The High Court in Pretoria has set aside the Department of Health's tender awards for the main HIV medicine taken by South African adults, finding them unlawful and unconstitutional. Acting Judge Graham Girdwood ordered the department to repeat the tender awards process within 120 days.

The tender, which took effect in December 2025, is worth R15.5 billion. Of that, R12.6 billion is for a single daily pill combining three antiretroviral drugs, the standard first treatment for adults, supplied in one-month and three-month packs. Millions of South Africans take it. Local manufacturer Cipla Medpro Manufacturing won none of the awards for those packs and went to court.

The judge found that two companies, Innovata Pharmaceuticals and Viatris Healthcare, did not hold a valid licence for their manufacturing site when bids closed and should have been eliminated at the first stage. “A licence that has expired is not, and was not on bid closure date, a valid licence,” he said.

He also found that the department accepted claims by Innovata and Barrs Pharmaceuticals that they were owned by historically disadvantaged people without checking them, which raised their scores. Both are subsidiaries of the same company, Avacare. The judge ordered the department to investigate whether the two had colluded in their bids.

To prevent shortages, current suppliers must keep delivering, and the order takes effect only 90 days after the new awards are made. The judge dismissed a separate challenge by another losing bidder, Hetero Drugs South Africa, and ordered the health minister and the department’s director-general to pay Cipla’s legal costs.