YOUR CALL TO REPRODUCTIVE JUSTICE: WE ARE WATCHING AND LISTENING Reproductive Justice [1] is defined by three principles: The right to have a child; the right not to have a child; the right to parent children in safe and healthy environments. In 1997 South Africa enacted a globally renowned law on abortion. The Choice on Termination of Pregnancy Act (CTOPA) aimed to address the imbalances of the past where 429 black women died each year from lack of access to these basic health services [2]. The political act of passing this legislation was historical in laying the framework for Reproductive Justice in South Africa. Having an act such as CTOPA in place meant that women and pregnant people would be free to make their own decisions about their bodies and their futures. 22 years later, many people still struggle to access these basic services. But with national elections coming up, we have a chance now to ensure the 5 major political parties commit to lobbying for an increase in the sexual and reproductive health services budget. There is limited information on how people can access abortion services, decreases in the amount of contraceptives available and currently only 7% of healthcare facilities provide abortion services [3]. Because of this, many pregnant people are either forced to turn to unsafe and illegal abortion practices or suffer the physical, emotional and mental harm that comes with bearing an unwanted pregnancy. Leading up to elections, political parties will be running election campaigns focused on winning votes. If they want our votes, they will need to prove to us that they care about the lives of all people seeking access to Sexual & Reproductive Health services. We have a chance now to pressure the 5 major political parties into using their power as members of Parliament to address these issues by ensuring the budget for sexual and reproductive health services is increased. This money will be used to create sexual reproductive justices and access to these services for ALL. This will ensure greater access to public information on safe abortion procedures, fully stocked healthcare facilities with affordable and free contraceptives and more healthcare facilities nationwide providing safe, legal abortions. Sign and join our campaign to ensure sexual reproductive justice for all. If enough of us come together and flood the email inboxes of the 3 major political party leaders, they will have no choice but to support increasing the sexual and reproductive health budget. We have written an email that you can send to one, or all, of the political parties. Here is the email and each political party's email address: ANC- [email protected] EFF- [email protected] DA- [email protected] "Dear Political Party Leader (Mmusi Maimane, President Cyril Ramaphosa and Julius Malema) I am joining other South Africans in calling on you provide leadership on reproductive justice. Reproductive Justice is defined by three principles: The right to have a child; the right not to have a child; the right to parent children in safe and healthy environments. We need you to support an increase in the sexual and reproductive health budget for 2020 and use your power as a member of parliament and political party leader to lobby for an increase before voting day on 8 May. Currently there are decreases in the amount of contraceptives available, there is limited information on how people can access abortion services and currently only 7% of healthcare facilities provide abortion services. Because of this, many pregnant people are either forced to turn to unsafe abortion practices or suffer the physical, emotional and mental harm that comes with bearing an unsupported pregnancy. A budget increase will ensure that there is sexual reproductive justice and access to these services for ALL. We need health managers to lead and to not obstruct access to reproductive justice services. The money should be spent on ensuring that public healthcare facilities are always fully stocked with contraceptives, health professionals are trained in the provision of sexual and reproductive health services and greater access to information on safe abortion procedures and increased delivery of public services of abortion provision. It is time you took sexual and reproductive health seriously. If you want my vote, you must prove to me that you truly care about the people most affected by the lack of sexual and reproductive health services. The Choice on Termination of Pregnancy Act (CTOPA) aimed to address the imbalances of the past where 429 black women died each year from lack of access to these basic health services. 25 years have passed and to get our vote we want to hear your political commitment to real implementation. I trust you will hear our voices." [1] https://www.ucpress.edu/book/9780520288201/reproductive-justice [2] https://www.ajol.info/index.php/samj/article/view/157185 [3] https://amnesty.org.za/research/barriers-to-safe-and-legal-abortion-in-south-africa

The Msunduzi Local Municipality is dysfunctional and is on the brink of collapse and as residents and ratepayers of Msunduzi, hereby unanimously voice our strong and serious concern at the continued lack of effective and efficient delivery of basic services. We demand that the Msunduzi address and improve the service delivery issues and implement the auditor-general report recommendations of (2017-2018) by the 15 April 2019 failing which we, the long suffering residents and ratepayers of Msunduzi, will have no alternative but, in terms of Section 139 of our National Constitution, to motivate for National and Provincial intervention in the local government and management of Msunduzi, including that the Council be dissolved and the municipality placed under administration.

We all know Mzansi’s health system is under a lot of pressure, and globally experts have warned that sugary drinks are increasing rates of obesity and Type 2 Diabetes [1]. Researchers from Wits University [2] and the World Health Organisation back policies like the Sugary Drinks Tax as measures to improve people’s health. The introduction of the Sugary Drinks Tax is an important first step towards lifting the pressure on our health system and keeping South Africans healthy. So far the tax has raised R2.3 billion which will be used for health promotion and go back into our healthcare system. But the Department of Trade and Industry committee has called on the Minister of Trade and Industry to intervene in what they call ‘a crisis in the sugar industry’. Chairperson of the Portfolio Committee on Trade and Industry, Joanmariae Fubbs, has called for a moratorium on the Sugary Drinks Tax [3]. Big business are trying to maximize profits by getting the Sugary Drinks Tax repealed. We know their greed has put our nation's health at risk. But we have a chance now to stop this. Let’s send a message to Joanmariae Fubbs and the rest of Parliament, we the people stand behind the Sugary Drinks Tax. If enough of us come together, our voices will be so loud that Joanmariae Fubbs will have to listen. Tackling obesity-related diseases needs to be a national priority, and the tax on sugary drinks is a first step in addressing this national epidemic. One in four people in South Africa are obese [4]. Excess sugar consumption is a major cause of obesity and its related diseases, as excessive sugar intake causes increased risk of diabetes, liver and kidney damage, heart disease, and some cancers. The World Health Organisation (WHO) and the World Cancer Research Fund recommend that people should consume no more than 10% of total calories from sugar. The South African government has been under pressure from beverage companies and retail groups who have been flooding Parliament and Treasury with comments to stop this life-saving policy or weaken it with exemptions and loopholes—and they are having an impact. The South African government MUST put the health of South Africans before special interests who target the most vulnerable populations with their unhealthy products. Please make your voice heard today! [1] Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis, Malik VS, Popkin BM, Bray GA, Després JP, Willett WC, Hu FB. Sugary Drinks and Obesity Fact Sheet, Harvard School of Public Health. [2] Sugar tax could save South Africa billions by James Thabo Molelekwa for Health- E News. April 21, 2016. [3] MPs call for intervention in embattled sugar industry by Linda Ensor for Business Day, February 2019 [4] Is SA the ‘fattest nation’ in sub-Saharan Africa, with a third of people obese Kate Wilkinson for Africa Check July 2015

We all know Mzansi’s health system is under a lot of pressure, and globally experts have warned that sugary drinks are increasing rates of obesity and Type 2 Diabetes [1]. Researchers from Wits University [2] and the World Health Organisation back policies like the Sugary Drinks Tax as measures to improve people’s health. The introduction of the Sugary Drinks Tax is an important first step towards lifting the pressure on our health system and keeping South Africans healthy. So far the tax has raised R2.3 billion which will be used for health promotion and go back into our healthcare system. But the Department of Trade and Industry committee has called on the Minister of Trade and Industry to intervene in what they call ‘a crisis in the sugar industry’. Chief Whip of the DA, John Steenhuisen, has called for a moratorium on the Sugary Drinks Tax [3]. Big business are trying to maximize profits by getting the Sugary Drinks Tax repealed. We know their greed has put our nation's health at risk. But we have a chance now to stop this. Let’s send a message to John Steenhuisen and the rest of Parliament, we the people stand behind the Sugary Drinks Tax. If enough of us come together, our voices will be so loud that John Steenhuisen will have to listen. Tackling obesity-related diseases needs to be a national priority, and the tax on sugary drinks is a first step in addressing this national epidemic. One in four people in South Africa are obese [4]. Excess sugar consumption is a major cause of obesity and its related diseases, as excessive sugar intake causes increased risk of diabetes, liver and kidney damage, heart disease, and some cancers. The World Health Organisation (WHO) and the World Cancer Research Fund recommend that people should consume no more than 10% of total calories from sugar. The South African government has been under pressure from beverage companies and retail groups who have been flooding Parliament and Treasury with comments to stop this life-saving policy or weaken it with exemptions and loopholes—and they are having an impact. The South African government MUST put the health of South Africans before special interests who target the most vulnerable populations with their unhealthy products. Please make your voice heard today! [1] Sugar-sweetened beverages and risk of metabolic syndrome and type 2 diabetes: a meta-analysis, Malik VS, Popkin BM, Bray GA, Després JP, Willett WC, Hu FB. Sugary Drinks and Obesity Fact Sheet, Harvard School of Public Health. [2] Sugar tax could save South Africa billions by James Thabo Molelekwa for Health- E News. April 21, 2016. [3] MPs call for intervention in embattled sugar industry by Linda Ensor for Business Day, February 2019 [4] Is SA the ‘fattest nation’ in sub-Saharan Africa, with a third of people obese Kate Wilkinson for Africa Check July 2015

Companies like Coca-Cola have been allowed to sell a product that drives type 2 diabetes [1] and they have specifically targeted poor communities who have the least access to quality health services [2]. We all know that many of our schools and spaza shops are covered with Coca-Cola adverts, and for decades many of us didn’t know the truth about sugar in cold drinks, and now many people have family members who are too sick to work. While Coca-Cola makes millions, the queues at our clinics grow longer. In 2017 there were over 100,000 new diabetes cases in the public sector alone [3]. There’s hope though. Thanks to public pressure a Sugary Drinks Tax was introduced in 2018, but our work isn’t done yet. Because of companies like Coca-Cola, the tax was watered down to almost half of what Wits academics have said it needs to be: 20% [4]. 89% of private companies were found not to be paying taxes properly in 2017 [5], yet every day we have to bear the high costs of the VAT hike, and yet there isn’t enough for government funding for health and education. Because of private companies not paying taxes properly, Treasury has cut R350 million from our health budget since the February 2019 budget and now [6] [7]. We need much more money for our health budget, not less. Between now and February 2020, Treasury may make big decisions about our budget and taxes. We know that wealthy companies and individuals will be fighting against taxes on themselves and their products, but if enough of us come together, we could send a clear message to Treasury that we want a strong sugary drinks tax of 20% announced in February 2020 budget speech. We stopped Coca-Cola’s attempts to scrap the Sugary Drinks Tax last year, and now more than ever, we need a strong taxes on products that can be deadly to our health, products like sugary drinks, cigarettes and alcohol. A 20% sugary drinks tax could fill the R350 million hole in our health budget, and prevent more people from consuming sugary drinks which drive diseases like type 2 diabetes, heart disease, liver and kidney damage, and some cancers. [1] Decreasing the Burden of Type 2 Diabetes in South Africa: The Impact of Taxing Sugar-Sweetened Beverages Mercy Manyema, J. Lennert Veerman, Lumbwe Chola, Aviva Tugendhaft, Demetre Labadarios, Karen Hofman Published: November 17, 2015 [2] Big business - and people - grow fat on sweetened drinks. Lynley Donnelly for Mail & Guardian 1 June 2016 [3] Junk food, junk status cause skyrocketing medical costs. Amy Green for Health-e News 24 April 2017 [4] Sugar tax could save South Africa billions in diabetes costs. Thabo Molelekwa 29 April 2016 Health24 [5] Corporates ‘not tax compliant’. Baldwin Ndaba for The Mercury, 22 Aug 2018. [6] http://www.treasury.gov.za/documents/national%20budget/2018/review/FullBR.pdf [7] http://www.treasury.gov.za/documents/mtbps/2018/mtbps/FullMTBPS.pdf

While other Life Esidimeni families have been paid [1], there are still remaining families yet to receive payment. Why split the families? [2]. The Life Esidimeni families share a collective pain, why prioritise payment for others and not all? The remaining families also need closure and the payment is necessary for this. The Premier made a public commitment to honour the payments [3], now his office is giving the remaining families the run around and it's not right, haven't they suffered enough! All the families ask for is a firm commitment of the 10th December 2018 as a previously agreed deadline for everyone to receive payment and for the Premier's office to stop postponing and commit. References [1] https://www.enca.com/south-africa/life-esidimeni-families-have-received-their-payment [2] https://www.sowetanlive.co.za/news/south-africa/2018-10-16-esidimeni-families-have-to--wait-for-payment/ [3]https://www.news24.com/SouthAfrica/News/makhura-vows-life-esidimeni-families-will-get-compensation-before-deadline-20180611

Government institutions tasked with compensating sick miners have become dysfunctional with backlogs of 200 000+ unpaid certified claims and an even larger number of unprocessed claims. Stringent requirements and processing centralised in Johannesburg makes it very difficult for sick and repatriated miners to access compensation. Many are unaware of their rights to compensation and thousands have already died without being compensated. Without serious reform of the compensation system, and a concrete plan of action from the TSHIAMISO TRUST, most of the 500 000 miners will die without receiving anything, unless we make this our business and do something. THE COMPENSATION SYSTEM IS BROKEN and if the R5 billion is not paid out within 12 years, it will remain with the mining companies.

Our country is facing a health crises with 10,000 new cases of diabetes reported each month [1], type 2 diabetes has been linked to sugary drinks, and so has heart disease, liver and kidney damage, But thankfully we stopped Coca-cola’s greed and Parliament passed a Sugary Drinks Tax late last year. Now, the new Finance Minister Tito Mboweni is walking a tightrope, and right now there is a good chance industry could be fighting anything that threatens their profits. In his first budget speech, Minister Mboweni missed an opportunity to mention anything on the sugary drinks tax. But right now Parliament has opened public comment on the Mboweni’s ‘mini- budget’ (also known as the Mid-Term Budget Policy Statement). If enough of us come together and make submissions calling for the Sugary Drinks Tax to be increased from 11% to 20%, we could counter industries greed and have a stronger Sugary Drinks Tax. We already know that the WHO and Wits researchers recommend a minimum tax of 20% on sugary drinks to start reducing diseases like type 2 diabetes. We know the private sector doesn’t want a Corporate Income Tax increase, We know the Finance Minister is under pressure to increase tax especially, and may even consider increasing VAT again [2]. But if we make enough noise, we can show Treasury and Parliament, that increasing taxes on sugary drinks, tobacco and alcohol, are better for our nation's health and budget than another VAT hike. References [1] Diabetes risk because of status. Amy Greene. News24. 04 May 2017 [2] What to know before #MTBPS is presented. Staff reporter. 24 October 2018

The beverage industry is furious that our people powered campaign beat their attempts to stop the sugary drinks tax. But with a recession and a new Finance Minister, greedy companies will be fighting to pay less tax.This week, as we observe World Obesity Week, we have an opportunity to send Treasury a message they may not be expecting. A thank you.If we come together and send enough thank you messages, we could counter any attempts by the beverage industry to pressure Treasury to not increase the sugary drinks tax, and instead remind them that they are accountable to us, the people, not corporations. Together we ensured a 11% sugary drinks tax as a start. However we need to keep working towards a 20% tax if we are to have a real impact [1]. We are reaching crisis point with obesity and type 2 diabetes on the rise especially amongst young people. Studies show that obesity among young people has doubled in the last six years and obese children have a 70% chance of being obese adults [3].The risks of obesity include diabetes, hypertension, heart and kidney diseases [3]. [1] Sugar tax could save South Africa billions by James Thabo Molelekwa for Health-E News. April 21, 2016 [2] Mexico’s sugar tax leads to fall in consumption for second year running, The Guardian. February 22, 2017 [3] Obesity in young South Africans doubles in six years by Nico Gous, Sunday Times. 03 January 2018

The right to sexual and reproductive health (SRH) is an essential component of the right to life, the right to health, the right to education, and the right to equality and non-discrimination. Many women, young women, adolescent girls, and gender non-conforming people in South Africa are vulnerable to ill-health due to several economic and social barriers that prevent them from accessing timely and life-saving SRH services, including safe abortion and contraception. Better access to these services can prevent unsupported pregnancies and reduce unsafe abortions. When a woman is denied unencumbered access to these services, her agency and the right to make decisions about her body are limited. More than two decades have passed since the progressive Choice on Termination of Pregnancy Act (CTOPA), 1996, liberalised abortion in South Africa. However, women in South Africa continue to face barriers in accessing safe abortion services. This is due to severe stigma, refusal by healthcare providers to provide services due to their religious or moral beliefs, lack of information on the legally safeguarded rights under the CTOPA, and poor infrastructure and limited availability of safe abortion services. Due to these barriers, women and adolescent girls often resort to illegal and unsafe abortion services, which put their health and lives at risk. Unchecked advertising of ‘quick and pain free abortions’ by illegal providers perpetuates the stigma and misinformation about abortion among the population. According to a 2009 study, two illegal abortion procedures took place in South Africa for every safe legal procedure. Globally, unsafe abortion is one of the top five causes of maternal mortality, along with post-partum haemorrhage, sepsis, complications from delivery, and hypertensive disorder. In our country, many women die every year, or sustain injuries and disabilities due to unsafe abortions. For example, the 2014 Saving Mothers report, covering the period from 2011 to 2013, reveals that pregnancy-related sepsis accounted for 9.5% of maternal deaths during the said period.

Each year South Africa spends more than R59 billion [1] to address tobacco related illnesses like lung cancer, emphysema, asthma and bronchitis. At the same time the country only collects between R11 billion and R13 billion from tobacco taxes. Last year South Africa’s largest tobacco company British American Tobacco alone took a profit of R2.3billion, after tax [2]. This means the South African taxpayer is paying for the healthcare bill of tobacco-related harm while the tobacco industry collects the profits. The only way to change this scenario is to substantially increase excise taxes on tobacco. In 2018, the finance minister increased the tobacco excise tax by just R1.22 for a pack of 20 cigarettes [3]– this translated to an increase of a mere R2.50 for someone who smokes two packets a week. Although this increase was in line with the CPI, it did little to reduce the affordability of cigarettes. And this small increase will not encourage a drop in consumption. The tobacco industry has constantly exaggerated the size of the illicit trade to put false pressure on tobacco tax policy. But 2014 research by UCT’s Professor Corne van Walbeek shows that the tobacco industry has been adjusting its estimates of the illicit trade to create the illusion that it has been rapidly growing [4]. Although he agrees that illicit trade exists, he says that if previous estimates by the tobacco industry were incorrect, the credibility of current estimates should be questioned. Illicit trade in South Africa can only be tackled through enforcement. This primarily comes from the criminal justice sector. But the Hawks and the National Prosecuting Authority have been in disarray and the South African Revenue Service has deliberately been undermined. As a result, enforcement has not taken place, particularly in the last six years. The long-term solution for South Africa is to implement the World Health Organisation’s Illicit Trade Protocol [5]. This calls for the use of an independent and effective system that regulates cigarette production, import, export and sale. South Africa signed the Protocol in 2013 [6] but has still not ratified or taken steps to implement it. What can be done? Prevention costs less than treatment. Prevention means reducing the number of smoker- and one of the most effective ways to do this is to increase the price of tobacco. This is how we can take back the tax that is spent on tobacco-related health harm. We call on the National Treasury to increase the excise tobacco tax to 70% of the current price of cigarettes and other tobacco products. This has been recommended by both the World Health Organisation and the World Bank [7]. It would make cigarettes more expensive and reduce consumption. And it will send a clear message to the tobacco industry that their attempts to undermine evidence-based healthy public policy are not successful. Tobacco taxes are a win-win for public health and public finances. References [1] The Tobacco Atlas - South Africa [2] BAT revenue rises but profit and market share fall. Robert Laing for Bizcommunity 28 JUL 2017 | [3] 2018 Budget Speech by Malusi GigabaMinister of Finance 21 February 2018 [4] Are the tobacco industry's claims about the size of the illicit cigarette market credible? The case of South Africa. 2014 Corné van Walbeek, Lerato Shai [5] WHO Protocol to Eliminate Illicit Trade in Tobacco Products [6] SA signs tobacco smuggling treaty. IOL, 11 JANUARY 2013 [7] TAXING TO PROMOTE PUBLIC GOODS: TOBACCO TAXES. World Bank

Imagine having to stand in a queue outside the clinic from 6:00am, have the doors open around 7:30am, and only be attended to around 14:00pm. This is the reality of people who live in Kagiso who have been complaining about the poor services at Maki Legwete Clinic. Last week, Tshidi* took her eight month old daughter to the clinic, she became worried when her daughter's temperature spiked up in the middle of the night. Her child also had sore red eyes, she cried continuously and was restless throughout the night. "Akere kea tseba gore di line tsa ko clinic di jwang, so ka kopa ntate wa ngwana wa ka gore a eme ko queue ka bo 6:00am hoseng" Because I know how long the queues are at the clinic, I asked the father of my child to stand in line from 6:00am in the morning." Tshidi* arrived with the child around 7:00am before the clinic opened, and it was already packed, she sat in the queue and was finally assisted around 14:00pm. "Nurse ha ya check-a ngwana sintle, o butsitse feela ka di symptoms, a re fa panado le iliadin" The nurse didn't check my child properly, she only asked about the symptoms and gave us panado syrup and iliadin. Tshidi* left the clinic feeling that she did not receive proper assistance, or that she could ask sensitive health questions she had intended to. Often, young mothers are stigmatized, nurses sometimes give them a bad attitude, and make unwelcoming remarks about the fact that they gave birth at a young age. For 18 year old Tshidi* this is something she experiences frequently, and this makes it difficult and uncomfortable for her to even ask questions about her own health. Two days later , 06 September 2018, Tsidi's daughter's condition had not improved even though she had given her medication as prescribed by the clinic. Tshidi's mother became worried about her granddaughter's condition, she took a day off from work on Thursday, and accompanied Tshidi* to see a doctor for a check up. "Ke kolomaka di ntlu tsa makgowa, ha ke na tjelete, ha Kliniki i sa thusi ngwana sintle, jwale ka Mme o tla kadima tjelete gore o thuse ngwana wa go akere" I clean white people's houses, I have no money, if the clinic doesn't assist, as a mother you'll even borrow money to assist your child." The doctor discovered that the child in question has flue, weak eye-sight, and her eyes are also easily irritable. According to Tshidi, in less than 48 hours of seeing the doctor and using the prescribed medication, she could see an improvement in her daughter's condition. Many woman rely on local clinic services because they cannot afford private health care or medical aid. Unfortunately, Tshidi* is not the only person who has received poor services from the mentioned clinic. For 55 year old Mme Martha* it is having to walk for almost an hour just to get to the clinic, and then having to wait in a long queue that she has a problem with. "Ke tla dira eng, ke domestic worker, ga ke na tjelete ya go ya bona doctor..." What can I do, I am a domestic worker, I don't have money to see a doctor... " A few weeks ago, a number of Economic Freedom Fighters (#EFF) members (mostly residing in and around Kagiso) were gathered outside the clinic in protest. The main road, Geba Street, was blocked, in order to address the issue of poor service delivery. In South Africa, generally, clinics provide poor services. In 2009, a report entitled "Public Inquiry: Access To Health Care Services" was launched by the South African Human Rights Commission (SAHRC). The report mainly focused on (among other issues) complaints regarding poor health services across South Africa. This report was published in 2009, it's 2018 and people are still facing similar issues. Why is that? It is highly advisable that the manager of Maki Legwete Clinic should read the mentioned report, especially the proposed solutions to similar issues faced by the clinic. Earlier this year, the Mitchell's Plain Community members were up in arms about poor services from the Mitchell's Plain Community Health Center. In an article by Kaylynn Palm: https://www.google.co.za/amp/amp.ewn.co.za/2018/01/05/wc-clinic-slammed-for-poor-service-delivery several similarities can be drawn between issues of poor service delivery faced by the Mitchell's Plain community, as well as the Kagiso community. In 2015 two children died outside Lenasia South Clinic due to poor clinic services: https://www.google.co.za/amp/amp.ewn.co.za/2015/02/16/Another-child-dies-after-being-denied-clinic-access. The stories regarding poor health services in South Africa are endless... Maki Legwete Clinic must be reminded of Section 27 of The Constitution of South Africa, which stipulates that: Everyone has the right to "access health care services, including reproductive health services." Access to the clinic is a basic and fundamental right. People deserve to be treated with respect, regardless of their age. For better services from Maki Legwete Clinic, sign the petition below. #PoorClinicServices #MakiLegweteClinic *Not their real names SOURCES: https://www.google.co.za/amp/amp.ewn.co.za/2018/01/05/wc-clinic-slammed-for-poor-service-delivery http://www.ngopulse.org/article/sa-healthcare-system-failing https://www.google.co.za/amp/amp.ewn.co.za/2015/02/16/Another-child-dies-after-being-denied-clinic-access