Fighting for the reinstatement of the National School Nutrition Programme (NSNP)
The NSNP came to a halt with the closure of schools due to COVID-19 on 18 March 2020, and the subsequent lockdown on 27 March. We took action after receiving testimony about increased levels of hunger among learners and their families due to the suspension of the NSNP, and after numerous broken promises surrounding the delivery of nutrition to learners. On 12 June, SECTION27 and the Equal Education Law Centre, representing Equal Education and the School Governing Bodies (SGBs) of two Limpopo schools, filed an urgent application in the High Court to ensure that 9 million children were fed through the feeding programme despite the lockdown.
In a judgment that vindicated the rights of learners, the court ruled that Basic Education Minister Angie Motshekga and eight Education MECs neglected their Constitutional duties by failing to roll out the NSNP to all qualifying learners – whether those learners were back at school or at home. The court issued a structural order requiring the national and provincial departments of education to roll out the NSNP to all learners and report progress every two weeks.
The court victory turned out to be hollow, as learners who were not yet phased back into school could not access the NSNP; and secondly, on days when learners were not at school, due to rotating schedules, they did not have access to meals.
We demanded that government clearly communicate with communities to ensure food collection; the distribution of period food parcels for learners who were rotated out or learning from home and the provision of food transport so learners could collect food while remaining at home. When provinces implemented our recommended strategies, the uptake of the NSNP was significantly better. SECTION27, Equal Education and the EE Law Centre continued to monitor the roll-out of the NSNP programme throughout 2020.
In 2021, we returned to court, due to the state’s non-compliance with the court order.
The ongoing battle to eradicate pit toilets in Limpopo Schools
The case of Michael Komape, the little boy who fell into a pit toilet and drowned in 2014, brought the issue of dangerous and undignified school sanitation squarely into public focus. The fight to end pit toilets has continued for over six years. We helped the Komape family to achieve some measure of justice for the death of little Michael with a compensation award. The fight continues, however, for the eradication of all pit toilets in Limpopo schools. We have demanded a reasonable plan from the Department of Education that meets the appropriate constitutional standard. The case was heard on 6 August 2021.
We highlighted the issue of safe sanitation in schools – which continues to be an issue, exacerbated by the COVID-19 pandemic – in an article published in the Daily Maverick on World Toilet Day, 18 November 2020.
We conducted interviews on Kaya FM, Salaam Media, EWN, Cape Town TV and eTV to commemorate this day and draw attention to continued conditions of unsafe sanitation in South African schools.
Driving health systems reform
Our work on the National Health Insurance continues to be central despite the national debate on NHI being overshadowed by the COVID-19 pandemic for the majority of the year.
Shortly before the national lockdown in March 2020, we convened civil society organisations to discuss a rights-based approach to the NHI law-making process.
We also partnered with Concentric Alliance on a consensus-seeking process in health. We conducted research with stakeholders in the private sector, public sector, civil society, media and academia. We heard some reports of important public/private collaboration in respect of the COVID-19 response, but at the same time there were frustrations in the private sector (particularly the hospitals) that more was not done at provincial level to facilitate engagement. Indeed, only the Western Cape government struck an agreement on sharing of resources with the private hospitals.
There are deep concerns about the lack of management capacity and corruption in the health sector and people fear this will hamper any efforts to implement health reforms.
In our view, there is an appetite to find consensus on the health reform process.
We used the COVID-19 period to draw attention to the need for health systems change, including through open letters to the private sector, the President and the Minister of Health. We wrote to the Minister recommending principles for the contracting of private health providers to ensure that such contracting would be in line with constitutional precepts (including transparency, equality and protection of the most vulnerable) and would set the stage for longer-term contracting with the sector. Our work on this issue continues.
Sasha Stevenson participated in the Special Investigating Unit/Daily Maverick Corruption in Health webinar, which focused on NHI and corruption. The webinar was a conversation between Sasha and Nicholas Crisp of the NHI Office, and was moderated by Mark Heywood.
The regulation of complementary medicines
In May, SECTION27 was back in court for the first time since the start of the lockdown, pushing back against the return of medical quacks. On 26 and 27 May, SECTION27 was in court – online – defending the right of people to have access to medicines of proven quality, safety and efficacy and argued that proper regulation of complementary medicines is necessary to protect people’s constitutional rights. In 2018, the Association of Natural Health Products (ANHP), an association of manufacturers of complementary medicines, brought a court case against the Minister of Health and South African Health Products Regulatory Authority (SAHPRA) challenging the regulation of complementary medicines.
SECTION27 represented TAC as a friend of the court
Unfortunately, the Court did not consider TAC’s submission on the proper interpretation of medicine or the Minister’s constitutional obligation to regulate medicines for the protection of consumers. The National Department of Health has appealed the ruling. We will seek to intervene on behalf of TAC when the court hears the case.
Supporting the rights of migrants to access healthcare
SECTION27 sought justice for the unnecessary and tragic death of a child because he was turned away from emergency care due to his immigration status. A Zimbabwean national whose one-and-a-half-year-old child passed away after he swallowed rat poison was told that as a migrant, she needed to pay R5 000 or produce a birth certificate when she sought emergency health services at Charlotte Maxeke Johannesburg Academic Hospital. By the time they returned home to collect the birth certificate, the child had died. Cliffe Dekker Hoffmeyr represents the parents.
SECTION27 will join the case as co-defendants in a claim against the MEC of Health following the death of the child. We will be seeking compensation for the parents for the pain and suffering they have endured, as well as systemic relief for clarity around the rights of migrants to have access to healthcare.
In addition, SECTION27 provided training to doctors at Charlotte Maxeke Hospital following a request made by one of the doctors after an apparent recent crackdown against migrants by administrative staff at the hospital. The training outlined the legal framework on access to health and rights of migrants, with a particular focus on children. Following the training, many cases were referred to our office in which migrant children, most under the age of 6 years, were denied access to treatment unless large sums of money were paid. We have successfully managed to assist the parents in most of these cases.
AIDS Councils and community leadership on HIV and health
SECTION27 participated in AIDS Council Civil Society sectors and contributes to AIDS councils at local, district, provincial and national level, particularly in Mpumalanga, KwaZulu-Natal and Limpopo. Field researchers lead civil society in these structures, and host workshops (including on HIV, SRHR and COVID-19). At the national level, we participated in SANAC meetings.
We monitored service delivery at clinics, including the COVID-19 response, availability of PPE, and access to abortion services. We secured undertakings from Hlanzeni District to resolve problems with pit toilets and the waiting area at Msogwaba Clinic. We have also worked with the HIV and AIDS/STI/TB Unit (HAST) team in Vhembe District on contraceptive stock outs in the area.
Our field researchers continue to support TAC through workshops, participation in meetings and programmes, mentoring of leadership in branches and support to branch AGMs. SECTION27 contributed to the People’s Country Operational Plan 21, an annual report by civil society working on HIV to influence PEPFAR in its prioritisation and funding of the programme in South Africa.
Sexual and Reproductive Health and Rights (SRHR) in Schools
During 2020, we advanced SRHR through community education, taking on a new format during the COVID-19 pandemic. In 2020, we started a project to develop animations of the sexual reproductive health rights handbook for adolescents and the sexual violence guide for learners and parents. They can be viewed here and podcasts are available here. The animations are housed on a designated page on our website as well as on SECTION27 YouTube.
Section27 Sexual and Reproductive Health & Rights
Sexual Abuse | FAQ
Section27 Sexual and Reproductive Health & Rights
Let’s not make a baby | The 411 on Contraception
Section27 Sexual and Reproductive Health & Rights
Sexually Transmitted Infections (STI’s) | Better Safe Than Sorry
Researchers Patrick Mdletshe, Thuthukile Mbatha and Motheo Brodie discussed content on sexual violence in schools and SRHR during the period of 16 Days of Activism for No Violence Against Women and Children on community radio stations like Inanda FM and Motheo FM. Our community radio campaign included Zulu, Xhosa, Sepedi and Xitsonga programmes dealing with sexual violence, HIV, abortion, STIs and other topics.
In November, SECTION27 launched a Girls Empowerment campaign in two schools in the Vhembe district of Limpopo, with the aim of empowering learners with knowledge on SRHR. The schools are characterised by high teenage pregnancy rates. The launch was attended by 73 adolescent learners. This programme continues in 2021 with community radio interviews with learners who participated in the workshop.
Our advice office dealt with multiple complaints from young women who were turned away from public health facilities around Gauteng when seeking abortion services. During the COVID-19 lockdown period, confusion about what health services were considered ‘essential’ led to some women being turned away when seeking abortion services. We asked the Gauteng Department of Health to ensure that SRHR services were appropriately designated as ‘essential’, and a circular was published to that effect.
Abortion in Eastern and Southern Africa
UN Special Rapporteur Dr Tlaleng Mofokeng wrote the foreword for our digital publication, Abortion in East and Southern Africa. In it, Dr Mofokeng notes that the laws in many countries in the region are outdated and where there are progressive laws, there still exist systems of discrimination and oppression of young women, in particular. Activists across the region joined us in a webinar for the launch of the publication on International Safe Abortion Day on 28 September 2020.
As with many health issues, COVID-19 reprioritised resources from TB. We sought to bring this back into the spotlight given that we still have a high burden of TB in South Africa. We submitted a Promotion of Access to Information Act (PAIA) request on behalf of Spotlight to the National Department of Health (NDOH) to request the National Tuberculosis Prevalence Survey, which was completed in March 2020 but not released. Following our PAIA request, the NDOH scheduled the release of the findings on 26 October but again delayed their release. The results of the survey, which were finally made available in February 2021, revealed that of the estimated 390 000 people who fell ill with TB in 2018, only 235 652 were diagnosed. This means that an estimated 154 348 people with TB were not diagnosed. Our publication Spotlight reported extensively on the findings.
Ten of thousand of people with TB in SA not diagnosed, survey
Access to Medicines
The Fix the Patent Laws Coalition, in which SECTION27 plays a leading role, has energetically advocated for equitable access to COVID-19 vaccines, diagnostics and treatment. Alongside this, as wealthy countries bought up more than half the world’s future stocks of vaccines, SECTION27 joined global initiatives such as the People’s Vaccine Coalition and the global civil society call to support the COVID-19 patent waiver proposed by South Africa and India at the World Trade Organisation (WTO).
Nations have come out in support of the proposal to waiver intellectual property on vaccines (YouTube)
Nationally, we continued to advocate for the urgent finalisation of the reform of South Africa’s outdated patent laws.
Our work has included letters, media work and a petition asking the Minister of Trade and Industry to table draft legislation on patents and public health for public comment, which has been signed by more than 500 individuals and organisations and widely shared among civil society groups around the world.
Local and global solidarity in the
Our team has led international solidarity calls to the G20 requesting an equitable response to COVID-19, and to the World Health Organisation calling for a human rights approach and equitable access to health services and treatment. We have joined the People’s Vaccine Alliance and participated in advocacy relating to the TRIPS waiver of Intellectual Property rights on COVID-19 technologies, a proposal made by the South African and Indian governments. We contributed to an article in the Health and Human Rights journal calling to capacitate health through adequate funding.
Early in the pandemic, we asked the Minister of Health and the President to be transparent and share epidemiological data with the public. Thanks to our efforts, the data was subsequently made available. In addition, we have participated in the education, health and communication working groups of the C19 People’s Coalition to contribute to sharing accurate information about the pandemic. We contributed to the drafting of fact sheets on COVID-19 Myths and things to know about HIV and COVID-19. We developed a summary of COVID-19 health regulations and have written several opinion pieces on issues relating to COVID-19, ranging from law and policy to mental health and clinical trials.
The People’s Vaccine poster
Fighting for gender Justice
SECTION27’s health rights team advocated for the rights of women to be able to access sexual and reproductive health (SRH) services, including abortion services, during lockdown, and wrote a letter to the Minister in which we outlined circumstances in which young women were denied access to abortion services. We reminded the department of its commitment to expand the number of facilities offering abortion services and requested that the Department review its Designation protocol in terms of Section 3 of the CTOP Act so that all health facilities which have a 24-hour maternity service may terminate pregnancies of up to 12 weeks without having to go through a separate accreditation process. We also asked, in light of the COVID-19 pandemic, that guidance be published which allows for the virtual prescription of self-managed medical abortion medication in circumstances where women have access to an accurate source of information and/or a trained healthcare provider.
We continued to support the Call to Action Collective, a group of civil society organisations working on gender-based violence and femicide (GBVF), to popularise the new National Strategic Plan for GBVF and strengthen the development of the GBVF council. Over 12 weeks from 9 July to 23 September, we participated in discussions about the NSP and the role of civil society, and how government and others could collaborate to address gender-based violence and femicide. CALL TO ACTION VIDEO
Budgeting for basic
In order to mitigate economic damage and save lives through specific COVID-19 relief packages, the government cut funding substantially from the basic education sector. Basic education did not benefit from the relief package despite the enormous costs to the sector to ensure learners and teachers could return to schools in compliance with the COVID-19 protocols. Instead, when Parliament passed the Special Adjustments Budget (SAB) in June 2020, cuts to education infrastructure spending were the largest cuts made across government.
The SAB showed that planned Education Infrastructure Grant (EIG) spending of R6.6 billion was suspended, reducing the EIG budget available for long-term education infrastructure projects by 60%. Of this, R2.2 billion was cut completely from the EIG baseline – a 20% cut in its original budget, and redirected to “frontline” departments. A further R4.4 billion of the EIG was repurposed for COVID-19-related expenditure in schools, which was allocated towards sanitation, infrastructure, PPE, and mobile classrooms.
Recognising the unequal impact of lockdown on learners across the country, SECTION27 developed a ‘one-stop’ Resource Map for educational materials and identified zero-rated websites, which enabled learners and parents to access educational resources on one platform. We also called for the zero rating of all learning materials. This Resource Map has been widely circulated and well received by learners and parents.
Recognising the lack of knowledge about vaccines and hesitancy about their safety and effectiveness, we worked with partners on vaccine literacy infographic cards leading up to the first delivery of vaccines and their rollout in South Africa. We started compiling a list of frequently asked questions about vaccines and answered them in plain language for social media. This formed the basis for a more sustained vaccine literacy campaign in 2021.
Budgeting for socio-economic rights
Our budget analysis work has become more and more important as austerity and inequality deepen. In addition to integrating budget analysis into our health rights and education rights work, we have continued to convene partners to develop budgeting for socio-economic rights thinking. We hosted a workshop for Budget Justice Coalition member organisations on Litigating Against Austerity to discuss challenging budget policies which violate people’s rights. We also planned the Imali Yesizwe – Our Nation’s Money, developed with BJC to inform a ‘human rights-based budget framework’, to challenge the prevailing narrative of ‘zero-based budgeting’ which is focused on cutting budgets with little regard for socio-economic rights.
Support package favours business not the poor: BJC
Health access in the Eastern Cape
SECTION27, as the co-ordinator of the Eastern Cape Health Crisis Action Coalition (ECHCAC), highlighted the serious effects of the COVID-19 pandemic on the already weakened Eastern Cape health system. SECTION27 joined calls by the Treatment Action Campaign for the removal of then-MEC for Health Nomakhosazana Meth and Superintendent General Thobile Mbengashe following repeated reports of a failure to provide critical health services to people across the province.
Members of the SECTION27 team used the COVID-19 pandemic to re-imagine opportunities to address health systems in a series of articles published in Spotlight. The series also offered a chance to reflect on the guiding objectives of the work of the Coalition.
Imali Yethu coalition for open budgets
The Imali Yethu coalition continues to lobby the National Treasury on budget transparency and participation. We are leading the development of a Phase Two of the Vulekamali.gov.za project by developing a concept note which is based on inputs from civil society organisations that are leaders in their respective fields. Treasury has provisionally committed to funding the project in the next financial year. The coalition has demanded that Treasury officials upload provincial budgets since mid-2019.
Stop Stock Outs Project
SECTION27 is a member of the Steering Committee for the Stop Stock Outs Project (SSP), a consortium which addresses reporting, diagnosis and resolution of stock outs of medication in the public sector. During this period, the SSP continued to monitor stocks of medicines and expanded its scope to include monitoring of personal protective equipment (PPE) for health workers.
These findings were reported to the Department of Health. When we followed up, 94% of the PPE cases and 52% of the essential medicines cases had been resolved within a week of reporting.
Economics and Human Rights
SECTION27 has partnered with the Institute for Economic Justice and the Centre for Economic and Social Rights (based in New York) on a project looking at the intersection of Economics and Human Rights. A fact sheet was developed entitled Budgeting for Human Rights during COVID-19: ‘The Duty to Use the Maximum Available Resources during the COVID-19 Pandemic’.
The Institute for Economic Justice, SECTION27 and The Centre for Economic and Social Rights jointly convened a conference on Economics and Human Rights on 11 and 12 November 2020, launched with a separate panel discussion on 9 November 2020. The conference was well attended and the SECTION27 leadership contributed substantially to the conceptualisation, organisation and facilitation of the conference. Many ideas were shared and documented about how to integrate a human rights framework into economic policy formulation and evaluation. The long-term aim of the project is to develop a community of economists and human rights advocates who can bring the best of each other’s disciplines together to inform research and advocacy campaigns for social and economic justice. We published a report based on the lessons learnt during the project.
Broadening our influence
The head of our health rights programme, Sasha Stevenson, is on the Ministerial Advisory Committee on social behaviour. She also presented at the Open Society Foundation seminar on COVID-19 in Africa. Executive Director Umunyana Rugege was appointed to the UNAIDS Advisory Committee on access to medicines. Patrick Mdletshe was appointed to the KwaZulu-Natal (KZN) vaccine coordinating committee, which coordinates and monitors the implementation and vaccination of people in that province.
Online engagement and media advocacy
SECTION27 received 1 417 media mentions throughout the year. The issues driving coverage were access to COVID-19 vaccines, and the National School Nutrition Programme.
TOTAL combined monitoring units for SECTION27: 1 Jan – 31 Dec 2020
PRINT | 249
BROADCAST | 309
ONLINE | 857
Our Facebook following grew to 17 967. Our Twitter following grew to 41 700. Organic growth on our platforms is stable. We implemented a digital marketing campaign on LinkedIn which has already seen our following on this platform grow to nearly 900 followers. Instagram is emerging as a strong news-sharing platform and we aim to take advantage of this by tailoring our news content to suit the medium. Our following on Instagram has grown to 1 650. Similarly, LinkedIn is a useful tool in our effort to drive our thought leadership in the areas of health and education rights.
Our newsletter is an avenue for supporters to keep up to date with our work and for the media to source story angles. We have used this channel to report on our campaigns.
Spotlight published 275 original articles in 2020. The online publication produces more articles than any of the other journalism entities specialising in healthcare in South Africa – this while maintaining high journalistic standards. Spotlight secured agreements with News24, Daily Maverick, and others which amplified the reach of the articles produced almost 10-fold. From the science of how COVID-19 impacts the lungs, to the trade-offs between a National State of Disaster and new proposed regulations in terms of the National Health Act, and from questions over how medical devices are regulated to front-line reports from community healthcare workers, Spotlight has continued to throw the net wide.
While much of Spotlight’s output remains COVID-19-related, we took a decision in July 2020 to again start doing more HIV, TB, healthcare system and healthcare reform reporting and analysis. This grew from a realisation that even though COVID-19 is extremely serious, it is quite possible that more people will die of TB in 2020 than of COVID-19. At the same time, critically important healthcare policy and reform processes remain in progress. Our guiding principle is to do public-interest journalism that both empowers readers and holds those in power accountable.
Some positive feedback: “Spotlight is one of the media stakeholders we hold in high regard – you remind us of our role and you keep us accountable. Any critique or vote of confidence from Spotlight is received with serious consideration by us.” – Nelson Dlamini, Acting Head of Communications at the South African National AIDS Council.
Our people writing for Spotlight
To celebrate SECTION27’s 10-year anniversary, we organised a webinar titled “Social justice in a time of crisis”. Daily Maverick Associate Editor Ferial Haffajee moderated the session, which included Umunyana Rugege, Thabang Pooe, Sha’ista Goga and Francois Venter. Over 360 people registered and 167 attended the webinar, which we live streamed on Facebook. This reached an additional 1,026 people, was viewed 440 times and shared 6 times.
Analytics of our webinars:
- The role of civil society in ensuring the right to basic education during the COVID-19 pandemic: 223 registrants, 108 attendees, 17 replay attendees.
- The parlous state of poverty eradication: human rights and austerity: 281 registrants, 144 live attendees, 43 replay attendees, 111 Youtube views
- Addressing child hunger and food insecurity: The National School Nutrition Programme and beyond: 204 registrants, 97 live attendees, 36 replay attendees, 30 Youtube views
- Civil society discussion with Dikgang Moseneke: 309 registrations, 126 live attendees.
- Abortion in ESA: 117 registrants, 66 live attendees, 10 replay attendees.
- Privacy in the pandemic: the (mostly) untold story of digital contact tracing in South Africa: 341 registrants, 76 live attendees, 28 replay attendees.
Visit our website for recordings of the webinars.
Following the opening of schools, the advice office received complaints from refugee and migrant parents and learners about exclusions due to lack of proper documentation or payment of fees.
After our involvement in the Ncube case, we received over 50 referrals of refugees denied access to healthcare services due to lack of documentation and/or payments demanded in advance for various procedures. We are assisting these clients.
Our partnership with Cliffe Dekker Hofmeyr (CDH) continues, with assistance to SECTION27 clients in 120 matters.
STATEMENT OF FINANCIAL POSITION AS AT 31 DECEMBER 2020
SECTION27 incorporating the AIDS Law Project NPC
Formerly AIDS Law Project NPC | Registration Number (2006/021659/08)