Ahead of the local government elections on 4 November Health-e News is turning the spotlight on how municipal services and their failures affect people’s health with a new investigative series: Elections 2026: Is Your Municipality Keeping You Healthy? 

While provincial health departments manage clinics, hospitals and medical staff, municipalities are responsible for many of the conditions that shape the health of the communities where we live. Clean water, working sanitation, reliable waste removal, stormwater drainage, safe food environments and accessible roads all have an impact on public health. When local services fail, communities get sick. 

The scale of some of these challenges is already evident. The governments’ Green Drop Report found that 47% of South Africa’s wastewater treatment systems were in a critical state, up from 39% in 2022. The Department of Water and Sanitation says this deterioration is placing increasing pressure on water resources, the environment and public health. 

The series also comes at a time of widespread dissatisfaction with local government. A 2026 Afrobarometer survey found that 70% of South Africans say their local councillor is doing a bad job. Only 17%  say local councillors often or always listen to ordinary people. 

The Institute for Security Studies (ISS) also points to the scale of the infrastructure challenge. 73% of South Africa’s Water Services Authorities were rated critical or poor in the Department of Water and Sanitation’s 2023 assessments. 

But wastewater is only part of the bigger picture. What happens when rubbish is not collected, sewage leaks into communities, waste is burnt near people’s homes, roads deteriorate or broken infrastructure makes it harder to reach healthcare? 

These are some of the public health questions Health-e News will investigate in coming weeks. 

Through our network of Community Journalists (CJs) we will document what happens on the ground in communities living with failing water and sanitation systems, uncollected refuse, brining waste and broken infrastructure across South Africa, and examine the consequences for people’s health. 

Is municipal failure affecting health in your area? We want to hear from you. Send your story, photos, or tip-offs to editor@health-e.org.za  and help us hold local leaders accountable.