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.