27 November 2025
Illustration: Lisa Nelson
Earlier this year, we made a request for data to the National Health Laboratory Service (NHLS) using the Promotion of Access to Information Act. In October we were provided with the data we requested (and more).
We are grateful and impressed that the NHLS provided the data without fuss and without the need to go to court. Other state institutions could learn from this.
We used the data to analyse HIV viral load data in light of the withdrawal of US aid. It led to us publishing this article: Withdrawal of US aid has hurt South Africa’s HIV programme.
From the outset we’ve intended to make the data public. No information on patients is recoverable from this data as the finest detail is at the monthly provincial level. We are therefore publishing this data, as an open document format spreadsheet, today. We are of the view that the data provided is useful for scientists and journalists and we hope the NHLS will regularly publish updates to it.
The spreadsheet contains monthly tallies per province of viral load tests, CD4 counts, TB tests, syphilis tests, full blood counts and cholesterol tests. The period covered is January 2015 to September 2025.
Much of the data is not straightforward to interpret. For example, after we puzzled over the decline in cholesterol tests, one expert pointed out to us that the decrease is probably due to changes in the standard second-line HIV treatment used in the public sector (some older HIV medicines had potential side effects that made cholesterol tests necessary). Similarly, changes in the number of TB tests conducted will have been impacted by guidelines that expanded eligibility for TB testing.
The NHLS informed us of the following caveats:
- All counts reflect the number of tests captured on the NHLS TrakCare (LabTrak) Laboratory Information System (LIS) as at the time the counts were performed (21 October 2025).
- A system-generated date from the time a sample was captured onto the LIS was used to total counts per month/year.
- There may be anomalies in counts for a few months from July 2024 because of disruptions caused by a cyber-attack.
- As test counts were requested, rejected tests and unreviewed results were included.
- As test counts were requested, the counts provided reflect the number of tests done, not the number of patients tested, as multiple tests may be performed on one patient sample. For example, for a full blood count, each individual test was counted.
- The “Pregnant or postnatal women” group was identified according to the NHLS maternal eGK (electronic gatekeeping) codes.
(We have amended the NHLS spreadsheet by inserting a new sheet with the above caveats and a link to this article. No other material changes have been made to the spreadsheet.)