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The Western Cape Department of Health and Wellness welcomed the positive response to the introduction of the injectable drug Lenacapavir, a long-acting medication for HIV prevention.

The Department confirmed that nearly nine out of ten people choosing the Lenacapavir injection are new users of this form of prevention. It is important to note that Lenacapavir is an antiviral drug intended for both treatment and prevention of HIV, and it is not a vaccine, but rather a highly effective means of HIV prevention.

According to the Department's data, between June 8 and July 24, 2339 injections of Lenacapavir were administered across 22 public health facilities in the Metropolis. Of the total injections given, 2049 (87.6%) were received by individuals who had not previously used pre-exposure prophylaxis (PrEP), indicating that the program is reaching thousands of residents who were not previously using long-term HIV prevention.

In addition to Lenacapavir, which is administered twice a year, PrEP is also available as a daily tablet, which was introduced in South Africa in 2016.

The Minister of Health and Wellness, Mireille Wenger, noted that preliminary results demonstrate the value of providing people with more choices in HIV protection methods. She emphasized that one of the main opportunities for reducing new HIV cases is ensuring access to effective prevention options for at-risk groups.

Wenger added that it is particularly encouraging that almost 88% of people receiving Lenacapavir are starting PrEP for the first time. This signifies an expansion of access to HIV prevention and coverage for those who might have found daily medication difficult or never used PrEP.

She stated that offering a more convenient option for long-term prevention removes barriers to HIV prevention and gives residents greater choice in self-protection methods. For these reasons, the introduction of Lenacapavir is considered a significant achievement for the Western Cape.

Wenger reported that healthcare workers observe that many patients prefer Lenacapavir because an injection every six months is easier than taking a daily pill. The program has also recorded a successful transition of clients who previously struggled with daily oral PrEP to the injectable form.

The Department reported that the program showed encouraging growth among women, who remain the most vulnerable group. During the reporting period, 162 pregnant women started receiving Lenacapavir, and seven more patients in antenatal care switched from oral PrEP to injectable PrEP, strengthening HIV prevention during pregnancy.

The highest number of injections were registered at the following locations: Nolungile Community Centre (192 administrations), Hayelitsha Community Health Centre (Site B) (186 administrations), and Phumulani Clinic (182 administrations).

The initial phase of implementation prioritized adolescent girls and young women, women of reproductive age, pregnant and breastfeeding women, as well as other key populations at high risk of HIV infection.

The next batch of Lenacapavir is expected to arrive from the national Department of Health in the first week of August after completing necessary quality tests post-import. Meanwhile, existing stocks are being carefully monitored, and oral PrEP remains an easily accessible and effective means of HIV prevention.

Wenger concluded that these early results provide confidence that long-term HIV prevention can help reach more people, especially those for whom daily oral PrEP proved difficult to manage. As access to Lenacapavir expands, the focus remains unchanged: to ensure every suitable resident has access to the most appropriate HIV prevention option.

She added that preventing every HIV infection is an opportunity to help someone live longer and healthier, bringing the world closer to the end of the HIV threat to public health.

The Department urges residents interested in learning about their eligibility for Lenacapavir to consult healthcare workers at participating facilities or visit the nearest public health facility to discuss available HIV prevention options. Although Lenacapavir is currently available at select medical facilities, the Western Cape Department of Health and Wellness continues to offer a wide range of HIV prevention measures, including free condoms, testing, and HIV counseling, oral PrEP, and PEP, so that people can choose the option that best suits their needs.

The Gauteng Department of Health has refuted the Democratic Alliance's (DA) claims that a patient permanently lost sight in his right eye due to a delay in a vision-saving operation at the Steve Biko Academic Hospital Eye Clinic (SBAH) in Tshwane.

These statements were made by the DA in a media release on Monday, August 3rd. The DA alleged that the delay was caused by a breakdown of the compressor and suction systems required for the Constellation machine, which had not been replaced.

The DA's representative for health in Gauteng, Madeleine Hicklin, stated that the party urges the Gauteng Health Minister, Faith Mazibuko, and the department head, Dr. Darian Barkley, to intervene urgently. The goal of the intervention should be the immediate procurement of the necessary equipment, the restoration of retinal surgery services at SBAH, and the prevention of further irreversible vision loss in patients.

Hicklin reported that the patient, who had suffered from a retinal detachment in his right eye since February, brought the suspension of retinal surgery at the Steve Biko Eye Clinic to the party's attention. He noted that despite numerous consultations at the Steve Biko and Mahomedali Eye Clinics, he had not received the necessary urgent operation. The procedure was recently performed at the Mahomedali Eye Clinic only as an attempt to save his left eye, after which he was referred to Steve Biko.

According to Hicklin, the patient informed the party that he is one of the 'countless patients' affected by prolonged delays in repairing retinal surgery equipment at the Steve Biko Eye Clinic. Another patient confirmed this, stating that during a follow-up examination, the clinic informed him that retinal operations were not being performed due to an unresolved compressor issue.

The party also stated that a reliable source informed them that specialists had even gathered 10,000 rand to buy a replacement compressor and resume retinal surgeries. However, it is reported that hospital management rejected this proposal, insisting that the procurement must comply with the Gauteng Department of Health's supply chain management processes. Hicklin added that a WhatsApp message confirms the frustration of specialists who believe that unnecessary procurement delays hindered the resumption of operations and put patients at risk. This contradicts previous assurances from hospital management that the situation was under control and there were no waiting lists for operations.

Nevertheless, in a statement dated Tuesday, August 4th, the Gauteng Department of Health rejected these claims, calling them 'factually incorrect.' A Department representative, Steve Mabona, stated that they sympathize with the patient and acknowledge the stress associated with vision deterioration or loss. He emphasized that such sensitive issues must be discussed responsibly and based on verified clinical information, not on assumptions that could unnecessarily worry patients and undermine trust in public healthcare services.

Mabona clarified that the patient faced medical problems resulting from several previous surgical interventions. Specialists at another hospital within the SBAH cluster assessed the patient's condition and performed surgery on the eye that had a better chance of retaining vision. According to Mabona, the patient was informed during the consultation process that the prognosis for the other eye was already poor, and the operation was unlikely to restore vision. Therefore, in his view, it is incorrect and misleading to attribute irreversible vision loss solely to the hospital's equipment and infrastructure problems.

Mabona admitted that the Department is aware of procurement delays related to infrastructural issues affecting service delivery. He reported that the procurement processes for the necessary equipment are at an advanced stage, and equipment delivery is expected soon to alleviate the situation. He specifically noted, however, that the patient's medical documentation does not support the claim that infrastructural problems contributed significantly to the blindness. Presenting these problems as the direct cause of irreversible blindness ignores the documented medical history and creates a distorted picture of the circumstances.

For several months now, there has been a shortage of barium sulfate in Uzbekistan—a drug used for X-ray examinations of the gastrointestinal tract. This issue is actively being discussed among radiology specialists and on social media. Due to the lack of the necessary substance, patients are forced to search for barium themselves, including on marketplaces, which creates a high risk of acquiring non-certified products.

Barium sulfate is an insoluble white suspension that serves as an X-ray contrast agent. The patient takes it (or it is administered by another method) before the radiological examination. Since the soft tissues of the gastrointestinal tract are poorly visible on standard X-rays, barium helps make these organs clear on the image by delaying X-rays. This allows the doctor to assess the condition of the organs in detail, including their shape, patency, and to detect narrowing, ulcers, tumors, or any other abnormalities. This method is one of the most common and fundamental ways to diagnose the GI tract, used worldwide, including before surgeries in abdominal and thoracic surgery departments.

Reasons for the shortage and dependence on imports

Representatives of the medical community note that the shortage is not due to the drug being unavailable on the world market or demand exceeding production capacity. The main reason is that medical institutions in Uzbekistan rely almost entirely on the import of this contrast agent, as domestic production of such barium sulfate is absent in the country. Obtaining official permission for expedited import of the drug faces prolonged bureaucratic procedures, and coordinating the necessary documents takes months.

While the package of documents goes through all necessary authorities, supplies in clinics are dwindling. Old batches of barium run out faster than a new import batch can be processed. As a result, medical institutions find themselves in a situation where the officially approved and tested drug is physically unavailable; its arrival time depends not on logistics or the manufacturer, but on the completion of the approval documentation process.

Consequences for patients

The situation is particularly critical for patients who require a GI tract contrast examination not as part of a routine check-up, but immediately before undergoing surgery, for example, in abdominal and thoracic surgery departments, because timely diagnosis directly affects the choice of treatment tactics. Due to the lack of official supplies, patients have to look for the drug outside established channels, which includes traveling to other cities, purchasing from private pharmacies, or ordering through online marketplaces. Doctors emphasize that patients bear the greatest losses from this situation.

The medical community believes that solving the problem is only possible by accelerating certification and import approval processes, as well as promptly resuming official supplies of certified drugs to medical institutions. The editorial office of Podrobno.uz sent an official request to the Ministry of Health of Uzbekistan to ascertain the reasons for delays in barium sulfate import documentation and to learn about measures being taken to supply clinics with the contrast agent. At the time of publication, the ministry had not provided a response.