Community monitoring group Ritshidze has uncovered severe staff shortages and service declines at public health facilities in Gauteng, KwaZulu-Natal, and the Eastern Cape following US Pepfar funding cuts earlier in 2025. Data from April to June shows over 90% of clinics in some areas lacking sufficient personnel, leading to longer waits and poorer record-keeping. The group urges national and provincial health departments to act urgently.
The Treatment Action Campaign's Ritshidze initiative, which has tracked primary healthcare since 2018, gathered data from 326 facilities across 16 districts in six provinces between April and June 2025, shortly after Pepfar reductions. In Gauteng, 84% of surveyed facilities reported too few staff, with 38% attributing this to Pepfar partners reducing operations; the province had the most vacancies overall. Waiting times ranked third-longest among monitored areas, often blamed on shortages, raising risks of treatment interruptions due to work and family demands, as noted by TAC General Secretary Anele Yawa.
Filing systems deteriorated, with over 50% in bad condition province-wide; in Johannesburg, 67% were poor, up 28% from January. ARV dispensing fell to 75% for three-month supplies, down from 81%, and 24% of sites reported fewer staff for HIV viral load tests. The Gauteng Department of Health did not respond to inquiries.
In the Eastern Cape, 93% of facilities cited staff shortages, reaching 100% in Buffalo City, mostly due to unfilled vacancies and reduced Pepfar support. Waiting times were second-longest, with 69% of users blaming staff issues. Filing was bad at 53% of sites, up from 48%, though improving in OR Tambo. ARV supplies remained strong at 88% for three months or more. Spokesperson Camagwini Mavovana attributed delays to administrative shortages and space issues, announcing ministerial hires for doctors, nurses, and others, plus emergency funding to bridge Pepfar gaps and improve filing via external archiving.
KwaZulu-Natal saw 90% staff shortages, mainly from vacancies, with 27% of King Cetshwayo users noting worsening post-Pepfar. It had the shortest waits but disastrous filing in King Cetshwayo (89% bad). ARV three-month supplies dropped sharply to 53% from 84%, with only 13% affected on viral load tests. The KZN Department of Health offered no response.
Yawa called for funding vacant posts, more counsellors, and external ARV pick-up points, supporting longer prescriptions to ease clinic burdens despite limited six-month implementation.