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South Africa unveiled a new dashboard at the International AIDS Conference in Rio to track the roll-out of lenacapavir, the country’s new six-monthly HIV prevention injection. The data released from the event shows a clear preference for the long-acting treatment over the daily pill. Almost everyone who can choose between the two options is opting for the injection.

Clear preference for six-monthly injections. The dashboard tracks usage at 360 clinics across six provinces. By August 3, close to 36,000 people had received the shot. A quarter of these users were pregnant or breastfeeding women, a high-risk demographic. The majority of users identified as between 25 and 34 years old. While the tool tracks stock levels and demographics, it lacks data for the Western Cape due to different electronic record-keeping systems.

The move to offer a six-monthly injection alongside the daily pill reflects a broader trend in chronic disease management.

Historically, adherence to daily medications has been the primary barrier to effective HIV prevention. By introducing long-acting solutions, health systems are attempting to remove the daily friction of taking a pill, potentially increasing uptake among populations with high mobility or irregular schedules.

Sanac and the health department plan to switch to cheaper generic versions of the medicine starting in 2027. Officials noted that while the dashboard is a critical step for monitoring, its effectiveness depends on integrating disparate data systems across provinces.

Aspen Pharmacare, South Africa’s largest drug maker, secured a license to produce a monthly HIV prevention pill. The medicine, known as alimatravir (MK-8527), is developed by Merck, known as MSD in South Africa. This marks the first time a manufacturer has been licensed before clinical trials are complete.

Mitchell Warren, executive director of the international HIV advocacy organisation Avac, told reporters that Merck is taking a strategic risk by licensing the drug before proving it works. Seven companies in total received licenses, including manufacturers in Uganda, Kenya and India. Aspen will import the active ingredient and finish manufacturing in South Africa, according to the company’s group senior executive for strategic trade, Stavros Nicolaou.

If studies show the pill is effective and regulators approve it, Aspen will be able to sell and export the medication to 129 low- and middle-income countries, including all 54 African nations. This expansion aims to address South Africa’s roughly 140,000 new HIV infections each year.

Sanac has completed an assessment of local drug makers to determine who can produce lenacapavir locally. The shortlist was submitted to Gilead Sciences for review. CEO Thembi Xulu stated that the assessment includes site visits to verify technical capacity across the region.

The process will take three to six months before Gilead issues final licenses. Previously, Gilead only licensed manufacturers capable of producing the active pharmaceutical ingredient from scratch. Sanac successfully argued for a “developmental” approach, allowing companies that can make the injectable or tablets to be considered for generic licences.

Officials believe this strategy will help make the medicine more accessible, affordable and sustainable for South Africa and the broader SADC region. The government hopes that local production will eventually reduce reliance on imported doses and stabilize supply chains.