Approximately 90% of African women live in countries with overly restrictive abortion laws. [1] While the vast majority of African countries strictly condemn abortion, proscription may be waived under certain conditions: to preserve life (out of necessity); for health preservation; if the pregnancy is a result of rape or incest; or if the fetus is impaired. [1] However, the aforementioned grounds for abortion are not available to all women. For instance, Nigeria, Uganda and Somalia condone abortion solely out of necessity. [1] Burundi and Cameroon extend the grounds to physical health, at the exclusion of mental health and fetal impairment, while Burkina Faso permits abortion on all three grounds, including cases of rape and incest. [1] Ghana, Algeria and Namibia also make provision for all of the aforementioned grounds. [1] Women are further required to seek parental or spousal consent to procure an abortion in Equatorial Guinea and Mauritius. [1] Abortion is strictly prohibited, without any legal exceptions, in 11 African countries, including Angola, Congo-Kinshasa in the Democratic Republic of Congo , Congo-Brazzaville in the Republic of Congo and Senegal. [1] Although these statistics are perturbing, as the majority of African women are being stripped of their human rights, they are to be expected, since Africa is the most religious continent in the world. [3] A recent world survey revealed that 'more than 8 out of 10' Africans identify as religious, actively participating in religious practices and traditions. [3] Approximately 95% of South Africans are religious. [2] Nevertheless, SA is one of only five African countries (along with Cape Verde, Mozambique, Tunisia and Zambia) that currently provide women with unrestrictive abortion services, within gestational limitations. [1] SA's liberal abortion laws are to be expected since it is a secular state, established upon a Constitution [4] that ensures that women are guaranteed rights conducive to their reproductive health, which is echoed in the country's laws governing abortion. [5] Although reportedly half of all African countries are considered secular, [6] most implement rigorous legal prohibitions on abortion that often coincide with religious ethical and moral views. SA's Choice on Termination of Pregnancy Act (CTOPA) No. 92 of 1996 [7} is lauded as one of the most liberal abortion laws worldwide. [8] It encapsulates and endorses several constitutional rights that women were denied during Apartheid, [9] particularly the rights to reproductive health, bodily integrity, privacy and access to information. In light of the vast strides the CTOPA has contributed towards safeguarding and championing women's constitutional, sexual and reproductive rights, one might also ask whether SA's current abortion law is inclusive of religious ethics. This question entails an understanding of religious ethics, secular morality and SA abortion laws. This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

The USA's Protecting Life in Global Health Assistance policy (PLGHA) is an expansion of the Mexico City Policy (MCP), which prohibited foreign NGOs that provide termination-of-pregnancy (TOP) services or actively promote TOP as a family-planning method from receiving US federal funding for family planning programmes. The expanded programme came into global effect in 2017. [1-7] PLGHA affects a number of major US funding agencies responsible for providing the majority of foreign health assistance to sub-Saharan Africa. [5,8] PLGHA proscribes TOP and TOP-related services, including counselling, referrals or lobbying, with only rare exceptions, and extends to global health assistance programmes that include HIV/AIDs programmes-unlike MCP, which was limited to family-planning assistance. [6] Ostensibly, HIV/AIDS programmes would not be affected by PLGHA, since HIV/AIDS NGOs are not TOP providers. However, numerous HIV/AIDS programmes provide information on sexual and reproductive healthcare that may include TOP-related services or activities prohibited by PLGHA. South Africa (SA) is shouldering the highest HIV burden in the world, and many South Africans rely on treatment programmes provided by SA HIV/AIDS NGOs. The majority of funding received by these NGOs to support HIV/AIDS programmes is funded by the US government. [9,10] Consequently, SA HIV/AIDS NGOs receiving US foreign assistance are required to comply with PLGHA in order to continue to receive funding for their HIV/AIDS programmes. This article explains PLGHA and how it might affect funding for HIV/AIDS in SA by illustrating how certain programmes and activities of HIV/AIDS NGOs can violate the provisions of PLGHA, and suggests ways in which such NGOs can prevent jeopardising their funding. The Mexico City Policy The MCP was instituted by the Reagan administration in 1984, during President Reagan's visit to the second International Conference on Population in Mexico City. [1,2] MCP was founded on the obligation to legally safeguard the life of a child 'before it is born as well as after birth' , as enshrined in the United Nations' Declaration of the Rights of the Child. [3] The principle objective of MCP was to promote the adoption of 'sound economic policies and where appropriate, population policies consistent with respect for human life and family values' in developing countries. [2] US support for family planning programmes is predicated on safeguarding and upholding human life and human dignity, and supporting families. [2] The USA at the time deemed TOP unacceptable, rejecting its use as a conventional family planning method. [2] Accordingly, NGOs that either provided or actively endorsed TOP were precluded from receiving any family planning funding from the US government. [2] Since its implementation 35 years ago, MCP has been rescinded and reinstated several times, but been in effect for at least 18 years.

REVIEW 'Partial-birth abortion' (PBA) is a US colloquialism for intact dilation and extraction (D and X), [1] coined by conservative pro-life advocates, who liken the procedure to infanticide. [2] Their reasoning is founded on the erroneous belief that D and X constitutes the partial delivery and subsequent murder of a full-term baby. [3 ,4] Conversely, D and X is a variant of dilation and evacuation (D and E), [5,6] possibly the safest procedure employed during late termination of pregnancy (LTOP), which refers to abortions that occur after 20 weeks' gestation. [7-15] The Centers for Disease Control and Prevention have stated that on average, 1.3% of abortions in the USA are LTOPs, of which D and Xs comprise fewer than 20%. [15] D and Xs are carried out between 20 and 24 weeks' gestation, [16] and typically comprise four steps: cervical dilation; breech conversion; breech extraction, excluding the fetal head; and cephalocentesis to induce vaginal delivery of the intact fetus. [14,17] The defining feature of D and X is cephalocentesis, which entails the removal of the intracranial contents by way of a suction device, consequently preventing cervical injury by reducing the diameter of the fetal skull prior to intact delivery. [9,10] Hence D and X may be more advantageous than D and E, [14] which involves fetal dismemberment that is known to increase the risk of maternal mortality and morbidity. [11,12] Nevertheless, D and X is federally proscribed except in lifethreatening circumstances, as per the US Partial-Birth Abortion Ban Act of 2003. [18] Failure to comply with the provisions of the Act will result in a fine, imprisonment of up to 2 years, or both a fine and imprisonment. [18] The legality of the Act was brought before the Supreme Court in Gonzales v Carhart [19] and scrutinised for its perceived ambiguity; the Act proscribes surgical feticidal abortion procedures comprising the substantial removal of the fetus via vaginal delivery. [19] D and E encompasses fetal dismemberment requiring substantial removal of the fetus through the vagina, a practice that is explicitly proscribed by the Act, and therefore D and E could be included under the ban, which could subsequently impose an undue burden on women by restricting their reproductive health choices. [19] The Supreme Court found the state to hold a bona fide interest in fetal protection, and held that the Act exclusively proscribes D and X; therefore, proscription is not unduly burdensome to women. [19] Currently, D and X is proscribed in 32 US states. [13] Currently, the US is the only country worldwide to legally proscribe and criminalise D and X. [14] South Africa (SA)'s Choice on Termination of Pregnancy Act No. 92 of 1996 (CTOPA) [20] is universally hailed as one of the most liberal pieces of legislation worldwide. [21] CTOPA makes provision for LTOP after 20 weeks' gestation once a physician, having consulted with another physician or registered midwife, concludes that: the patient's life is at risk; the fetus is suffering from acute malformation; or t...