High Court Reverses National Tender for Circumcision Device

The Gauteng High Court in Pretoria has ruled that the awarding of a tender for a circumcision device utilized in 40 provincial health districts and the military is unlawful. As a result, the device cannot be used for circumcising boys between the ages of ten and 14.

This 36-month tender was awarded to CircumQ by the National Treasury in April 2023, with implementation set to begin on September 1 of that year.

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Concerns surfaced swiftly regarding the device’s safety and the absence of adequate testing, particularly for the ten to 14 age group—a critical demographic for South Africa’s voluntary medical male circumcision programme (VMMC), which aims to reduce the risk of HIV infection.

Unicirc, a competitor, took the matter to court, claiming to act in the public’s interest.

On Thursday, Judge Elmarie van der Schyff determined that the tender’s approval had permitted the “mandatory use of an untested surgical device on children.” She reviewed and overturned the Treasury’s decision.

The judge stated, “There are process and verification irregularities; however, no evidence shows that the [CircumQ] device is clinically harmful or has resulted in systematic injury. Annulment of the tender would revert all circumcision procedures within the programme to the dorsal slit method.”

She deemed it essential to suspend its use for boys aged 10 to 14 immediately.

The judge observed the impending expiration of the contract, allowing it to “run its course” instead of being terminated at great expense and disruption, despite the overarching unlawfulness of the entire award.

She ordered that the Treasury and provincial health departments cannot instruct healthcare providers to utilize the CircumQ device on boys under 14 years of age.

Health authorities must ensure that healthcare professionals are “free to use any clinically appropriate method” deemed in the best interest of their patients.

The tender’s specific conditions stipulated that the surgical device must be non-invasive and either have received or be in the process of obtaining approval from the World Health Organization (WHO).

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The tender also required that the device be suitable for boys aged ten to 14 and classified as a Class A device, which poses the lowest risk.

Although both the Treasury and the Department of Health opposed the application, Judge van der Schyff found it “strange” that CircumQ did not contest or take part in the review proceedings.

Gauteng High Court, CircumQ, National Treasury, HIV infection, Unicirc, World Health Organisation, Department of Health

“All parties involved recognize the public health advantages of medical male circumcision and the associated reduction in a man’s HIV acquisition risk. They also acknowledge that circumcising boys aged ten to 14 presents several significant benefits.

“Due to warnings about adverse effects linked to both traditional and current dorsal slit methods, Treasury and the department supported a bid to assist health professionals in moving away from that practice.”

Regarding the WHO pre-qualification standards, she indicated that while CircumQ’s application had not been “outright rejected,” it had also not received approval to proceed. As of now, it remains unapproved, with no public records showing that the necessary additional studies have been completed or that the deficiencies noted by WHO have been addressed.

“This tender represented not a standard procurement process but was explicitly designed to select a service provider to deliver high-quality, high-volume VMMC services to males aged ten and older across 40 health districts as part of South Africa’s HIV prevention strategy. Therefore, patient safety, particularly that of children, is not a secondary concern but the foundational reason for the tender,” the judge stated.

“The WHO pre-qualification requirement should not be seen as a mere bureaucratic formality but as a direct signal of the focus on ensuring patient safety.”

Bid Evaluation Committee Criticized

Judge van der Schyff criticized the Bid Evaluation Committee (BEC) for recommending the tender “without evidence of safety standards.”

She emphasized that the committee had “passively accepted” CircumQ’s claim that its device was classified as “Class A.”

“No reasonable BEC could overlook the issue of whether a device used widely is accurately classified, given that its classification has direct implications for its risk profile.

“A BEC that merely accepts the manufacturer’s assertions and continues to endorse an award has neglected its duty to critically assess all pertinent information and thoroughly engage in the matter at hand,” the judge asserted.

The “safety issue” should have been a significant priority.

Furthermore, she noted that while the Gauteng Department of Health claimed the device was being used successfully, their data lacked a breakdown for the critical age group.

In January, GroundUp reported that approximately 96,000 circumcision devices purchased under this controversial tender were scheduled for distribution to clinics in KwaZulu-Natal.

Before the April hearing, Unicirc attempted to submit an affidavit from a nurse aware of a ten-year-old who allegedly faced serious complications after using the CircumQ device. However, the court ruled this as hearsay and did not allow the evidence.

The judge ordered the Treasury to bear the costs associated with the review application.

© 2026 GroundUp. This article was first published here.