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Campaign: Southern Africa Charter on Access to Health

Get ready to contribute! Participate!


What is the issue?

There is lack of access to health, particularly accessible, available, affordable and acceptable health services, including HIV-related services by people who have been marginalised based on sexuality and gender.

What is the demand?

As people on the margins, we stand together to demand access to affordable, acceptable and accessible health services, including HIV related services. We are deeply concerned that health and health services for all is in a state of sustained crisis in Southern Africa and elsewhere on the African continent.
We refuse to be denied access. We refuse to be silent.
We reassert that health is “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” (WHO, 1948)
We have a right to health.

Participate in the drafting of the Southern African Charter on Access to Health by and for Marginalised People!

In preparation for its Regional Workshop on Marginalised People, Sexual Rights and Sexual Health to be held at the end of February 2017, the Coalition of African Lesbians is inviting you to submit your suggestions and comments on what you, your organisation or your activist collective or group want to see in this Charter. The Charter will make rights claims and demands to access sexual and reproductive justice for people who are marginalised based on their sexuality and gender. This campaign is part of the KP REACH Learning Project and is a joint effort by its partners: the Coalition of African Lesbians (CAL), the African Sex Workers Alliance (ASWA), and the Southern African Trans Forum (SATF).
CAL, as part of the KP REACH Project has already collected information and demands from a number of groups including women living with HIV, sex workers, lesbian women, transdiverse people and men who have sex with men, through our work in eight Southern Africa countries. We have also, as part of the Autonomy Project of CAL, begun to articulate a set of issues and demands as women who are marginalised based on sexuality and gender.
We have prepared a list of questions to help you start your reflection and input:
Some discussion starting points and questions:
In Southern Africa, what are the demands of people who are marginalised based on sexuality and gender?

  1. Abortion: What are the issues related to accessing abortion services in your country? What are the obstacles to obtaining safe abortions where you live? What do we want in relation to access to abortion?
  2. Sex Work: What kind of issues are sex workers facing in accessing health services including sexual health, reproductive health and HIV related services? What do we want in relation to access to health by sex workers?
  3. Sexual and Reproductive Health: What are the issues related to accessing general sexual and reproductive health in your country? What changes would you like to see?
  4. Access to Health Services for Marginalised Communities: What kind of issues have you experienced in trying to access health care in your country? What would have made your experience better? If you had a good experience in accessing health care in any country, what made it good, exceptional?
  5. Top Three: If you could think of 3 things that could improve health services and access to sexual and reproductive health, what would those be?

Send us your inputs!

You can either send your input by email to or participate in our conversations on social media.

Find us on social media!

From 20 February to 24 February 2017 we will be collecting inputs to the Charter on social media. You can either participate in the discussions listed below or take a picture that illustrates your demands for access to health care and sexual and reproductive health services for marginalised communities. Contribute your picture by posting it on Twitter using the #DemandHealth hashtag and directing it toย  @CALAdvocacy or on theย  RALF Feminists Facebook page.

Twitter conversation:

To collect input into the Charter, CAL is inviting you to participate in a twitter conversation:

Tuesday, 21 February 2017

Using the hashtag: #DemandHealth, we will discuss issues related to access to health and sexual and reproductive health services for marginalised communities in Southern Africa.

Join us from 13:00 to 16:00 SA Time (GMT+2) by following our twitter account: @CALAdvocacy.

Facebook Dialogues:

Find us on Facebook at RALF Feminists from 20 February 2017 to 24 February 2017 to participate in the discussion and send us your input by commenting on the various discussion topics that we will be posting there.

Why this Campaign and why now?

We are ready to take access as a right

As marginalised people in Southern Africa, we are ready to insist on our rights to access health, health services, sexual and reproductive health and rights and refuse to stand by and wait while we get sick and die of preventable and treatable illnesses and disease. We are ready to act.

We recognise that our right to health includes the right to health services and more broadly, our right to health itself means that the current state of attack on our bodies and lives must end so that we can enjoy, alongside all other people, a state of complete physical, mental and social wellbeing in keeping with the WHO definition of health.

Access to health is overdue. This is a crisis.

A lack of autonomy

As women and marginalised people in Southern Africa, we often have little control over our bodies, health and lives and over our sexuality. Social, political and economic conditions are deeply hostile and seek to prevent us from exercising autonomy over our bodies and lives. Until we take seriously as a people the right to health for all people and invest heavily in advancing this right, we will not and cannot realise the right to development and transform Africa into a place where all people live in dignity, freedom and equality.

HIV and quality health services

Access to affordable, accessible, acceptable and available HIV prevention, treatment, and care services will best be achieved for the maximum number of people when the health systems themselves are strengthened. Quality HIV services in the absence of quality health services are not sustainable. Those who are poor, those who have inadequate income and all those dependent on the public health system stand small chance of accessing quality health services, including HIV related services. These services generally neglect communities that are at increasing risk of infection such as sex workers, women who have sex with women, transdiverse people and men who have sex with men. These groups are oppressed by health personnel who treat us with hostility, stigma and discrimination. The health system enables and even encourages such treatment.

Sexual and Reproductive health and rights

The drive to advance access to health services and HIV related services in particular must be located within a sexual and reproductive health and rights framework. Sexual orientation, gender identity and expression and sex work are issues linked with human sexuality. We are sexual beings. This has implications for health systems and services. Denial of human sexuality and its related health implications means we take longer to solve problems and meet needs related to sexual and reproductive health. Much of this reluctance is based on fear, ignorance and patriarchal control over the bodies and lives of others by state and non-state actors, including communities and traditional and religious institutions.

Hostile contexts in Southern Africa fuel ill health and disease

State actors in the political and legal systems set the tone for such treatment when they criminalise us and subject us to harassment, detention, prosecution and imprisonment. National planning documents and donor funding agreements at times mention men having sex with men and sex workers, but little programming actually exists. Many states rely on international donor aid to provide HIV programming and services, making these services precarious and subject to aid conditionalities and changing donor priorities. Too often doctors, religious leaders, policy makers and politicians make decisions regarding our access to sexual and reproductive health, claiming to know what is good for us. They exclude us. We are barred from or it is made very difficult for us to participate in these decision making processes.


Come and join us next week, online and offline, to discuss your inputs on the Charter!

CONTACT: Alla Moyo :