On 22 October 2025, Ritshidze launched a detailed report into the state of the public healthcare system in Gauteng that reveals the challenges arising in our clinics following the PEPFAR disruptions earlier in the year. Overall critical staffing shortages were reported with many facilities blaming the withdrawal of PEPFAR support. Compounded with filing systems in a terrible state, waiting times remain long and continue to frustrate public healthcare users. Friendliness, compassion and support have worsened, particularly for people living with HIV returning to care, members of key populations, and migrants. Key HIV services have also been impacted including condom distribution, HIV testing, viral load testing services, and routine clinical consultations.
The full press release is here.
This is the fifth edition of the annual Gauteng State of Health report. Prior to the end of January 2025, Ritshidze data was collected across sites in four PEPFAR priority districts in Gauteng: City of Tshwane, Ekurhuleni, Johannesburg, and Sedibeng. Ritshidze monitoring has continued in all four districts. PEPFAR implementing partners are still active in the City of Tshwane and Ekurhuleni – while contracts have been terminated in Johannesburg and Sedibeng. Ritshidze data will be able to document any changes in the quality of service provision following the PEPFAR disruptions.
Facility level data was collected between April 2025 and June 2025 at 81 public health facilities in four districts: City of Tshwane (20 sites), Ekurhuleni (20 sites), Johannesburg (28 sites), and Sedibeng (11 sites). Surveys were carried out with 81 Facility Managers, 4,038 public healthcare users and 1,993 people living with HIV in the Patient survey, and 3,444 public healthcare users in the Patient Exit survey.
Key Population service data was collected in the community between July 2024 and September 2024 in 4 districts in Gauteng: City of Tshwane, Ekurhuleni, Johannesburg, and Sedibeng. A total of 2,788 surveys were carried out in the province (including 1,132 people using public health facilities). This combined 286 gay, bisexual, and other men who have sex with men (GBMSM), 472 people who use drugs, 286 sex workers, and 88 trans people.
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