Number of viral load tests is significantly lower than expected.

The number of HIV viral load tests recorded by the National Health Laboratory Service (NHLS) is significantly less than expected since February 2025. We are aware of no compelling reason to explain this except the withdrawal of US aid.

All patients in the public health system with HIV are supposed to get viral load tests regularly, usually once a year. These tests are used to determine if HIV is being suppressed successfully in their blood using ARV medicines. If the number of viral load tests declines, it likely indicates either that patients are being lost to the public health system, they are being monitored less diligently, or the system for recording viral load tests has become less accurate. Any one of these would imply a serious hit to South Africa's public sector HIV programme.

GroundUp and Spotlight used the Promotion of Access to Information Act to request, among other things, viral load test numbers from the NHLS. We were provided a spreadsheet with the number of tests per month for each province from January 2015 to September 2025.

The current US Administration began taking steps to reduce US aid...