In this article a ground-breaking report titled "Bodies 'at the Altar of Forced & Coerced Sterilisation': Journeys of Strife and Stride of HIV-Positive Women", is discussed by Unisa’s Vice-Principal for Research, Postgraduate Studies, Innovation and Commercialisation, Prof Thenjiwe Meyiwa, as one of the authors of the report.

The study exposes a deeply troubling practice that has violated the dignity, autonomy and reproductive rights of HIV-positive women in South Africa since 1997. The rights to equality, freedom from discrimination, dignity, bodily integrity, freedom and security over the women’s bodies, the right to the highest attainable standard of health, including sexual and reproductive rights, as well as to be free from cruel, torturous or inhuman and degrading treatment as stipulated in the Commission for Gender Equality (CGE) of 2020.

Prof Thenjiwe Meyiwa, Unisa's Vice-Principal for Research, Postgraduate Studies, Innovation and Commercialisation

The Special Rapporteur on torture has also classified forced sterilisation as an act of violence and a form of social control that violates a person’s right to be free from torture or other ill-treatment.

The report was authored by Prof Thenjiwe Meyiwa, Unisa's Vice- Principal for Research, Postgraduate Studies, Innovation and Commercialisation; Vicci Tallis, Programme Manager for the HIV and AIDS Unit at the Open Society Initiative for Southern Africa; Prof Puleng Segalo, incumbent of the Chief Albert Luthuli Research Chair at Unisa; Prof Azwihangwisi Mavhandu-Mudzusi, Head of Postgraduate Studies and Research in Unisa’s College of Human Sciences; Prof Zethu Cakata, senior academic in Unisa’s Department of Psychology;  and Sixolile Ngcobo, Director of the NSP GBVF Localisation Lab

The report brings to light the harrowing experiences of women who have endured forced sterilisation, often under coercion or misinformation, in healthcare settings. This study is not solely an academic exercise, but a moral imperative to confront systemic injustices and deliver justice to the victims. The report is also a painful reminder of how deeply entrenched racism, patriarchy and gendered systemic economic and political inequality remain in our society.

Black, impoverished HIV-positive women bear the brunt of this atrocity, their humanity disregarded, and their socio-cultural identities as women and mothers are violated. South Africans are encouraged to stand in solidarity with these women, to challenge societal norms that perpetuate stigma, and to demand systemic change.

The experts further emphasised "the practice of coerced sterilisation, particularly of ethnic minority and indigenous women, is also an outcome of the intersectional discrimination and violence experienced by women and girls living in poverty". They further recommended that states "adopt a feminist and human-rights-based approach to the measurement of intersecting forms of discrimination to ensure a gender equality centred and sustainable development approach to poverty, with enhanced attention to the groups of women and girls identified as being in heightened conditions of marginalisation and exclusion."

A wake-up call to perpetrators

To the healthcare professionals and institutions complicit in these acts: your time of operating under the shadow of systemic negligence and abuse is over. The evidence is undeniable. The voices of these women are powerful and unrelenting. This report demands accountability, transparency and the immediate cessation of these violations.

Regarding consent, the former Special Rapporteur on the right of everyone to the enjoyment of the highest attainable standard of physical and mental health stressed that "[g]uaranteeing informed consent is a fundamental feature of respecting an individual’s autonomy, self-determination and human dignity in an appropriate continuum of voluntary health-care services". He further stressed that "[i]nformed  consent is valid only when documented prior to a medical procedure and provided voluntarily, meaning without coercion, undue influence or misrepresentation", which "requires disclosure of the associated benefits, risks and alternatives to a medical procedure". The Special Rapporteur emphasised that "[i]nformed consent invokes several elements of human rights that are indivisible, interdependent and interrelated". In addition to the right to health, these include the right to freedom from discrimination, security and dignity of the human person, recognition before the law, freedom of thought and expression, and reproductive self-determination.

An urgent appeal to funders

We call upon funding agencies, philanthropists and private sector entities to rally behind this cause. Resources are urgently needed to establish victim support programmes, including counselling and legal aid. The report underscores the importance of aligning national healthcare policies with international human rights standards. Your contributions can directly influence systemic reform and amplify the call for justice.

To the victims: You are heard

To the brave women who have shared their stories of trauma and resilience: this report is your voice. It acknowledges your pain, amplifies your courage and pledges to honour your journey by fighting for justice. As Chimamanda Ngozi Adichie powerfully stated, "We are not passive victims but active agents of resistance, navigating systems of oppression with resilience".

The findings of this report call for immediate legal and policy reform, echoing of  UN Committee on the Elimination of Discrimination against Women, which noted with concern reports of forced sterilisation of women living with HIV/AIDS in public health facilities and demanded that Government immediately stops the practice of forced sterilisation of women living with HIV/AIDS, and amends the Sterilisation Act (Act No. 44 of 1998) in order to require the free, prior and informed consent of the woman concerned to any intervention.

Most importantly, the report demands a transformation of healthcare practices to restore dignity and autonomy to those affected. The time to act is now. The stories of these women must not fade into silence but must become a catalyst for change. Forced and coerced sterilisation is a scar on our collective conscience. It is a practice that must end – forever.

For more information or to support this initiative, contact the Unisa Research, Postgraduate Studies, Innovation and Commercialisation Office, or Her Rights Initiative, a not-for-profit organisation for and by HIV-positive women who are victims of forced sterilisations in South Africa.

Together, we can turn these stories of injustice into a legacy of empowerment and transformation.

* Compiled by the Department of Institutional Advancement