“They No Longer Come to the Clinic” – HIV Experts Alarmed by New Developments in South Africa

Drastic Decrease in Testing Among the Most Vulnerable

South Africa, a country where approximately 8 million people live with HIV, is now experiencing a concerning decline in testing and follow-up. This is shown by previously unpublished data from the country’s national health laboratory. The figures reveal that the number of viral load tests among young people aged 15 to 24 dropped by over 17% in April 2025 compared to the previous year. For newborns and pregnant women, the situation is even worse: testing fell by 19.9% and 21.3%, respectively.

The viral load test is essential for measuring the amount of HIV virus in the body and thereby ensuring that treatment is effective. A decline in testing means not only a lack of monitoring, but also that individuals could unknowingly spread the virus.

Consequences of US Funding Cuts

The roots of the crisis can be traced to Washington. In February 2025, former President Donald Trump cut all US HIV aid to South Africa, a support that amounted to over 400 million dollars yearly. This led to the loss of up to 15,000 paid health workers responsible for testing, counseling, and follow-up in vulnerable areas. Many NGO-run clinics have since closed.

Without these outreach efforts, there is no longer anyone to contact patients who miss check-ups. In the Diepsloot district, HIV activist Sophy Moatshe explains, “These people, they won’t go to the clinic. If there’s no one checking on them, they die.”

Experts Warn of a Hidden Catastrophe

The share of patients with suppressed virus levels—a key figure for effective treatment—dropped by 3.4% nationwide in March. This isn’t just a statistic; it’s a warning that more individuals are slipping through the cracks of the treatment system. Epidemiologist Dvora Joseph Davey from Cape Town told Reuters that the lack of tests means healthcare workers can no longer provide PrEP (preventive medication) to pregnant women: “Our clinics have fewer nurses. No one is drawing blood samples, and nobody is providing prevention.”

Experts now fear that the decline in testing is just the beginning. An epidemic in the shadow of an epidemic.

The Future: Uncertain and Dependent on New Donors

The South African Ministry of Health has acknowledged the issues but points out that patient drop-off and testing challenges existed before the funding cuts.

According to spokesperson Foster Mohale, authorities are now working to secure new local and international donors.

Until then, the reality is harsh: Longer queues at public clinics, stigmatization, and invisible virus transmitters in densely populated cities. A development that could become excruciatingly difficult to reverse if testing and treatment are not promptly restored.

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