The Congress of South African Trade Unions (COSATU) is proud of the leadership role it has played in contributing towards securing the game changing HIV prevention drug, lenacapavir (LEN), for the nation.

LEN prevents new HIV infections; but unlike other pre-exposure prophylaxis, it is injectable and administered twice a year – only. Meaning an individual who receives a jab in January will receive the next jab six months later but will be protected throughout. It is for this reason that LEN is seen as a gamechanger in the fight against HIV and AIDS because it will drastically reduce HIV incidents and infection rates and if successfully rolled out, bring us closer to ending HIV as a public health threat by 2030.

South Africa has the largest number of people living with HIV and will be among the first African countries to receive LEN. The procurement of LEN into South Africa is made possible through funding from the Global Fund. Various countries contribute to the Global Fund, which grants allocations to qualifying countries to fund the implementation of TB, HIV and malaria interventions. South Africa receives funding for TB and HIV.

Since the Global Fund doesn’t have an office in South Africa, it has created a Country Coordinating Mechanism (CCM) to oversee this rollout. The CCM has two co-chairs; namely COSATU’s HIV/ AIDS, TB and Occupational Health and Safety Coordinator, Ms Mulalo Murudi, representing Organised Labour and the CEO of the South African National AIDS Council (SANAC), Dr Thembisile Xulu. In addition to providing oversight, the CCM is charged with developing the Request for Funding (RFF), engaging the funder and appointing the Principal Recipients who ultimately run the programmes.

The Global Fund offers cyclical grants every three years.  South Africa has just emerged from Grant Circle 6 (GC6), which expired on 30 September and is now in GC7 from 1 October, which will come to an end in March 2028. For GC7, South Africa has successfully secured $402,450,343 million to implement TB and HIV interventions over 3 years.  This will provide an invaluable boost towards our badly overstretched healthcare, in particular for the poor and the working class.  South Africa’s allocation is implemented by the Principal Recipients with  55% allocated towards TB interventions through the Department of Health with the remaining 45% shared among the HIV intervention programmes.

The Minister for Health Dr. Aaron Motsoaledi played a key role in ensuring South Africa’s selection among the early adopter countries to roll out LEN. The Global Fund secured $29 million for these initiatives and put in place measures to ensure this would be done in a way that would not compromise other community led interventions.

Currently South Africa does not have the rights to manufacture LEN locally or to procure LEN directly, and therefore the drug will be procured by the Department of Health through the Global Fund selected procurement mechanism.  Processes to finalise the LEN implementation plan by NDOH are underway with the starting date aimed for April 2026. Engagements are underway as LEN is a new drug that requires buy-in from all key stakeholders and active collaboration and coordination to ensure its successful rollout.  It is critical that discussions about the local manufacturing of the LEN are expedited to not only help sustain and grow our domestic pharmaceutical manufacturing capacity, save and create badly needed jobs, but also to ensure South Africa and the continent have the security of such essential medication.  

Whilst welcoming this potentially game changing development that if successful will save millions, it is important that space be given for its roll out, including the need to make adjustments as required.  It is equally critical that society continue to embrace the ABC campaign of abstain, be faithful and condomise as the most effective means of preventing the spread of sexually transmitted diseases.  Vaccinations are key but so are behavioural changes.

COSATU is proud of the leadership role it has played as Co-Chair of the CCM, in securing this game changing drug that will see high risk groups including adolescent girls and young women, sex workers and the LGBTQI Plus communities protected from one of the most deadly diseases.  This is a positive vote of confidence in South Africa at a time when the prophets of doom have sought to constantly denigrate the nation.  

Issued by COSATU Mulalo Murudi (COSATU HIV/AIDS Health and Safety Coordinator) on 066 340 8484

OR

Matthew Parks (COSATU Parliamentary Coordinator) on 082 785 0687