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South African

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AIDS Is Not Over

Four years ago optimism was high that AIDS was in retreat, and could ultimately be eradicated. Back then the Joint United Nations Programme on HIV/AIDS (UNAIDS) was boldly predicting “the end of AIDS by 2030.” Nobody is feeling that optimistic now.

New HIV infections, after dropping steadily for the ten years to 2005, more or less stabilised at 2 million a year in the last decade, and the annual death toll from AIDS has also stabilised, at about 1.5 million a year. But the future looks grimmer than the present.

Two-thirds of all HIV-positive people (24 out of 36 million) are in Africa, and an even higher proportion of the AIDS deaths happen there. If it were not for Africa, the predictions of four years ago would still sound plausible. So what’s wrong with Africa? Two things: it’s poor, and there are “cultural practices” that facilitate the spread of the HIV virus.

The great achievement of the International AIDS Conference that was held in Durban sixteen years ago was to break the grip of the big pharmaceutical companies on the key drugs that were already making HIV-positive status a lifelong nuisance rather than a death sentence in other parts of the world. Unfortunately, the drugs were so expensive that the vast majority of Africans simply could not afford them – so they died instead.

In a diplomatic and media battle that lasted for almost a decade in the late 1990s and early 2000s, African countries managed to shame the big pharmaceutical countries into accepting the importation of much cheaper “generic” versions of the main anti-retroviral drugs, mainly from Brazil, India and Thailand, for use in poor African countries.

The Western drug companies not only dropped their collective lawsuit against the South African government in defence of their patents. Some of them even began providing their own patent drugs to the African market at one-tenth or even one-twentieth of the price they charged elsewhere. A widely used course of treatment that cost $10,000 a year in the US at the time became available to Africans at a price of about $100 a year.

Many HIV-positive Africans could not even afford that amount, but Western governments and private foundations also began providing major funding for anti-HIV programmes in Africa: $8.6 billion in 2014. (80 percent of the money comes from the United States and the United Kingdom)

Even today half of Africa’s HIV-positive population is not using the basic cocktail of anti-retroviral drugs on a regular basis. There is still a stigma attached to having the virus, and many of the non-users who have been diagnosed as positive don’t go the clinics to collect their drugs because it involves standing in line and being seen by people they know.

The continent’s death rate from AIDS went into a temporary steep decline, but it is now heading back up for a number of reasons. The main one is that resistance to the standard mix of drugs has grown into a major problem.

The second-line treatment, using newer drugs that are still available at the “African discount”, costs $300 per person per year – and resistance is also apparent in 30 percent of those cases. The third-line or “salvage” treatment costs $1,900 a year even in Africa. The governments can’t afford it, and very few Africans have medical insurance.

Drug resistance has been growing in the developed world too, of course, but the solution there is to move HIV-positive people onto newer combinations of drugs that are far more expensive. The cost of treatment in the US today can be higher than $20,000 a year, and not one African in a thousand can afford that.

African governments will probably have to wage another long diplomatic and media battle to access generic or cut-rate versions of the best new drugs. In the meantime, a great many people will die. And this is happening just as the amount of funding from Western sources for anti-HIV programmes in Africa has gone into decline: donations last year were down by almost one billion dollars.

The other specific reason for sub-Saharan Africa’s much higher rate of HIV infections is “cultural”. What that means, in plain English, is that sexual traditions are different there: pre-marital and extra-marital sex is commonplace. Moreover, older men often exploit their relative wealth and power to have unprotected sex with many young women and girls.

This may explain why in southern Africa, uniquely in the world, 60 percent of new HIV infections are among young women. And it is striking that HIV infection rates are far lower in those parts of the continent that have been Muslim for many centuries – or Christian for many centuries, like Ethiopia – and where the sexual rules of engagement are therefore much stricter.

The situation in sub-Saharan Africa is almost bound to get worse, not better, because the 15-24 age group, the most likely to become infected, is growing explosively fast. They number about 200 million now, but that will double to 400 million by 2040. Africa has long been the world capital of HIV and AIDS, and it will remain so for the foreseeable future.
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To shorten to 725 words, omit paragraphs 8 and 14. (“Even…know”; and “This…stricter”)

South Africa – Is Zuma to Blame?

South Africa is now verging on the status of economic basket case. GDP growth last year was around half of one percent, the country’s currency has been in free fall for the past year, and its bonds face an imminent downgrade to “junk” status. So is the South African economy doomed to a long period of low or no growth no matter who is in charge – or is President Jacob Zuma to blame?

“Zuma is no longer a president that deserves respect from anyone,” said Julius Malema, leader of the Economic Freedom Fighters (EFF) party, in South Africa’s parliament last month. And as Zuma tried to give his eighth State-of-the-Nation speech (he became president in 2009), the EFF members of parliament chanted “Zupta must fall”. (“Zupta” is a reference to Zuma’s close ties with the immensely wealthy Gupta family).

Julius Malema does not qualify as an unbiased observer, but his view of Zuma is shared right across the political spectrum in South Africa and beyond. “No-one believes anything he says,” concluded veteran political analyst William Gumede. And yet Zuma continues to be in charge of Africa’s largest economy – which is now deteriorating practically by the day.

Post-apartheid South Africa was never a great economic success. After the end of apartheid in 1994, there were high hopes that the economy would grow at 6 percent annually or better and create half a million new jobs a year. In reality, growth averaged just over 3 percent in the next decade – and then fell off a cliff after the global financial crisis of 2008.

South Africa joined Brazil, Russia, India and China as a member of the BRICS in 2010, but it didn’t really qualify. While its fellow BRICs powered through the great recession of 2009-2012 with undiminished growth rates, South Africa’s economy fell to 2 percent growth a year,, then one percent, and now half a percent.

It is no crime that Zuma was born poor and never went to school. Neither is it a crime that he has never worked in the private sector: all his jobs, from the age of sixteen, have been in the service of the now-ruling African National Congress (ANC). But it is remarkable, given these facts, that he has nevertheless become very rich (at least $20 million).

Zuma has never been jailed for corruption, but his principal financial adviser, Schabir Shaik, was sentenced to 15 years in prison in 2005 for corruption and fraud. The judge said that the evidence of a corrupt relationship between Shaik and Zuma was “overwhelming”, and Zuma was immediately fired as deputy president by then-president Thabo Mbeki.

Police raids on two of Zuma’s homes yielded evidence that led to charges of money-laundering and racketeering in connection with a multi-billion dollar arms deal. Just three days before Zuma was installed as president in 2009, the charges were dismissed on grounds that the evidence had been tampered with, but a recent High Court decision has reinstated the charges.

Then there was the Nkandla scandal, in which Zuma got his government to pay for the $23 million expansion of his country home in KwaZulu-Natal. (He was eventually forced by the courts to pay back some of the money.)

Or consider the astounding events of last December, when South Africa had three ministers of finance in the same week.

The first finance minister, the widely respected Nhlanhla Nene, had annoyed Zuma by refusing to approve some very large contracts in nuclear energy and the state-owned airline. (Nene may have suspected that big kickbacks were involved.) So he was dismissed.

The second finance minister was David van Rooyen, an unknown party wheelhorse with no financial experience. It was soon discovered that he had close ties to the Gupta family, which gave rise to speculation that Zuma was helping the Guptas to capture control of the state’s financial policies. He was forced to resign after four days.

The third man, Pravin Gordhan, was respectable and competent, but by then South Africa’s stock market had collapsed, its currency had tanked, and the Standard and Poor’s ratings firm had reduced the country’s credit rating to just one notch above “junk” status.

So Zuma does bear the blame for the collapse in international confidence in the South African economy – but not for its long-term failure to grow as fast as was expected. What is to blame for that?

South Africa was already a developed country when apartheid ended. It was a very strange sort of developed country, with around ten million people living in a modern economy among thirty million others who filled menial roles or lived by subsistence farming. But it was already urbanised, already industrialised, and therefore not eligible for the once-only bonus of high growth that some big “emerging economies” enjoyed.

The best that South Africa could ever have expected was the 3 percent growth that it had in 1996-2008. That would have been barely enough to meet popular expectations for rising living standards. The main cause for its failure to meet those expectations, and for any political upheavals that may subsequently ensue, is Jacob Zuma.
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To shorten to 725 words, omit paragraphs 8 and 9. (“Police…money”)

Prejudice and History

Last week, a Thai cosmetics company called Seoul Secret launched a new beauty product, Snowz, and got locally famous Thai actress Cris Horwang to appear in the promotional video. She starts out white, and explains: “In my world there is tough competition. If I don’t take care of myself, everything I have built, the whiteness I have invested in, could be gone.”

Then her skin gradually darkens until she resembles one of those “blackface” comedians in early 20th-century America. She looks down at herself in dismay, then at another Thai beauty, very white indeed, who magically appears beside her. “If I was white, I would win,” Horwang says to herself.

But salvation is at hand: her young rival generously points to a package of Snowz that magically appears between them. Cris brightens up, and so does her skin. The ad ends with her smiling again and saying: “Eternally white, I’m confident.”

After an eruption of protests the ad was withdrawn with “heartfelt apologies” from Seoul Secret. But they didn’t withdraw the product.

They would have been crazy to take it off the market, because Asian women spend $13 billion a year on skin-whitening products. Africa is even more extreme, with 35 percent of South African women using skin-whitening creams, and an astonishing 75 percent of Nigerian women.

Several hundred million women are using these products regularly, despite a range of possible side-effects that run from ochronosis (which causes the skin to turn a dark purple shade) to leukemia, diabetes and cancers of the liver and kidneys. But why? What’s wrong with dark skin?

Nothing, obviously. Originally, several million years ago, all our ancestors were “white”, but they weren’t actually human yet. They had pale skin, like most animals with fur, because the fur blocked most of the incoming sunlight, and pale skin is six times more efficient in turning the ultraviolet light (UV) from the sun into the vitamin D that they all need.

When modern humans evolved, they lost their fur – and since they evolved in equatorial Africa, where there is an abundance of sunlight, their bare skin was actually getting too much UV. So early humans developed dark skin to cut down on their UV intake, and early humans were all “black”. Then some of them migrated out of Africa and colonised the rest of the planet, including the parts in the high latitudes where there is much less UV in the sunlight.

The ones who ended up in northern Eurasia went back to having pale skin – Europeans in the west, North Asians in the northeast – in order to make better use of the limited UV that was available. And that’s the end of the story: we ended up with the skin colour that suited where we lived.

The details are more complicated, of course. Bare skin was getting plenty of the UV that triggers the production of Vitamin D, which helps calcium absorption (for bones and teeth) and is needed for various metabolic processes. But so much UV also depleted another vitamin, B12, which is essential for a healthy nervous system and other key metabolic processes. It also risked causing severe sunburn. Dark skin solved both those problems.

When the migrants moved north, there was no risk of sunburn and no threat to Vitamin B12, because far away from the equator the UV rays come in at a slant through the atmosphere, not straight down, and most are absorbed before they reach the surface. In fact, there was not enough UV in the north to make Vitamin D, especially in winter.

So evolution went into reverse, and by ten or twenty thousand years ago practically everybody living north of the Mediterranean and the Himalayas was pale-skinned, to make better use of the limited UV that was available. And that’s all there is to know about skin colour. It’s not good or bad; it just suits the geographical circumstances.

So why the prejudice against dark skin? It’s all about history, but it’s much older than the European conquest of the world in 1500-1900. That left particularly deep psychological scars, but light-skinned people from the north have been conquering dark-skinned people further south for thousands of years.

The reasons are too complex to go into here, but it had nothing to do with skin colour. (See Jared Diamond’s classic book “Guns, Germs and Steel” for a plausible explanation.) Nevertheless, dark-skinned people have been the historical losers for thousands of years, and people tend to blame themselves for losing.

Add in a few details like the European and Arab slave trade in Africa, and the fact that people who work outdoors, and therefore have skin darkened by the sun, tend to be in the lower social classes, and you have an explanation for the internalised prejudice against dark skin even in many dark-skinned people.

But this prejudice really is on the way out at last. The most important thing about that awful advertisement is not the fact that it was made. It’s the fact that the outcry in Thailand forced it off the air.
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To shorten to 725 words, omit paragraphs 10, 11 and 12. (“The details…circumstances”)

Rape is an African Problem

15 September 2013

Rape is an African Problem

By Gwynne Dyer

Last May, with considerable trepidation, I wrote an article about what seemed to be extraordinarily high rates of rape in Africa. The original data came from a study by South Africa’s Medical Research Council in 2009 which found that more than a quarter of South African men – 27.6 percent – admitted that they had committed rape. Almost half of those men had raped two or three women or girls. One in thirteen had raped at least ten victims.

Over the next couple of years, I ran across a couple of other less detailed studies suggesting that the problem was not just South African. A report from the eastern Congo in 2012 said that over a third of the men interviewed – 34 percent – had committed rape, and an older report from Tanzania found that 20 percent of the women interviewed said they had been raped (although only one-tenth as many rapes were reported to the police).

So I wrote a piece called “An African Iceberg” in which I said that this was a phenomenon that needed urgent investigation continent-wide – but it did occur to me to wonder if there were similar icebergs in other developing countries. The only figures that were available for developing countries elsewhere were official ones, and those normally only record the number of women who tell the police they have been raped. Most don’t.

Women are reluctant to report rape in any society, and in traditional societies much more so. The South African study was the only one that had adopted the strategy of asking men directly. Maybe if the same sort of study were done in other continents, I thought, it would return equally horrifying figures. And lo! Somebody else had the same thought, and the resources to do something about it.

The new report, conducted under the auspices of four United Nations agencies cooperating as “Partners for Prevention”, was published last week in the online version of “The Lancet Global Health”, a respected British medical journal. The study was undertaken quite specifically to learn if the South African figures were duplicated in developing countries outside Africa. .

The researchers chose six countries in the Asia-Pacific region: China, Cambodia, Bangladesh, Sri Lanka, Indonesia and Papua New Guinea. As in the South African study, the word “rape” was not used in the questionnaire. The 10,178 men interviewed were asked if they had ever “forced a woman who was not your wife or girlfriend at the time to have sex” or “had sex with a woman who was too drunk or drugged to indicate whether she wanted it.”

There were further questions about forcing a wife or girlfriend to have sex (which is also rape), about gang rape, and about raping males, but for simplicity’s sake let us stick with the questions about what the researchers called “single perpetrator rape” of a woman who was neither wife nor girlfriend. The answers varied from country to country, but the overall picture was clear. Africa (or at least South Africa) is all alone out there.

In most of the Asian countries involved in the study, between 2 and 4 percent of the men interviewed said that they had raped a “non-partner” woman. That falls into the same range that prevails, one suspects, in most developed countries (although their reported cases of rape are much lower).

There were some local peculiarities, like the fact that in rural Bangladesh men are more likely to get raped than women. China came in surprisingly high, with 6 percent of the men interviewed admitting to rape, but that may be related to the growing surplus of males in a society where the gender ratio has become very skewed: there are 99 large Chinese cities where more than125 boys are born for every 100 girls.

But Papua New Guinea was right up there with South Africa: 26.6 percent of the men interviewed had committed “single perpetrator rape” of a non-partner woman. And the other numbers were just as startling: 14 percent of PNG men had participated in a gang rape, and 7.7 percent had raped a man or boy. So Asia as a whole is quite different from Africa on this count – but PNG is practically identical.

What is so special about Papua New Guinea? It is a country with an extravagantly large number of different tribes and languages. It is an extremely violent country, where most people live in extreme poverty. It is a place where the law is enforced only sporadically, and often corruptly. And it is a place where traditional tribal values, patriarchal to the core, reign virtually unchallenged among a large part of the population. Remind you of anywhere?

Well, you already suspected that this was at the root of it, didn’t you? You just didn’t want to say so, for fear of being accused of being racist, anti-African or something of that sort.

But it does need to be said, loudly and repeatedly. Women and girls are more likely to be the victims of sexual violence in Africa than almost anywhere else, and the only way to change that is to change the behaviour of African men. By persuasion if possible, but also by enforcing the law.

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To shorten to 725 words, omit paragraphs 2 and 9. (“Over…police”; and “There…girls”)