Gilead Sciences seeks to expedite local registration of its six-monthly anti-HIV injection in South Africa, offering it at no-profit prices to 18 countries, including SA. Generic versions will be available in 2027 for 120 high-HIV-rate countries. Lenacapavir, the drug in the injection, has shown 100% protection for HIV-negative women and 96% reduction in HIV infection risk for other groups. SAHPRA, though understaffed, aims to expedite reviews using EU-M4All, potentially reducing review times from over a year to seven months. The National Department of Health considers publishing a request for information before SAHPRA approval to save time. Price negotiations and market demand will be crucial for the drug's affordability and accessibility.