As the pipeline of new HIV prevention technologies (including long-acting injectables, vaginal rings, antibody infusions, and, potentially, vaccines) expands careful planning is needed to ensure these innovations are effectively and equitably introduced within public health systems. Such planning is particularly important because the introduction and scale-up of HIV prevention tools has historically been hampered by insufficient national ownership, implementation in pilot settings that do not reflect the realities of broader public health systems, insufficient community engagement, and fragmentation across financing, regulatory pathways, and service delivery domains. A health systems approach to new product introduction that elevates government leadership at all levels, integrates launch and access activities into existing health system structures and capacities, leverages local manufacturing capacity where possible, and aligns closely with community needs and contextual realities is vital for ensuring that new prevention tools achieve their intended impact. As external funding declines, strengthened, nationally led pathways for the introduction and scale-up of new prevention tools that enable convenience and efficiency for clients and providers will be essential to support medication continuation, reduce HIV acquisition, and sustainably advance progress toward ending the HIV epidemic.