore remain an important part of our prevention message, alongside testing, STI screening and other available services.
We are also committed to ensuring that prevention services reach people who have historically experienced barriers to healthcare, that is why we continuously visit the underserved communities through our Siyabaphilisa outreach campaigns.
Additionally, among the facilities offering Lenacapavir is the Johannesburg Wellness Centre, which provides services to the LGBTI+ community. This is important because an effective public health response must reach people where they are, without discrimination or stigma.
We cannot end HIV by reaching only some communities, we need every partner to join us. Civil society organisations and NGOs have been an integral part of our HIV response for many years. Their work in communities helps government reach people with information, support and services that can change lives. We will continue strengthening these important partnerships.
The same applies to our Traditional Health Practitioners. As we mark African Traditional Medicine Week from 26 to 31 August, I want to acknowledge the Traditional Health Practitioners (THP’s) who continue to work with the Department in our communities. THP’s are often trusted voices and an important point of contact for people seeking healthcare.
I encourage them to continue educating their clients about HIV prevention and to refer people to public health facilities when they require services or treatment beyond the scope of traditional healthcare. The fight against HIV requires cooperation, not competition.
Globally, we have committed to ending AIDS as a public health threat by 2030. South Africa’s National Strategic Plan for HIV, TB and STIs similarly seeks to put the country on track to eliminate HIV, TB and STIs as public health threats by 2030.
The World Health Organisation has made it clear that innovation is an important tool for success. We trust that they will push the world to be on track to meet all the 2030 HIV targets. This means we cannot become complacent.
For Gauteng, the strong uptake of Lenacapavir gives us reason to be encouraged, but it also gives us a responsibility. We must continue expanding access, listening to communities, strengthening prevention, education and making sure that nobody is left behind.
This regrettable temporary shortage was an eye opener as it showed us that communities are ready to embrace innovation. Now we must make sure that our health system is ready to receive them. That is how we move from talking about ending HIV to building a province that can achieve it.
Siyabaphilisa AsibeHealthyGP
Faith Mazibuko is Gauteng MEC for Health and Wellness
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