The Paradox of Progress: Genetic Counselling in a South African Context and the Challenges of Workforce Retention.

This invited commentary explores the paradox of progress in genetic counselling in South Africa, where established training programmes and professional recognition have not yet translated into sustainable clinical genetic services. Drawing on workforce data and insights into training, employment and service delivery, the authors highlight how limited funded public-sector posts, geographic concentration of services and loss of professionals from patient-facing roles constrain equitable access to genetic counselling. The commentary aims to support coordinated workforce planning and investment to ensure that the expansion of genomic medicine is accompanied by accessible, sustainable and equitable genetic counselling services.