Genetic counseling in South Africa: A growing profession.

The Genetic Counseling profession in South Africa (SA) was established 35 years ago when the first degree program was initiated at the University of the Witwatersrand in 1989. A second program was developed at the University of Cape Town in 2004. This article aims to describe the development of the profession in SA, with a focus on the last decade. The profession has been growing against the backdrop of a diverse population of 62 million with high rates of HIV/AIDS and tuberculosis and a poorly functioning health care system. SA was one of the first countries to regulate the profession when the Health Professions Council recognized genetic counselors (GCs) as health care professionals in 1992. Since 2017, the student body (now including some internationals) is becoming more representative of the local population and SA graduates are assisting in establishing counseling and training programs in Ghana and Oman. The professional group (GC-SA), formed in 2008, now represents the profession locally and internationally. Challenges remain, although training programs are established, and registration and billing in place. State employment opportunities are few and graduates have to become entrepreneurs, setting up private practice and seeking work in laboratories and research projects. With about a third (16) of qualified GCs (47) leaving the country and only 31 presently working locally, only about 10% of the genetic needs of the population can be met. Addressing these issues, as well as the lack of funding and political will, is a priority for the future.