<?xml version="1.0" encoding="UTF-8"?><rss xmlns:content="http://purl.org/rss/1.0/modules/content/" version="2.0"><channel><title>IRIN - South Africa</title><link>http://www.irinnews.org/</link><description>Updated everyday</description><language>en-gb</language><lastBuildDate>Mon, 17 Jun 2013 17:31:35 GMT</lastBuildDate><item><title>Making a dent in South Africa’s drug culture</title><pubDate>Mon, 17 Jun 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201306171353520815t.jpg" />]]>JOHANNESBURG 17 June 2013 (IRIN) - In pink tracksuit and big sunglasses, Nomvula Mokanyane, premier of South Africa’s Gauteng Province, delivered a combative warning to the drug dealers of Eldorado Park that had the crowd buzzing: “Leave, your days are numbered!” But then a distraught mother, urged to speak but unable to, brought everyone back down to earth with the news that her addict daughter had just died.</description><body><![CDATA[JOHANNESBURG 17 June 2013 (IRIN) - In pink tracksuit and big sunglasses, Nomvula Mokanyane, premier of South Africa’s Gauteng Province, delivered a combative warning to the drug dealers of Eldorado Park that had the crowd buzzing: “Leave, your days are numbered!” But then a distraught mother, urged to speak but unable to, brought everyone back down to earth with the news that her addict daughter had just died.

The mother was one of the organizers of the 2 June prayer march by Mokanyane and community leaders to confront Eldorado Park’s drug problem - her 14-year-old daughter had committed suicide just a few hours earlier. 

Eldorado Park, south of Johannesburg, is mainly low-cost small brick housing and council-owned apartment blocks, next door to Soweto. It was established by apartheid city planners in the late 1960s as a mixed race, so-called “coloured” township, and today the 350,000-strong community still suffers high rates of poverty and neglect.

But in May it attracted a visit by President Jacob Zuma, in response to a series of public letters that went viral written by a group of mothers appealing for help against a “wave of drugs [that] has swept over our community and has taken over our lives, killing our children by the day. Children as young as eight are drug addicts”.

Sense of siege

The letter, addressed to Zuma, went on: “Help us lock up these murderers, drug dealers for good. Set up a special court for all drug-related crime. Close down all the Lolly Lounges [named after the lollipop shape of the home-made pipe used to smoke methamphetamine]. Dismiss all corrupt cops that [are] on a payroll. Call in the K9 unit. We need a rehab centre that will assist with detoxing our kids and give them a second chance at life. We need recreation centres to keep our kids busy… Let us have compulsory drug testing at our schools.”

Councillor Peter Rafferty believes the drug culture in Eldorado Park changed with the arrival of cheap methamphetamine, known as tik, as the drug of choice in the last few years. “Unemployment has become much bigger in the last five years. It’s not just the youth, if you’re 40-plus and have been retrenched, the chances of finding work are slim,” he told IRIN. 

He also pointed an accusing finger at parents for neglecting their children and the school system for a lack of support - only a handful of Eldorado Park’s 25 schools have a drug policy.

“Drugs are fun”

There is a sense of exclusion felt by “coloureds” in South Africa, where “racialized” identities are rarely escaped, and the community has few political champions. “Drugs are especially rife in the coloured townships,” said Lorreal Ferris, station manager of Eldoz FM. “It’s a form of escapism, but it’s also bread on the table. [Drug dealing] provides for families and communities, but also destroys families and communities - that’s the Catch-22.”

How widespread is drug use in Eldorado Park? Nobody seems to know, but anecdotally everybody IRIN spoke to said someone in their family was using – typically tik. The consequences include a rate of crime that impoverishes everybody - from stealing from your Mum’s purse to buy a US$5 bag of meth, to pilfering the copper on the window handles at schools, to the street lights smashed for their bulbs to make lolly pipes. 

There is a sense of bewilderment over how quickly tik took over. Before the police cracked down in May, dealers seemed to be operating on every other street in Eldorado Park. “The streets were crazy, large groups of people walking around late at night going to get their drugs,” said Le-Verge Constance, who used ketamine as her drug of choice up until a year ago, when she was partying hard but still managing to hold down a managerial job.

“Drugs are fun, it’s about socializing and partying, but what a lot of people don’t understand is that your body can become addicted,” she told IRIN. “You think your mind is stronger and you can control it.”

Constance now hosts a weekly chat show for recovering addicts on Eldoz FM. In the year that she has been clean, she has seen a change in drug use in Eldorado Park. From being part of the clubbing culture it has shifted to lolly lounges - where with up to 20 people in a house, safe from police attention, you can blaze away undisturbed until your money runs out. It is also where women and girl tik addicts are extremely vulnerable, some running away from home to spend weeks in a house, swapping sex for drugs.

Elton Guerio, 28, has witnessed it many times. Out of work since 2005, both his parents dead, four of his five siblings - including two sisters - on meths, his family home was one of the lolly lounges visited by Mokanyane and the prayer marchers. “Tik is easily accessible, it’s like giving a child sweets, especially for girls. They give it to the girls on purpose so they can use them,” he told IRIN.

Community champions

Cheryl Pillay runs the Come Back Mission (CBM) [ http://www.comeback.co.za/ ], at its offices across the road from her house, offering help to women standing up to alcohol and drug addiction. For her, young girls trading sex for tik is a critical part of “the whole lolly lounges thing”. Sexual violence, and HIV, are just some of the consequences. 

According to CBM, as many as 60 percent of households in Eldorado Park are single-parent run. While that does not automatically mean alarm bells should sound, it nevertheless represents hurdles for children and parents to struggle through in a community with a dizzying unemployment rate. Pillay has time and again seen girls tripped up by problems at home or school, slip into addiction and wind up in lolly lounges [ http://www.youtube.com/watch?v=Ixnp7hZjlH8 ].

“The first night you’re on a high, and you can stay like that for three or four days, enjoying yourself. But you don’t want to go home and seem high to your parents, so you stay there until the drugs are out of your system or you run out of money,” Guerio told IRIN. 

Guerio, now off meths, works for Liesel Valoo, another redoubtable woman fighting for her community. His job is to find lolly lounges where girls are staying, and Valoo goes in and gets them. Valoo’s NGO is the South African Drug Abuse and AIDS Council, and she is a bustling bundle of energy. “When Liesel comes for you, there is only one option, you must go.” 

The police in Eldorado Park have taken action, closing down 20 lolly lounges, arresting over 130 people for drug-related crimes, and re-opening hundreds of previously closed cases. Some of that targeting has been a result of tip-offs by Pillay. She chairs the Local Drug Action Committee, which among other things collects the names of dealers and details of how they operate, often sent in by their neighbours. But Pillay is clear that just sending dealers to jail is not the solution, given the lack of rehabilitation provided by the criminal justice system. 

New ideas needed

“If you are caught with one bag - why not do community service?” asked Rafferty. “Most of the guys caught are the runners, and he won’t talk as his life is at stake. The analysis lab is in Pretoria and it takes months to get the results. Meanwhile, the guy is out on bail that night and the community thinks ‘corruption’.”

Arrests for petty crime like public drinking or possession of marijuana burdens youths with a criminal record that prevents them from being employed. Several community leaders called for a wiping of the slate as a positive step forward. “Every child before the age of 18 has been arrested three or four times,” Pastor Marcus Jacobs told IRIN. “They will never be able to work in a bank, for example, until that data is cleaned.”

For Ferris, “even though everybody condemns drug peddling, deep down we understand why they do it. There needs to be a dialogue, they need to ask for, and be given, forgiveness.”

The South African government recognizes the link between substance abuse and socioeconomic strife, and is seeking to pull a range of departments together - from health and education to police and correctional services - to work collaboratively in Eldorado Park. The strategy involves reducing demand, supply and harm, while also focusing on prevention, early intervention, treatment and after-care, according to SAPA, the South African government news agency [ http://www.sanews.gov.za/south-africa/gauteng-govt-committed-rooting-out-drugs ].

The visit by Zuma and the high-profile police presence has calmed the streets of Eldorado Park, but drugs remain available - just driven back underground. “Drugs are a symptom of something else. To say we’re winning the drug war is very naïve. But we can hope to make a dent,” said Rafferty.

oa/cb

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A series of articles exploring the humanitarian impact in developing countries of the global drugs trade.
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]]></body><link>http://www.irinnews.org/Report/98243/Making-a-dent-in-South-Africa-s-drug-culture</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201306171353520815t.jpg"/></td><td valign="top">JOHANNESBURG 17 June 2013 (IRIN) - In pink tracksuit and big sunglasses, Nomvula Mokanyane, premier of South Africa’s Gauteng Province, delivered a combative warning to the drug dealers of Eldorado Park that had the crowd buzzing: “Leave, your days are numbered!” But then a distraught mother, urged to speak but unable to, brought everyone back down to earth with the news that her addict daughter had just died.</td></tr></table>]]></content:encoded></item><item><title>Analysis: AU prepares its shock troops</title><pubDate>Fri, 31 May 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201305131245260795t.jpg" />]]>JOHANNESBURG 31 May 2013 (IRIN) - A newly sanctioned African Union (AU) force for quick deployment in conflicts such as in Mali is being promoted as a stop-gap measure ahead of the planned formation of the “rapid deployment capability” (RDC) African Standby Force (ASF).</description><body><![CDATA[JOHANNESBURG 31 May 2013 (IRIN) - A newly sanctioned African Union (AU) force for rapid deployment in conflicts such as in Mali is being promoted as a stop-gap measure ahead of the planned formation of the “rapid deployment capability” (RDC) African Standby Force (ASF).

Unlike the ASF, which will also have policing and civilian duties, the African Immediate Crisis Response Capacity (AICRC) force will have “a strictly military capacity with high reactivity to respond swiftly to emergency situations upon political decisions to intervene in conflict situations within the continent,” Nkosazana Dlamini-Zuma, chairperson of the AU Commission, said in her recent report [ http://cpauc.au.int/en/content/report-chairperson-commission-operationalisation-rapid-deployment-capability-african-standby ] to the AU summit in Addis Ababa.

While the AU’s failure to resolve crises in countries like Côte d’Ivoire, Libya and Mali has been a source of embarrassment to the continent-wide body, the AU Mission to Somalia (AMISOM) is widely regarded as a success, with the annual US$500 million running costs bankrolled by international partners [ http://www.irinnews.org/film/4786/Soldiers-Stories ].

AMISOM provides “pride” for the AU, according to analysts, as African forces at the cost of significant lives (some estimates say thousands), were able to achieve what a far better equipped US force failed to do in Somalia - bring about an opportunity for peace.

Spurred into action

Dlamini-Zuma said in her report Mali was a spur for the AICRC’s formation and it was “obvious” an African military force with an RDC would have meant the French military intervention would not have been “the only recourse”.

Solomon Dersso, a senior researcher at the Addis Ababa office of the Institute for Security Studies (ISS) [ http://www.issafrica.org/ ], a Pretoria-based think tank, told IRIN Mali interim president Dioncounda Traoré’s reaching out to former colonial power France for military assistance to counter the Islamist rebels “left a bad taste in the mouths of many people here [Addis Ababa and AU headquarters] and led to discussions at the highest level of the AU.”

According to Dlamini-Zuma, the AICRC will be drawn from a “reservoir of 5,000 troops, with operational modules in the form of tactical battle groups of 1,500 personnel that can be deployed rapidly… which must have a minimum initial self-sustainment period of 30 days”.

The report said the AICRC would have three tactical battle groups, comprised of three infantry battalions of 850 troops each, an artillery support group and light armour elements, as well as an air wing of 400 troops, which would include strike aircraft and helicopters and logistical support, including strategic airlift capabilities. The unit would have a “10-day notice of movement”.

The force headquarters will have a nucleus of 50 staff and AICRC duties would range from “stabilization, peace enforcement and intervention missions; neutralization of terrorist groups, other cross-border criminal entities, armed rebellions; and emergency assistance to Member States within the framework of the principle of non-indifference for protection of civilians,” Dlamini-Zuma’s report said.

Lamamra Ramtane, AU commissioner for peace and security, said in a statement [ http://summits.au.int/en/sites/default/files/21ST_AU_SUMMIT_-_PRESS_BRIEFING_OF_COMMISSIONER_PEACE_AND_SECURITY[1].pdf ] that troop contributions to the AICRC would be on a voluntary basis by member states and those countries participating would finance the AICRC so it could “act independently”.

On the face of it, the AICRC looks like a prototype of the ASF, except there appear to be slight differences in the way the two forces can be deployed. Lamamra said: “Command and control [of the AICRC] will be ensured by the AU Peace and Security Council upon request of a Member State for intervention.”

The ASF mandate under the Constitutive Act of the AU adopted in 2000, is a complete break from its predecessor, the Organisation of African Unity, which adopted a philosophy of non-interference in member states. The Act gave the AU both the right to intervene in a crisis, and an obligation to do so “in respect of grave circumstances, namely: war crimes, genocide and crimes against humanity”.

Clayson Monyela, spokesperson for the South Africa foreign affairs department, told IRIN the AU remained committed to the ASF, and although any AICRC deployment was conditional on a government’s invitation, “there may be exceptional circumstances” where the force could intervene in the absence of such a request.

Ad hoc forces

Outside of AU and UN missions, African military operations have favoured ad hoc forces, such as the four-country force ranged against Joseph Kony’s Lord Resistance Army (LRA) [ http://www.irinnews.org/report/95426/security-a-quick-reaction-force-moulded-by-africa-s-circumstances ].

The advantage of ad hoc forces, Sivuyile Bam, the AU Commission head of the Peace and Support Operations Division, told IRIN last year, was that it used the lead nation concept and was more direct, rather than dealing in the political intricacies of the ASF. “A country can go to the AU [with the ad hoc system] and say I have got a battalion. I will deploy it tomorrow.”

Bam envisaged a “combined system for the next 5-10 years. The ASF system is maturing and taking time to develop and still relying on the lead nation [ad hoc] concept. So when there is a need for an operation - send out a note to the (AU) member states saying `I need soldiers, please help me out’.”

The AICRC is framed as a “temporary arrangement”, the ISS’s Dersso said, but “once it gets a life it may take a different course altogether, depending on its success,” and may evolve from an ad hoc force into a “fully fledged unit” at the disposal of the AU.

Some analysts have argued that a functioning, efficient and well equipped ASF may still lack the capacity to simultaneously operate in places like South Sudan, the Sahel and the Democratic Republic of Congo (DRC).

If and when the ASF eventually materializes, troop contributions to the five stand-by brigades will be based on Africa’s five regional economic blocs with each supplying about 5,000 troops, 720 police officers and 60 civilian members (e.g. human rights advisers, political affairs and public information officers) - and each regional bloc’s brigade will be placed on a six month rotational standby every two years to be available for rapid deployments.

The ASF will fulfil a range of functions, for example, supplying troops for attachment to a regional military, political or UN mission; or it may deploy a regional peacekeeping force within a 30-day timeframe, or 14 days in “grave circumstances”, such as genocide.

Question marks over military capacity

An urgent need for quick reaction forces was highlighted in a recent ISS report [ http://www.issafrica.org/iss-today/the-future-of-intra-state-conflict-in-africa ] that said “the risk of instability and violence [in Africa] is likely to persist and even increase in some instances.”

Drivers of conflict cited by the report included: the fact that “many states were trapped somewhere in between autocracy and democracy;” the “bad-neighbourhood” syndrome resulting in the effects of conflict spilling across borders; and post-conflict states lapsing back into “repeat violence”.

The imminent deployment of a 3,000-strong “robust, highly mobile” intervention force - comprising troops from Malawi, South Africa and Tanzania - under the masthead of SADCBrig (Southern African Development Community Brigade) to “neutralize” armed groups in the eastern DRC under UN Resolution 2098 has a stronger resemblance to the AICRC’s mandate rather than to the ASF’s, as it will comprise a combat force without any civilian or policing appendages [ http://www.irinnews.org/report/97999/is-more-force-in-the-drc-more-of-the-same ].

However, deployment of the intervention force in DRC is being delayed by a combination of factors, including an increasing scarcity of available heavy air lift aircraft, and a paucity of landing strips capable of handling them, Helmoed-Romer Heitman, a senior correspondent for Jane’s Defence Weekly, told IRIN.

“How do you deploy quickly if you don’t have heavy airlift?” he asked. African militaries were chartering aircraft “as usual”, but relied on former Soviet logistical aircraft, such as Antonovs, which were becoming obsolete, he said.

South Africa ordered eight Airbus military A400m transport aircraft in 2005 at a cost of about US$1 billion, but later cancelled the order citing financial constraints and associated cost increases, and was reimbursed the $407 million down-payment in December 2011 by the European aircraft manufacturer. The transport aircraft were expected to enter service in 2013.

Heitman also questioned how the AU defined the concept of “quick reaction”, alluding to recent events in Bangui, the capital of the Central Africa Republic (CAR), that saw the botched deployment of South African troops in support of CAR President Francois Bozizé. Thirteen South African troops were killed and two others died from wounds on their return.

“A lot can happen in 48 hours. Putting a paratroop battalion on the ground in 24 hours is a quick reaction,” he said.

go/cb

]]></body><link>http://www.irinnews.org/Report/98139/Analysis-AU-prepares-its-shock-troops</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201305131245260795t.jpg"/></td><td valign="top">JOHANNESBURG 31 May 2013 (IRIN) - A newly sanctioned African Union (AU) force for quick deployment in conflicts such as in Mali is being promoted as a stop-gap measure ahead of the planned formation of the “rapid deployment capability” (RDC) African Standby Force (ASF).</td></tr></table>]]></content:encoded></item><item><title>Digital jobs offer skills, promise to Africa&apos;s unemployed youth</title><pubDate>Tue, 28 May 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201305281532240097t.jpg" />]]>JOHANNESBURG/NAIROBI 28 May 2013 (IRIN) - Although Africa’s economy has expanded rapidly in recent years, it has not kept pace with the growth of its youth population or their need for jobs.</description><body><![CDATA[JOHANNESBURG/NAIROBI 28 May 2013 (IRIN) - Although Africa’s economy has expanded rapidly in recent years, it has not kept pace with the growth of its youth population or their need for jobs. 

With almost 200 million people between 15 and 24 years old - a figure that is set to double by 2045, according to the African Economic Outlook’s (AEO) 2012 report [ http://www.africaneconomicoutlook.org/en/in-depth/youth_employment/ ] - the continent has the youngest population in the world. Yet despite the increasing percentage of Africa’s young people with secondary and tertiary educations, many find themselves unemployed or underemployed in the informal economy. Part of the problem, according to the AEO study, is a mismatch between the skills young jobs seekers have to offer and those that employers need. 

The world’s increasingly digitalized economy needs workers with the skills to capture and manage the vast amounts of data it generates. With appropriate training, such tasks can be performed anywhere in the world. Data generated by a high-tech company in Silicon Valley, for example, can be processed by youth with smartphones or tablets living in a slum in Nairobi, Kenya. This means that digital work could potentially alleviate the unemployment and poverty hampering development in many African countries.

Both the private and humanitarian sectors are starting to recognize this potential and find ways to harness it.

Skills for the future

The Rockefeller Foundation recently launched Digital Jobs Africa [ http://www.rockefellerfoundation.org/our-work/current-work/digital-jobs-africa ], a seven-year, US$83 million initiative to improve the lives of one million people in six African countries through digital job opportunities and skills training. 

Eme Essien Lore, the foundation’s Nairobi-based senior associate director, explained that having identified youth unemployment as one of Africa’s most pressing problems, the organization was looking for ways to help young people on the continent gain sustainable, long-term job opportunities. 

“The reason digital employment really rose to the top for us was because we saw the skills they get from these kinds of jobs as a springboard to other types of employment,” she told IRIN. “We know young people take time to figure out what they want to do. Also, we don’t know what the future labour market is going to look like. So we thought this was a very important sector because it develops skills they can use whether they stay in the digital economy or move into other sectors.” 

The six focus countries - Egypt, Ghana, Kenya, Nigeria, Morocco and South Africa - share particularly high youth unemployment rates and have rapidly developing information and communications technology (ICT) infrastructures. Some, such as Nigeria and South Africa, have booming ICT sectors in need of labour, while others, such as Morocco, are well-placed to meet demand from Europe and the US, said Lore. 

Winnie Mwihaki, 24, is among 500 Kenyan youths from poor backgrounds recruited by one of the Rockefeller Foundation’s grantees - San Francisco-based non-profit Samasource. Globally, the company has connected an estimated 3,700 young people in nine countries to paying work and hopes to expand this number to 5,000 by the end of 2013. 

Samasource secures data- and content-processing jobs from its US-based clients, and then uses its specially developed software to break these large digital projects down into small computer-based tasks it calls “microwork”. This work is then distributed to local partners that are responsible for recruiting, training and managing employees. 

Unlike most companies in the business process outsourcing (BPO) and information technology outsourcing industry, Samasource only employs people living below the poverty line. Workers must also be between 18 and 30 years old, and preference is given to women, who are less likely to have access to formal employment. 

“Part of the criteria is that people need to be literate in English,” added Lauren Schulte, director of marketing and communications at Samasource. “They don’t have to have any computer skills. We can bring someone in with virtually no experience, and in a matter of weeks they can start doing small tasks on a computer.”

With her monthly salary of 13,000 shillings [$149], Mwihaki is able to assist her mother, who had been struggling to care for their family of six. “Because of the money I earn from here, I am now able to help my mother [and] to also be a breadwinner in the family,” Mwihaki told IRIN.

Mwihaki grew up in Korogocho, a sprawling slum in Nairobi, where crime is commonplace. She was unable to proceed to college after secondary school because her parents could not afford it.

“Now I will use part of what I earn from this job to sponsor myself through college,” she said. 

A new trajectory

Samasource is not the only company targeting disadvantaged people in low-income areas with digital employment. Another Rockefeller Foundation grantee, Digital Divide Data, operates on a similar principle and employs more than 1,000 people in Cambodia, Kenya and Laos. Both companies are considered pioneers of impact sourcing, which the Rockefeller Foundation defines as “the socially responsible arm of the BPO and information technology outsourcing industry”.

 A relative newcomer to the sector, and another Rockefeller Foundation grantee, is the Impact Sourcing Academy (ISA) in Johannesburg, South Africa. ISA combines a training and job placement programme with a fully functional call centre that gives its students the opportunity to obtain practical work experience while earning enough money to help support their families. 

“We’re not so much interested in just giving them a job as a call centre agent,” said ISA head Taddy Blecher. “We really want to make sure they’re doing part-time studies while they’re working, getting access to more knowledge and training so they can move into higher-level jobs.”

Once graduates are fully employed and earning a decent salary, they are encouraged to fund another student from a similar background. Using this model, the academy is already about 65 percent self-funded and aims to be completely self-funded in the future.

Blecher described the Rockefeller Foundation initiative as “a massive opportunity” for South Africa, given the need for skilled labour to work in its booming BPO sector and its 51 percent youth unemployment rate. “In a short period of time, you can bring a family out of poverty and put them on a whole new trajectory,” he told IRIN.

Opening doors

For now, evidence that impact sourcing really can lift families out of poverty is limited to the small studies the Rockefeller Foundation has conducted with Samasource and Digital Divide Data. “What we want to do next is really measure the impacts on a household level,” said Lore. “Anecdotally, we’re quite convinced, but we need to work on measuring over the next seven years.”

The Rockefeller Foundation does not stipulate a minimum wage that its grantees must pay, and the line between a living wage and an exploitatively low wage can be a fine one. “This is a sector where companies’ first priority is really around cost savings,” acknowledged Lore. “If you take the example of someone living in a slum, [a job like this] won’t get them into a nicer neighbourhood. But it might be able to buy food for the family and get younger siblings into school,” she said.

She added that the demand for young people with these skills is such that they are often poached by rival companies offering slightly higher salaries. “We’ve seen that when people move from these jobs, usually after about two years, they go on to better jobs. You rarely see people sitting in these types of jobs indefinitely.”

ks/ko/rz

]]></body><link>http://www.irinnews.org/Report/98114/Digital-jobs-offer-skills-promise-to-Africa-apos-s-unemployed-youth</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201305281532240097t.jpg"/></td><td valign="top">JOHANNESBURG/NAIROBI 28 May 2013 (IRIN) - Although Africa’s economy has expanded rapidly in recent years, it has not kept pace with the growth of its youth population or their need for jobs.</td></tr></table>]]></content:encoded></item><item><title>Cape Town&apos;s asylum seekers struggle to get documented</title><pubDate>Thu, 16 May 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201305151132020076t.jpg" />]]>CAPE TOWN 16 May 2013 (IRIN) - When Jean Baptiste*, a medical student from Lubumbashi, in the Democratic Republic of Congo (DRC), arrived in South Africa in September 2012, he headed straight for Cape Town, where he knew he would be able to stay with his brother. No one at the border told him that it was no longer possible to apply for asylum in Cape Town.</description><body><![CDATA[CAPE TOWN 16 May 2013 (IRIN) - When Jean Baptiste*, a medical student from Lubumbashi, in the Democratic Republic of Congo (DRC), arrived in South Africa in September 2012, he headed straight for Cape Town, where he knew he would be able to stay with his brother. No one at the border told him that it was no longer possible to apply for asylum in Cape Town. 

He has since approached the city’s Refugee Reception Office (RRO) 18 times to try to secure an asylum seeker permit and become documented, but he has never made it past the security guards outside. 

Without documentation, finding even casual work in Cape Town has proved impossible, and without work, he lacks the funds to travel to the cities of Durban, Pretoria or Musina, the three remaining places in South Africa where RROs are still issuing permits to newly arrived asylum seekers. The distance between Cape Town and Pretoria, the nearest RRO where he could apply for asylum, is nearly 1,500km. 

“At the moment, I don’t have money to go to Pretoria or elsewhere,” said Jean Baptiste, whose involvement in a student group opposed to the Congolese government put his life in danger and forced him to flee the country. 

Catch-22 

“For newcomers, it’s a Catch-22 situation,” said Anthony Muteti, a community liaison officer with People Against Suffering, Oppression and Poverty (PASSOP). Together with the Scalabrini Centre of Cape Town, PASSOP has registered over 1,800 asylum seekers in situations like Jean Baptiste’s since Cape Town’s RRO moved locations in July 2012 and stopped accepting new asylum seeker applications. It seems likely there are many more who have not been counted. 

Last July, soon after the RRO stopped assisting new arrivals, a high court judgement ruled in favour of the Scalabrini Centre’s urgent application to force the Department of Home Affairs to resume these services in Cape Town [ http://www.irinnews.org/Report/95951/SOUTH-AFRICA-Court-orders-Cape-Town-to-process-asylum-applications ], pending a full review of the case. 

In March of this year, another high court judgement found that the Department’s decision to close the Cape Town RRO to newcomers had been unlawful due to a lack of consultation with the Standing Committee on Refugee Affairs or with affected groups. The Department is appealing both the interim court order and the March judgement, which requires it to resume full services to asylum seekers and refugees, including new asylum applicants, by 1 July 2013. 

The Scalabrini Centre has not opposed the Department’s leave to appeal on the condition that it be heard as soon as possible and that the Cape Town office assist asylum seekers with permits issued at other RROs around the country. 

Marlize Ackermann, an advocacy officer with Scalabrini, told IRIN that in recent months, most such individuals have been told they cannot renew their permits in Cape Town, but must return to the office where they originally applied for asylum. Scalabrini has registered over 400 such individuals since January. 

“Officially, they’re supposed to be assisted, but in reality permit holders are often refused further extensions of permits, and if it is extended, it’ll just be a 30 day permit to allow them time to get to Musina or wherever,” she said. 

For many asylum seekers, especially those with large families or health problems, travelling a minimum of 1,500km every three to six months in order to extend their permits is simply not possible. They have no option but to allow their permits to expire, making them undocumented and liable to arrest and deportation. 

Deborah Mbela Momba, a mother of six from DRC, who was separated from her husband when fighting broke out in Goma last November, is facing this predicament as the six-month asylum seeker permits she obtained for herself and her children from the RRO in Musina are about to expire. 

With assistance from the UN Refugee Agency (UNHCR), Momba travelled from Musina to Cape Town, where she had lived during a previous period of instability in DRC. Now, she and her children are staying with a friend in Mitchell’s Plain, and Momba is earning a small income from braiding hair. 

“I barely get enough [money] to eat,” she told IRIN, speaking tearfully through a translator. “I don’t know how I’ll find enough to go to Musina.” 

Fear of arrest 

According to Ackerman, the police in Cape Town are aware of the situation and rarely arrest asylum seekers without permits. However, Muteti of PASSOP said Home Affairs officials regularly raid places where foreign nationals are known to live and work, arresting those without documents. 

“They’re taken to Pollsmoor Prison and kept with violent criminals for up to 30 days,” he told IRIN. 

Those who avoid arrest, struggle to access healthcare and education for their children, let alone jobs. 

“Whenever I try to get piece work, they won’t take me cause I don’t have documents,” said Daniel Munyoro*, 23, from Zimbabwe. He arrived in Cape Town in March and has not been able to apply for asylum there. “It’s not even safe to walk around because the police might stop and ask me for papers. My buddy is giving me food and a place to sleep, but he keeps asking me when I’m going to start paying.” 

Even for those asylum seekers registered in Cape Town, renewing their permits is not a simple matter, said Muteti. “The RRO is scaling down its services, and treatment of foreigners there is appalling. Sometimes you wait all day and don’t get served.” 

He added that asylum seekers are often told to come to the RRO only on the day that their permits are due to expire. If they do not make it to the front of the queue on that day, they become liable for a R2,500 (US$266) fine. “If you can’t afford to pay, you become undocumented, which means you’ll probably lose your job, the banks will freeze your account and you can be arrested,” he said. 

RROs to relocate 

Asylum seekers in Cape Town are not the only ones struggling to get documented. The Department of Home Affairs has also closed RROs in Johannesburg and Port Elizabeth in the Eastern Cape Province in the last two years, ostensibly because of complaints from local business owners. In both cases, courts have ruled that the closures were unlawful [ http://www.irinnews.org/Report/94692/SOUTH-AFRICA-Red-tape-ensnares-asylum-seekers ]. The Eastern Cape High Court ordered the Department to re-open the Port Elizabeth RRO to newcomers last February, but so far it has not done so. 

On several occasions in the past year, department officials have stated that the closure of RROs in metropolitan areas is in line with a strategy to eventually relocate all RROs to the country’s borders. Details have been sketchy, but a December 2012 statement by Home Affairs Director-General Mkuseli Apleni said the first of these RROs was under construction at the border with Mozambique, in Lebombo, although he did not give a timeframe for when it would be completed. 

Refugee rights organizations, such as Lawyers for Human Rights (LHR), have been critical of the Department’s plan to move RROs to the borders, particularly without having first introduced it as a policy that would have required inputs at the Parliamentary and Cabinet levels as well as extensive public consultation [ http://www.lhr.org.za/publications/policy-shifts-south-african-asylum-system-evidence-and-implications ]. 

Head of LHR’s Strategic Litigation Unit, David Cote, said there were fears that the move to the borders would have negative implications for asylum seekers. “We’re really concerned that it would create de-facto refugee camps [at the borders],” he told IRIN. 

Muteti of PASSOP is among many in South Africa’s refugee rights sector who have registered a major shift in the South African government’s approach to asylum seeker and refugee protection in recent years. “Being a refugee myself, I’ve been through the mill,” he said. “But there are serious problems affected asylum seekers now.” 

*Not their real names 

ks/rz 

]]></body><link>http://www.irinnews.org/Report/98051/Cape-Town-apos-s-asylum-seekers-struggle-to-get-documented</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201305151132020076t.jpg"/></td><td valign="top">CAPE TOWN 16 May 2013 (IRIN) - When Jean Baptiste*, a medical student from Lubumbashi, in the Democratic Republic of Congo (DRC), arrived in South Africa in September 2012, he headed straight for Cape Town, where he knew he would be able to stay with his brother. No one at the border told him that it was no longer possible to apply for asylum in Cape Town.</td></tr></table>]]></content:encoded></item><item><title>Quelling xenophobia in South Africa&apos;s townships</title><pubDate>Tue, 14 May 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201305141515080313t.jpg" />]]>PHILIPPI 14 May 2013 (IRIN) - This week marks five years since tensions between foreigners and South Africans living in impoverished communities across the country erupted in xenophobic violence, leaving more than 60 people dead and tens of thousands displaced, their homes and businesses robbed and abandoned.</description><body><![CDATA[PHILIPPI 14 May 2013 (IRIN) - This week marks five years since tensions between foreigners and South Africans living in impoverished communities across the country erupted in xenophobic violence, leaving more than 60 people dead and tens of thousands displaced, their homes and businesses robbed and abandoned [ http://www.irinnews.org/Report/78386/SOUTH-AFRICA-Xenophobic-attacks-spreading ]. 

Since May 2008, various initiatives have been established to detect early warning signs of future xenophobic attacks and to improve responses. But while no further outbreaks have occurred on the scale of the violence five years ago, attacks on foreign nationals have continued [ http://www.irinnews.org/Report/96589/SOUTH-AFRICA-Foreigners-still-at-risk ]. On average, one person was killed every week in 2011, according to the Consortium for Refugees and Migrants in South Africa (CoRMSA).

The looting and victimization of foreigners has also remained a feature of the frequent service delivery protests that have rocked South African townships in recent years, as has the near impunity of perpetrators [ http://www.irinnews.org/Report/88052/SOUTH-AFRICA-Foreign-nationals-attacked-with-impunity ].

In a statement released on 13 May, CoRMSA concluded that “much more still needs to be done to promote peaceful communities”.

Tensions high

Philippi Township, 25km southeast of Cape Town, has been a hotspot for xenophobic violence in Western Cape Province post-2008. In an area where nearly 60 percent of residents are unemployed, according to census data, Ward Counsellor Thobile Gqola, estimated that foreign nationals run more than half of businesses.

“Generally, people are happy to live side-by-side; the problem starts when it comes to business,” he told IRIN. 

Most of the violence has been directed at Somali refugees who run many of the small grocery stores known as ‘spaza’ shops in the township [ http://www.irinnews.org/film/4903/Living-under-siege ]. Like many other Somali traders in Philippi, Abdullahi Wehliye, 28, opened a shop there after losing his shop in neighbouring Khayelitsha Township during the 2008 xenophobic violence.

“I lost everything; I had to start over,” he told IRIN as he served customers through a metal grill, a security precaution that has done little to protect him from crime. 

Wehliye said his shop had been robbed seven times since it opened in 2010. During one incident in 2012, his brother was shot and killed. Although he reported all of the robberies, no arrests have been made. Of 60 Somali shopkeepers in the area, who have formed an association that Wehliye chairs, all have had their shops robbed and the vast majority have experienced shootings, Wehliye said.

A 2012 study [ http://www.irinnews.org/pdf/ElusiveJustice_17October.pdf ] by Vanya Gastrow and Roni Amit, of the African Centre for Migration and Society at Witwatersrand University in Johannesburg, found that Somali-run shops suffered disproportionately from crime, including attacks orchestrated by competing South African traders. Their vulnerability to such attacks was found to be partly the result of their lack of access to informal justice mechanisms and community structures.

In township settings, noted the researchers, leaders of local street committees, most of which fall under the authority of the South African National Civic Association (SANCO), often play a more important role in responding to crime than the formal justice system. 

“People in townships still respect their ‘chiefs’,” said Charles Mutabazi, director of the Agency for Refugee Education, Skills, Training and Advocacy (ARESTA), a Cape Town-based NGO.

Peace monitoring, community building

ARESTA partnered with the International Organization for Migration (IOM) to start a project in Philippi in 2012 that identified 20 community leaders in each of the townships’ five wards and trained them to be “peace monitors”. The three-day training included mediation and conflict-resolution skills as well as information about the rights of migrants and refugees. 

“There’s a lot of conflict here,” said Vra Mdledle, a SANCO member and secretary to a ward counsellor who went through the training last year. “When you’re in SANCO, they don’t give you training, they just nominate you. ARESTA gave us skills we could use in our communities.”

She gave the example of a Somali shopkeeper in her area who had recently experienced an arson attack. Following a similar attack last year, he alleged that local police had pressured him to drop the case. 

“I called all the peace monitors, and we decided to accompany him to the police station,” said Mdledle. “We asked to see the station commissioner and demanded that the previous case be reopened. I saw the police are not really doing their job.”

Although the focus of the project is to promote diversity and quell xenophobic tensions, the peace monitors do not limit themselves to advocating for foreign nationals. Locals also suffer as a result of police negligence, said Mdledle, and there are many situations that demand conflict-resolution skills in this densely populated township. 

Voyiseka Nzuzo, 24, who went through the ARESTA training in February, said peace monitors in her area had recently intervened after the family of a nine-year-old rape victim beat and stabbed a man they believed to be the perpetrator. “We found that the child had pointed out five different people. We went to the police station and tried to convince the case investigator they had the wrong suspect,” she told IRIN.

As the owner of a barber shop with foreign customers and the founder of a local business association that includes South Africans and migrants, Lefefe Mdunyelwa said he already had friends from other countries before he became a peace monitor, but that he still learned a lot from the training. “I learned that each and every person is just living for themselves; nobody’s trying to steal your business,” he told IRIN. 

Noticing that the foreign members of his association were often discriminated against when it came to the issuing of business permits and the charging of rent by municipal officials, he said his association is now advocating for equal treatment.

Although ARESTA has made efforts to include members of Philippi’s Somali community in the peace monitor training and quarterly peace marches, Mutabazi said participation had been disappointing. 

Wehliye, who is one of eight Somalis to have gone through the training, said language remained a barrier, and Gqola, the ward councillor, said foreign nationals often stayed away from meetings aimed at facilitating dialogue between local and foreign business owners because they felt intimidated.

Wehliye said he signed up for the training because “after we’d been robbed so many times, I wanted to know what rights I had. I learned I had the same rights [to justice] as local people. I feel empowered.”

Becoming a peace monitor has also brought him into contact with local leaders whom he works with to resolve conflicts. “I now feel like a member of the community,” he told IRIN.

Mutabazi said the success of the peace monitor project lay in its emphasis on changing the mindset of influential community leaders. Whether it will be rolled out in other townships will depend on funding, but Mutabazi is convinced that the value of the training has been tested. 

“It’s empowering [participants] to be better community leaders. If we’re leaving that kind of legacy behind, it’s very good for promoting social cohesion.”

ks/rz

]]></body><link>http://www.irinnews.org/Report/98035/Quelling-xenophobia-in-South-Africa-apos-s-townships</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201305141515080313t.jpg"/></td><td valign="top">PHILIPPI 14 May 2013 (IRIN) - This week marks five years since tensions between foreigners and South Africans living in impoverished communities across the country erupted in xenophobic violence, leaving more than 60 people dead and tens of thousands displaced, their homes and businesses robbed and abandoned.</td></tr></table>]]></content:encoded></item><item><title>South Africa&apos;s flawed asylum system</title><pubDate>Tue, 30 Apr 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201304240827440995t.jpg" />]]>JOHANNESBURG 30 April 2013 (IRIN) - South Africa attracts the largest number of asylum seekers in the world, but grants refugee status to very few of them, ranking only thirty-sixth in the world for the size of its refugee population, which the UN Refugee Agency (UNHCR) puts at about 58,000.</description><body><![CDATA[JOHANNESBURG 30 April 2013 (IRIN) - South Africa attracts the largest number of asylum seekers in the world, but grants refugee status to very few of them, ranking only thirty-sixth in the world for the size of its refugee population, which the UN Refugee Agency (UNHCR) puts at about 58,000. 

The Department of Home Affairs, the government ministry tasked with managing the asylum system, approved just 15.5 percent of the applications it processed in 2011, less than half the global average recognition rate of 38 percent, according to UNHCR [ http://www.unhcr.org/4fd6f87f9.html ].

Researchers and activists have repeatedly pointed to serious flaws in the country’s refugee status determination process, including the lack of individualized assessments, misapplications of both local and international refugee law, and high levels of corruption among Home Affairs officials. The government’s routine response has been that its asylum system is simply overwhelmed by the sheer number of applications it receives. 

In fact, although South Africa still receives the largest number of asylum applications in the world, the number of claims registered has dropped by more than half, from 222,000 in 2009 to 107,000 in 2011, possibly the result of the increased number of asylum seekers being turned away at the country’s borders [ http://www.irinnews.org/Report/94820/SOUTH-AFRICA-Asylum-seekers-resort-to-border-jumping ] and from its refugee reception offices [ http://www.irinnews.org/Report/94692/SOUTH-AFRICA-Red-tape-ensnares-asylum-seekers ] in recent years.

Despite the reduced demand, a 2012 study [ http://www.migration.org.za/report/all-roads-lead-rejection-persistent-bias-and-incapacity-south-african-refugee-status-determin ] by Roni Amit of the African Centre for Migration and Society (ACMS) at Witwatersrand University in Johannesburg, found that the problems with refugee status determination processes, identified in an ACMS study two years earlier, had not diminished.

Amit reviewed 240 refugee decisions issued in 2011 and found, among other things, that refugee status determination officers (RSDOs) had routinely failed to thoroughly investigate country of origin conditions and misapplied fundamental aspects of refugee law. South Africa’s 1998 Refugees Act established six grounds for persecution that qualify victims for refugee protection [ http://www.home-affairs.gov.za/index.php/immigration-services/refugee-status-asylum ], but Amit found that RSDOs limited their definition of persecution to political grounds and only considered a history of persecution as evidence of future risk. A woman who fled Kenya to avoid forced circumcision, a Ugandan man who fled persecution for being a homosexual, and a man who was targeted by the police in his country for exposing mineral trafficking were all rejected.

Amit concluded that “South Africa’s asylum system exists only to refuse access to the country and makes no attempt to realize the goal of refugee protection… [but] functions solely as an instrument of immigration control”.

Bias, corruption

Although part of the problem appears to be insufficient training of RSDOs and an unmanageable workload that requires them to make at least 10 refugee decisions a day, Amit also described “a general anti-asylum seeker bias that excludes the majority of claims”.

“It’s this general idea you hear coming out of Home Affairs all the time that the majority of people are economic migrants and they’re abusing the asylum system,” Amit told IRIN. She added that refugee rights are not a popular cause in South Africa, where asylum seekers and refugees are just as much a target for xenophobic attitudes and violence as other foreign nationals, particularly if they live in impoverished areas where they are viewed as competing with locals for scarce jobs and resources [ http://www.irinnews.org/report/96589/SOUTH-AFRICA-Foreigners-still-at-risk ].

The Department of Home Affairs did not respond to repeated attempts by IRIN to ask about its refugee status determination processes, but Amit’s findings are borne out by the experiences of several asylum seekers IRIN interviewed. 

Caroline* fled South Kivu Province, in the Democratic Republic of Congo, after her husband was murdered by rebels and she was held captive in a rebel stronghold and repeatedly raped for a month. She was denied refugee status in 2010, after an interview at the refugee reception office in Pretoria that lasted just 30 minutes. When she told the interviewer about the conflict in South Kivu, he did not seem to believe her. “I wasn’t feeling well, I was shaking - that’s when he stopped the interview,” she told IRIN. “There were more things I was supposed to tell him, but he said, ‘As you can see, there are many people waiting.’

“My interpreter said, ‘Whatever your story, they’re not going to give you anything unless you pay money’, but I had nothing; I’d just arrived in the country.”

Gertrude Nkey, 51, also fled the conflict in Kivu, leaving behind her husband and six children after an attack that has left her traumatized. “I didn’t decide to leave Congo, I just ran and people helped me and I found myself here in South Africa,” she told IRIN. 

It took four visits to the refugee reception office in Durban before she was finally admitted to the building, only to be sent away to find someone who could help her fill out the eligibility form in English. Finally, one of the interpreters employed by Home Affairs agreed to help her, but the interview was cut short when she started crying and her application was subsequently rejected. “I think because I didn’t have any money for them, they didn’t want to help me,” she said.

An interpreter who works at the refugee reception office in Pretoria - who asked not to be named - said these stories were typical. “The officers say, ‘Give me money, and I’ll give you refugee status,’” she told IRIN. “They’ll say they’ve lost a file, but if a bribe is found, they find the file.”

Several local refugee rights organizations have documented corruption at refugee reception offices. Eleven volunteers with People Against Suffering, Oppression and Poverty (PASSOP), who monitored the refugee reception office in Cape Town over a two-week period in 2011 all reported witnessing corrupt practices, including the payment of bribes to security guards to cut queues and the sale of fake documents by men working outside the office who appeared to have connections with officials inside [ http://www.passop.co.za/publications/reports ].

The interpreter said a small minority of RSDOs “do their job properly”, and that, in the absence of a bribe, the outcome of an application depended mainly on the mood of the interviewer and which country the applicant was from. “If there’s no war in that country, they will reject the application no matter what the individual says.”

Backlog

David Cote of Lawyers for Human Rights, which provides legal services to asylum seekers in Johannesburg and Pretoria, confirmed that claimants are often pre-judged based on their country of origin. “You can tell from the decisions that a lot of it is ‘cut and paste’ and based on outdated country-of-origin information,” he told IRIN.

According to UNHCR’s deputy regional representative, Sergio Calle-Norena, RSDOs have access to REFWORLD [ http://www.refworld.org/ ], a UNHCR website with all the latest country-of-origin information. “If they don’t make use of that information, it could be lack of interest or lack of time,” he commented. “They have to process 10 interviews a day; you can’t get into detail in that time.”

An initial decision can be appealed but the backlog of cases and the limited capacity of the Refugee Appeal Board, which consists of four members, means that asylum seekers often wait up to five years for an appeal hearing. Tjerk Damstra, former acting chair of the board said that, at the time his term ended in 2012, only about 10 percent of decisions were reversed. 

Although some asylum seekers have legal representation at the appeals stage, Cote said that RSDOs rarely allow any kind of representation during the initial status determination interview. Applicants who have recently arrived in the country are required to fill out an eligibility form in English, usually before receiving any information about the asylum process. According to Amit’s report, failure to include relevant details in one’s story on this form is often viewed as grounds for questioning the claimant’s credibility [ http://www.irinnews.org/Report/97906/Culture-of-disbelief-works-against-asylum-seekers ] and rejecting their application. 

The interpreter who spoke to IRIN said she often helped people fill out their eligibility forms but that there was a shortage of interpreters for some nationalities, particularly Somalis.

Calle-Norena says UNHCR has been engaging with the government about structural, operational and capacity problems in South Africa’s refugee status determination process, which emerged in an analysis the agency did last year. “In general, these problems were acknowledged by the government, but a discussion of corrective actions has yet to take place,” he told IRIN.

UNHCR has also offered technical advice and training for RSDOs, which the government has yet to accept. The agency limits its involvement in individual asylum cases to those facing critical protection risks or imminent deportation to a place where their life or freedom would be at risk. “We can only do [mandate determinations] in those cases,” said Calle-Norena, explaining that, as a signatory to the 1951 Refugee Convention, the South African government holds the primary responsibility for implementation while UNHCR can only provide a supervisory role.

*not her real name

ks/rz

]]></body><link>http://www.irinnews.org/Report/97944/South-Africa-apos-s-flawed-asylum-system</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201304240827440995t.jpg"/></td><td valign="top">JOHANNESBURG 30 April 2013 (IRIN) - South Africa attracts the largest number of asylum seekers in the world, but grants refugee status to very few of them, ranking only thirty-sixth in the world for the size of its refugee population, which the UN Refugee Agency (UNHCR) puts at about 58,000.</td></tr></table>]]></content:encoded></item><item><title>Shortages of new one-a-day ARV pills in South Africa</title><pubDate>Fri, 19 Apr 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2007/2007062614t.jpg" />]]>JOHANNESBURG 19 April 2013 (IRIN) - Just days into the rollout of fixed-dose combination (FDC) antiretrovirals (ARVs) by South Africa’s HIV treatment programme - the world&apos;s largest - activists are raising fears of drug shortages.</description><body><![CDATA[JOHANNESBURG 19 April 2013 (IRIN) - Just days into the rollout of fixed-dose combination (FDC) antiretrovirals (ARVs) by South Africa’s HIV treatment programme - the world's largest - activists are raising fears of drug shortages. 

Patients on the triple-therapy regimen will be able to take just one pill daily to control the virus. This has the advantages of improving adherence, simplifying regimens so that prescribing errors are reduced, and enabling the introduction of community models of care. 

Motsoaledi launched the phased rollout of FDCs on 8 April at a small community health centre north of the country's capital, Pretoria. New patients and HIV-positive women who are pregnant or breastfeeding will be the first to receive the new medication. They will initially receive a one-month supply of FDCs, while stable patients will be given a three-month supply. 

"The central procurement unit in the national department of health has worked tirelessly with suppliers, provincial medical depots as well as facilities, to ensure that depots placed orders with suppliers, and health facilities placed orders with depots," Health Minister Dr Aaron Motsoaledi said. "We are confident that we have sufficient supplies of ARVs for all patients who are eligible for the FDCs." 

But stock shortages have already been reported in Western Cape Province and more are thought to be occurring in other provinces, according to activists. In March, the Western Cape Department of Health told AIDS lobby group the Treatment Action Campaign (TAC) and Médecins Sans Frontières (MSF) / Doctors Without Borders that it had received significantly smaller stocks of the FDCs than had been ordered from suppliers. 

Dr Lynne Wilkinson, the MSF project coordinator in Khayelitsha, a township on the outskirts of Cape Town, said this meant the depot could not maintain the usual two- or three-month buffer stock. 

The ARV tender, worth about US$672 million, was awarded in November 2012 [ http://www.plusnews.org/Report/96930/SOUTH-AFRICA-New-ARV-tender-drops-prices-changes-treatment ]. It logged the country's second consecutive drop in drug prices and also introduced a 3-in-1 pill combining tenofovir, emtricitabine and efevarinz. 

Researcher Simonia Mashangoane said TAC continues to receive reports from health facilities in Mpumalanga and Gauteng provinces, with some saying they have received insufficient supplies of the FDCs. Recent shortages of the ARV, lamivudine, have also been reported. In a joint statement with the National Association of People Living with HIV and AIDS (NAPWA), TAC criticised the health department’s communications and called for clear timelines regarding the introduction of FDC drugs. 

"Public announcements created the expectation that the pills will be widely available from 1 April, but non-priority groups might have to wait many more months before being switched to the FDCs," TAC and NAPWA said in their statement. "Patients have not been given any indication as to when the various phases will be initiated, and how long they will have to wait." 

Wilkinson said there are also concerns that because new ARV patients have been prioritized to receive the FDC, they could be especially vulnerable if FDC stockouts force clinicians to switch them to the old regimen of three separate ARVs. 

"Newly initiated patients are counselled about the treatment that they are about to receive," Wilkinson told IRIN. "The problem is if they are counselled on how to take one pill a day, and in a few months that stock runs out and they have to be put on three separate pills, the clinic has to re-counsel them. If that doesn't happen, then there's a chance patients won't take the treatment properly." 

According to Western Cape Department of Health spokesperson Hélène Rossouw, the problem lies with the National Department of Health. “The problem is that the national government procures the medicines, so it’s all centralized at the national level in accordance with treasury regulations,” Rossouw told IRIN. “The awarding of the tenders… the signing of contracts… takes time.” 

"What’s happening in the Western Cape is a domino effect of [those delays],” she added. “The Western Cape Minister of Health Theuns Botha is looking at the possibility of procuring our own stocks separately because we have had too many problems with national government delays, and our patients go without.” 

Supply and demand 

The inability of pharmaceutical companies to ramp up production to meet demand after winning a tender has at times been seen as contriuting to the threat of drug shortages. 

Stavros Nicolaou, Senior Executive at Aspen Pharmacare, one of three companies to be given the FDC tender, said the latest award had sought to avoid stockouts at dispensing level by introducing a grace period for suppliers. Aspen is the largest supplier of generic medicines to the public and private health sectors in South Africa, he said, and is also the only local company producing the FDCs. 

"Historically, what happened was that a tender was awarded on 15 December, and on 1 January… you'd be expected to supply," Nicolaou told IRIN. "If it was the first time you were going to supply, you had to have anticipated winning the tender to be ready to go out with product on the first of January." 

Drug companies need about three months of lead-time to order, ship, receive and assure the quality of the active pharmaceutical ingredients needed for manufacturing drugs. In the case of FDCs, Aspen had also had to make structural alterations to its manufacturing facilities to accommodate the special technology required to manufacture a pill that combines three drugs. 

Nicolaou said he did not believe that any possible FDC shortage was attributable to the inability of drug companies to supply. He noted that Aspen and other drug companies had met with the Department of Health in June 2012, before the tender was opened, to devise feasible timelines for ramped up production of the FDCs, develop plans for a phased rollout, and discuss the requirements of the tender, which hinged largely on projections of how many patients would make the switch to FDCs. 

Stopping stockouts 

An estimated 70 to 80 percent of patients on the triple regimen are expected to make the switch by the end of the year. To combat stockouts, data is being collected on a weekly basis from provincial depots to identify weaknesses in the supply chain, and the department has also instituted monthly meetings with suppliers, at which three-month forecasts are presented. 

Recent stockouts of regularly prescribed ARVs in Gauteng Province have been attributed to financial management problems, including corruption, in the provincial department of health, rather than to supply-chain issues. The Gauteng provincial treasury intervened in December 2012. 

"We've been told that some of the drug shortages in Gauteng are due to poor budgeting and financial management," said TAC provincial coordinator Stephen Ngcobo. "We did our own research and found that... the budget was not covering the need, and that the [ARV] budget had been cut in half over the past two or three years, and this was having an effect… [now]." 

Activists have begun a civil disobedience campaign in the province to draw attention to ARV and other drug stockouts, and civil society organizations will soon be launching a project to monitor supply problems. 

llg/kn/he 

]]></body><link>http://www.irinnews.org/Report/97880/Shortages-of-new-one-a-day-ARV-pills-in-South-Africa</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2007/2007062614t.jpg"/></td><td valign="top">JOHANNESBURG 19 April 2013 (IRIN) - Just days into the rollout of fixed-dose combination (FDC) antiretrovirals (ARVs) by South Africa’s HIV treatment programme - the world&apos;s largest - activists are raising fears of drug shortages.</td></tr></table>]]></content:encoded></item><item><title>TB testing in South Africa rolling out slowly</title><pubDate>Tue, 26 Mar 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201202171245500971t.jpg" />]]>CAPE TOWN 26 March 2013 (IRIN) - South Africa will expand its rollout of GeneXpert tuberculosis (TB) testing machines, which can diagnose TB and drug-resistant TB within 90 minutes, but concerns remain about the capacity to back up this commitment with supplies and treatment.</description><body><![CDATA[CAPE TOWN 26 March 2013 (IRIN) - South Africa will expand its rollout of GeneXpert tuberculosis (TB) testing machines, which can diagnose TB and drug-resistant TB within 90 minutes, but concerns remain about the capacity to back up this commitment with supplies and treatment. 

The country is the largest buyer of GeneXpert technology in the world, but the machines have not yet become point-of-care tests and are often deployed at district rather than clinic level. Nonetheless, they have shaved weeks off waiting times for patients because samples no longer have to be transported to and from national referral hospitals kilometres away for diagnosis [ http://www.plusnews.org/IndepthMain.aspx?indepthid=90&reportid=92279 ].

At the opening of the TB Vaccines Third Global Forum in Cape Town on 25 March [ http://www.tbvaccines2013.org ], Precious Matsoso, director general of the South African Department of Health, announced that an additional 135 machines will be imported by the end of 2013. The GeneXpert was released in 2010 and South Africa already has 150. 

Matsoso's announcement was made a day after the health department handed over six machines to the Department of Correctional Services at Cape Town's Pollsmoor Prison. A former inmate at Pollsmoor, Dudley Lee, took the correctional services department to court after he contracted TB during incarceration. Although Lee eventually died of TB, the courts found in his favour [ http://www.irinnews.org/Report/95684/SOUTH-AFRICA-Overcrowding-fuels-TB-in-prisons ].

During the handover, South African Deputy President Kgalema Motlanthe also announced that TB screening for inmates would carried out every six months, and reiterated a commitment that at-risk miners would be annually screened for TB. Of the 735 Pollsmoor inmates screened for TB during Motlanthe's visit, 12 percent had TB, according to Matsoso [ http://www.presidency.gov.za/pebble.asp?relid=15108 ].

The World Health Organization (WHO) lists South Africa in the top 22 countries with a high TB burden. An estimated 500,000 cases of active TB are diagnosed annually and the disease remains the leading cause of natural death according to the national statistical service, StatSa. 

South Africa could become WHO observatory 

Matsoso also announced that the health department, the National Department of Science and Technology, and the US-based non-profit TB vaccine developer, Aeras, would continue to fund the recently created South Africa Consortium on TB Vaccines. 

"We are at the centre of the TB epidemic, so we have to have our own response… in terms of vaccines being developed. Hopefully, South Africa will become a global player," Willem Hanekom, director of the South Africa TB Vaccine Initiative, told IRIN. 

Matsoso, who has worked with WHO on issues of intellectual property, said that through the consortium South Africa would be well-placed to become one of the research observatories envisioned in WHO resolutions aimed at promoting research and development [ http://www.ghtcoalition.org/WHO-member-states-call-for-global-health-RD-observatory.php ]. She noted that these initiatives would have to be accompanied by changes to regulations, for instance to facilitate fast-track review to allow the country earlier access potential new vaccines. 

Stand and deliver 

South African AIDS lobby the Treatment Action Campaign (TAC) and international medical humanitarian organization Médecins Sans Frontières (MSF) have questioned the government's ability to deliver on these promises as stockouts and slow decentralization persist. 

In a joint letter delivered to South African Minister of Health Dr Aaron Motsoaledi on 22 March, the organizations stressed that the success of the GeneXpert rollout hinged on a steady supply of testing cartridges for the machines, the decentralization of drug-resistant TB (DR-TB) care and treatment, and improved supply-chain management to avoid recurring drug stockouts. 

The organizations also questioned the continued delay in implementing the health department’s 2011 policy decision to move DR-TB care out of designated TB hospitals with a shortage of beds to primary healthcare clinics closer to patients' homes. 

"Provincial operational plans for decentralization of multidrug-resistant TB (MDR-TB) care have not been drafted, nor have readiness assessments been conducted of all proposed decentralized MDR-TB (sites)," the letter pointed out. 

The organizations urged the health department to implement the 2011 policy, which would allow all of South Africa’s nine provinces to begin initiating and managing stable adult and paediatric MDR-TB at local clinics before the end of 2013. 

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]]></body><link>http://www.irinnews.org/Report/97730/TB-testing-in-South-Africa-rolling-out-slowly</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201202171245500971t.jpg"/></td><td valign="top">CAPE TOWN 26 March 2013 (IRIN) - South Africa will expand its rollout of GeneXpert tuberculosis (TB) testing machines, which can diagnose TB and drug-resistant TB within 90 minutes, but concerns remain about the capacity to back up this commitment with supplies and treatment.</td></tr></table>]]></content:encoded></item><item><title>Southern Africa cracks down on TB in mines</title><pubDate>Mon, 25 Mar 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2007/200703129t.jpg" />]]>JOHANNESBURG 25 March 2013 (IRIN) - South Africa&apos;s gold mines are estimated to have the highest number of new tuberculosis (TB) cases in the world, making the disease a leading export to neighbouring countries. IRIN takes a look at the declaration meant to change this situation.</description><body><![CDATA[JOHANNESBURG 25 March 2013 (IRIN) - South Africa's gold mines are estimated to have the highest number of new tuberculosis (TB) cases in the world, making the disease a leading export to neighbouring countries. IRIN takes a look at the declaration meant to change this situation. 

In August 2012, heads of state from the Southern African Development Community (SADC) agreed to sign the SADC Declaration on TB in the Mining Sector, following endorsements by their national ministers for health, labour and justice [ http://t.co/Fi6fAChcRe ].

According to Swaziland’s Minister of Health, Benedict Xaba, he and South African Health Minister Aaron Motsoaledi, and Lesotho’s former Minister of Health, Mphu Ramatlapeng, began pushing for the declaration in 2010. Xaba, the son of a miner, admitted that he has lost members of his family to TB. 

South Africa is supporting the declaration and related initiatives, including a 1,000-day campaign to meet TB and HIV targets in the region, but the country has not yet officially signed the declaration, according to Lynette Mabote, regional HIV, TB and human rights advocacy team leader at the AIDS Rights Alliance of Southern Africa (ARASA), a civil society body that has been heavily involved in the declaration and advocacy around TB in mines. 

How big a problem is TB in the mines? 

The South African Department of Health estimates the country's gold mining industry has the highest number of new TB cases annually in the world - up to 7,000 cases per 100,000 people per year - according to its TB Strategic Plan for South Africa 2007-2011 [ http://www.info.gov.za/view/DownloadFileAction?id=72544 ].

Data collected from autopsies on formers miners have also shown a prevalence of latent and undiagnosed TB as high as 90 percent, according to a 2009 study [ http://www.ncbi.nlm.nih.gov/pubmed/19105877 ].

Why is TB a problem on the mines? 

While many people may carry latent TB infection, active TB infection will usually only occur in a small number of them. However, those with compromised immune systems and HIV co-infection are up to 30 times more likely to develop active TB. 

In South Africa, where HIV prevalence is about 18 percent, many miners are no doubt living with HIV but face additional occupational risks, according to Rodney Ehrlich from the Centre for Occupational and Environmental Health Research at University of Cape Town. He describes these risks as: 

- A high burden of silicosis, a respiratory disease that develops due to inhaling silica dust during the mining process and could be viewed as an immune deficiency illness; 

- Silica dust load in the lungs and previous lung damage; 

- Poor living conditions, including overcrowding; 

- Circular migration between neighbouring countries and South Africa, leading to interrupted TB/HIV treatment and poor access to care. 

The mines have also not escaped the growing epidemic of drug-resistant tuberculosis, which in the absence of wide access to molecular testing has not only been harder to diagnose but also to treat. Research released in 2010 estimated that that almost four percent of the national multidrug-resistant TB (MDR-TB) burden, where TB is found to be resistant to both the commonly used first-line drugs isoniazid and rifampicin, may reside on the country's mines. 

Falling employment figures indicate that the mines now employ considerably fewer miners than in the late 1980s, Ehrlich added. Commodity prices dropped in 2008 and 2009, leading to further lay-offs, which may greatly complicate addressing the needs of affected miners who are no longer employed and will be relying on already stressed health systems in rural areas or home countries for treatment. 

What did countries commit to in the declaration? 

Countries agree to taking tangible actions like establishing independent mining ombudsmen to handle health-related complaints, harmonising treatment protocols related to addressing HIV, TB and silicosis on the mines, and - controversially for some - classifying TB and silicosis acquired in the mines as such. 

At a meeting of SADC health ministers in April 2012, mining companies were reluctant to classify TB and silicosis, a respiratory disease linked to exposure to silica dust produced during gold mining, as occupational diseases. In addition, the responsibility of mining companies to ensure treatment of mine workers with these diseases even after employees have left the company was a sticking point, according to David Mametja, head of South African Department of Health's TB Control and Management Programme. 

The document now calls on employers to take full responsibility for the management of all occupational diseases, including TB associated with silicosis post-employment. 

However, activists have cautioned that national legal frameworks must be changed to ensure TB is treated as an occupational disease. This would have to include provisions for mine workers who have left employment but later developed active TB. 

"The history around the issue of occupational health is littered with companies not taking responsibility," activist Gregg Gonsalves told IRIN at South Africa's 2012 TB conference. "It has to be about regulation - states have to regulate their business practices. Only in jurisdictions where that has happened has that problem been solved. It has to come through statues and regulation." 

The declaration also calls for the development of a minimum package of services to facilitate cross-border care. 

"Our referral systems do not take into consideration the dynamics that are experienced in the region as far as TB in the mines is concerned," said Stephen Sianga, SADC secretariat director for social and human development and special programmes. "There are challenges regarding standard treatment, both between countries and within countries, where you find that the system used in the mines is different to that used in the public health system." 

While TB treatment regimens across the SADC are largely already harmonized, activists have long been calling for the same to be done regarding HIV treatment. This would also facilitate the use of health passports, which would enhance cross-border care, as would the standardization of a minimum package of HIV, TB and silicosis services. 

What happens next? 

In the run-up to the August 2012 signing of the declaration, civil society groups like ARASA called for a five- or 10-year action plan, with concrete steps to be taken to implement the declaration. Now, SADC will be looking to operationalize the declaration at national level through a code of conduct. 

According to Mabote, the draft code was dismissed by ministers of health at a SADC meeting in Angola in July 2012. An SADC technical working group reworked the document in November, but a final version of the document has yet to be released. 

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]]></body><link>http://www.irinnews.org/Report/97719/Southern-Africa-cracks-down-on-TB-in-mines</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2007/200703129t.jpg"/></td><td valign="top">JOHANNESBURG 25 March 2013 (IRIN) - South Africa&apos;s gold mines are estimated to have the highest number of new tuberculosis (TB) cases in the world, making the disease a leading export to neighbouring countries. IRIN takes a look at the declaration meant to change this situation.</td></tr></table>]]></content:encoded></item><item><title>Aid for Trade - does it help the poor?</title><pubDate>Tue, 12 Mar 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2007/200705162t.jpg" />]]>LONDON 12 March 2013 (IRIN) - Since the World Trade Organization launched its Aid for Trade initiative in 2005, an estimated US$200 billion dollars of development funding has been mobilized for the programme. But some NGOs are asking whether Aid for Trade really helps reduce poverty.</description><body><![CDATA[LONDON 12 March 2013 (IRIN) - Since the World Trade Organization launched its Aid for Trade initiative in 2005, an estimated US$200 billion dollars of development funding [ http://www.wto.org/english/news_e/sppl_e/sppl262_e.htm ] has been mobilized for the programme. But some NGOs are asking whether Aid for Trade really helps reduce poverty.

Two of those NGOs, Traidcraft and the Catholic Agency For Overseas Development, commissioned a study of British and European Aid for Trade assistance, looking at whether the donors have assessed the impacts of these projects on the poor. 

The study, carried out by Saana Consulting [ http://www.traidcraft.co.uk/Resources/Traidcraft/Documents/PDF/tx/Aid%20for%20Trade%20Report%202012.pdf.pdf ], points out that the majority of funding goes to middle-income countries rather than low-income countries, and finds little evidence to demonstrate what impact the programmes have had on poverty.

The study reveals most reviews are completed within the lifetime of a project or at the end - too soon to see any real impact. It adds that “by and large, causal linkages between what a project delivers and the impact on poverty are based on a series of assumptions, and in some cases a leap of faith.”

Little known about poverty effects

The assumption underlying Aid for Trade is that “a rising tide floats all boats,” that more trade brings greater national wealth, and that everyone - including the poor - will benefit. 

Liz Turner, one of the study’s authors, does not dispute this notion. She says that, generally speaking, trade is good. But, she says, “looking at the effects of Aid for Trade in the long term, we end up defaulting back to macro-economic analysis and this issue around the winners and losers from growth. Even if you know that the net effects of a project are going to be positive, wouldn’t it be wiser to find out if there are going to be any losers?” 

Aid for Trade supports all kinds of projects: road building and port upgrading, providing technical support for trade negotiations and regulatory frameworks, designing better border posts, and teaching Ugandan farmers how to produce dried fruit for the lucrative European breakfast cereal market. But only the latter kinds of projects are likely to get evaluated for their effects on poverty reduction.

Kerry Hamilton manages the UK’s Food Retail Industry Challenge Fund, which supports such projects. She told IRIN, “The whole idea is that by doing this, there will be a developmental impact on the farmers and workers involved in that trade. All our projects have a monitoring and evaluation framework, and we ask for baseline data and a set of indicators against which we can measure its success. 

“The difficulty is in the time scales. Projects included in our fourth round of funding have to be completed within 18 months, and by the end of that period, the impact on poverty is going to be minimal. Ideally we should go back in two years’ or five years’ time, but because of the way the funding works, once the project has finished we probably won’t.” 

Hidden losers

Asked by IRIN for an example in which trade support was shown to have an impact on poverty, the head of Aid for Trade at the UK Department for International Development (DFID), Adaeze Igboemeka, cited a project to speed border and customs procedures in the Democratic Republic of Congo. 

“What it focused on was gender and the informal traders,” Igboemeka said. “We used methods like changing the actual structure of the border offices, adding glass panels. Officials working at the border were less likely to ask for bribes, and some of the sexual violence that affects women traders - we saw a very important decrease there. And just having clear procedures made it easier for poor, informal traders to trade.” 

But at a meeting to discuss the study at the Overseas Development Institute (ODI) in London, ODI researcher Yurendra Basnett used border post projects as an example of aid that produces losers as well as winners, notably in the communities that spring up to provide services to people waiting at congested borders.

“I was involved in designing a project in South Sudan aimed at improving customs administration,” said Basnett. “Now, from improving customs capacity, how do you go to saying this will have a poverty impact? In the long term it may, and you can make these assumptions, but it is a massive leap of faith, and there are tensions… Now if, for example, you are working on a border post and reduce the transit time from three days to three hours, then a lot of informal traders lose their livelihoods.” 

The University of Manchester also found both winners and losers emerging from trade programmes [ http://www.capturingthegains.org/ ]. After trade sanctions on South Africa were lifted in the early 1990s, its fruit growers became major exporters and a lot of work was done to meet the standards demanded by European supermarkets. Growers were under pressure meet social standards, which had some positive effects for workers, including higher wages and the provision of clinics.

But the demand for cheaper produce also led growers to cut staff and use more temporary workers, often migrants from Zimbabwe or Mozambique, who are paid less and enjoy fewer benefits.

Not enough information

Donors admit that poverty impacts are very hard to track, especially for broader attempts to support trade.

William Hynes, of the Organisation for Economic Co-operation and Development (OECD), says most smaller donors don’t even attempt to evaluate these impacts. They only monitor that the money was spent on what it was intended for.

“Impact evaluations are costly. They are burdensome, lengthy, and not necessarily aligned with the project managers’ incentives. They do help get across this idea that we should prioritize learning over accountability. But getting at the poverty impacts of a project would probably involve a household survey. A baseline and final survey for 500 households would cost around $300,000, so for most activities that is simply off the table straight away.”

And Igboemeka concedes that, in most cases, the effects of Aid for Trade on the poor are difficult to nail down. “The poverty impact is indirect, and we are very clear about that. The assumption is - and there is a lot of evidence to support it - that if a country is able to trade more, it will grow, and that will create jobs and increase incomes and lead to poverty reduction. That’s a very long results chain, so we don’t try to make a direct attribution of the direct poverty reduction impact. We don’t have enough information to do that robustly.”

All this uncertainty worries campaigners like Gareth Siddorn of Traidcraft. “I know Aid for Trade is just one part of an aid portfolio,” he told IRIN, “but I was struck by the recognition, by colleagues from both DFID and OECD, that it might not be the most effective way of directly benefitting poor people. And from an NGO perspective, that isn’t just one indicator among many - it’s the primary purpose of aid and development policies.” 

eb/rz

]]></body><link>http://www.irinnews.org/Report/97630/Aid-for-Trade-does-it-help-the-poor</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2007/200705162t.jpg"/></td><td valign="top">LONDON 12 March 2013 (IRIN) - Since the World Trade Organization launched its Aid for Trade initiative in 2005, an estimated US$200 billion dollars of development funding has been mobilized for the programme. But some NGOs are asking whether Aid for Trade really helps reduce poverty.</td></tr></table>]]></content:encoded></item><item><title>African migrants pay high prices to send money home</title><pubDate>Wed, 27 Feb 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2009/200909291220100610t.jpg" />]]>JOHANNESBURG 27 February 2013 (IRIN) - New data from the World Bank has revealed that African migrants pay more to send money home to their families than any other migrant group in the world.</description><body><![CDATA[JOHANNESBURG 27 February 2013 (IRIN) - New data [ http://sendmoneyafrica.worldbank.org/ ] from the World Bank has revealed that African migrants pay more to send money home to their families than any other migrant group in the world. 

While South Asians pay an average of US$6 for every $100 they send home, Africans often pay more than twice that - and in South Africa, which has the highest remittance costs on the continent, nearly 21 percent of money set aside for family members back home is spent on getting it there.

With an estimated 120 million Africans depending on remittances from family members abroad for their survival, health and education, the World Bank argues that high transaction costs are cutting into the impact remittances can have on poverty levels. 

To address this, the Bank is partnering with the African Union Commission and member states to establish the African Institute for Remittances [ http://sendmoneyafrica.worldbank.org/african-institute-remittances-air-project ], which will work towards lowering the transaction costs of remittances to and within Africa. It will also leverage the potential of remittances to influence economic and social development. 

“The World Bank’s approach supports regulatory and policy reforms that promote transparency and market competition and the creation of an enabling environment that promotes innovative payment and remittance products,” said Marco Nicoli, a finance analyst at the Bank who specializes in remittances.

Costly and difficult

Owen Maromo, a 33-year-old farmworker who lives in De Doorns, a grape-growing region in South Africa’s Western Cape Province, told IRIN that his family in Zimbabwe relies on the money he sends home every month. 

“I’ve got a house there and I need to pay rent. I’m also taking care of my youngest brother - since my mum died four years ago - and my wife’s family.

“Almost every Zimbabwean here is budgeting to send money back home,” he added. “If they could, they would send money home on a weekly basis.”

In a 2012 report by the Cape Town-based NGO People Against Suffering Oppression and Poverty (PASSOP), interviews with 350 Zimbabwean migrants revealed some of the reasons sending money home from South Africa is both costly and difficult [ http://www.passop.co.za/news/featured/press-statement ].

A key impediment is the stringent regulatory framework that governs cross-border transfers from South Africa. Exchange control legislation, for example, requires money transfer operators (MTOs) to partner with a bank. According to PASSOP, this has had the effect of stifling competition that would likely reduce transaction costs.  

Legislation intending to counter money laundering and terrorist financing requires that customers provide proof of residence and proof of the source of their funds before they can access financial services. This effectively excludes the many migrants living in informal settlements and those who are paid in cash. 

PASSOP found that even among migrants who do have access to banks and MTOs like Western Union and MoneyGram, many lack the financial literacy to make use of them. 

“Some have just come from rural areas in Zimbabwe, so it takes time for them to know about such things,” said Maromo, adding that lack of documentation was another major obstacle. “If you’re undocumented, you can’t go through the banks.”

Three-quarters of the Zimbabwean migrants interviewed by PASSOP relied instead on “informal” remittance channels, such as giving money or goods to bus drivers, friends or agents to send home. This is often not much cheaper than using banks or MTOs, and it is significantly riskier. Of the respondents who used such methods, 84 percent reported negative experiences, including theft of their money, loss or destruction of their goods and long delays in remittances reaching intended recipients. 

Maromo relayed his own experience sending money home through an agent who charged a 15 percent commission to channel the money through his South African bank account before handing it over to Maromo’s relatives in Zimbabwe. “Some time ago, I nearly lost 2,000 rand ($225) because I deposited it in [the agent’s] account and he was saying he didn’t have it and giving excuses. In the end, we got the money, but it cost us nearly 1,000 rand ($113) in airtime calling Zimbabwe,” he said.

“Some are using bus drivers or those people who are going home, and you have to trust them because you’re desperate, but there can be a lot of problems,” he added. “There are a lot of people whose money just disappears. Almost on a daily basis, you hear those stories.”

Lowering transaction fees

Now, Maromo uses a UK-based online transfer service called Mukuru.com, which is popular with many Zimbabweans living overseas. The proof of residence and source of funds requirements are the same as for traditional MTOs, but the site charges 10 percent on transfers from South Africa to Zimbabwe - less than most banks. 

The South African Reserve Bank and the treasury have committed to bringing the cost of remittances down to 5 percent by relaxing regulations for smaller money transfers, negotiating with regulators in the Southern African Development Community on exchange control regulations, and removing the requirement that MTOs partner with banks.

However, at the time of writing, the Reserve Bank has not yet responded to questions from IRIN about how these changes will be implemented and within what timeframe.

Rob Burrell, director of Mukuru.com, said achieving the 5 percent target would be tough considering the numerous costs that MTOs have to cover, including fees paid to the companies that collect and pay out the money, the cost of supporting transactions through a call centre, and licensing and reporting requirements. “We would need everyone pulling together,” he said.

Burrell noted that less stringent laws governing MTOs in the UK mean more competition but much weaker anti-money laundering controls. To operate in South Africa, Mukuru.com has to comply with the regulation that they partner with a local banking license holder.

“In the UK, it’s easier to obtain your license. There are 4,000 [MTOs operating in the UK] compared to 12 in South Africa, but the downside is that it’s very difficult to police them all,” he told IRIN. “My last audit in the UK was four years ago because they can’t handle the volume of licenses.”

ks/rz

]]></body><link>http://www.irinnews.org/Report/97557/African-migrants-pay-high-prices-to-send-money-home</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2009/200909291220100610t.jpg"/></td><td valign="top">JOHANNESBURG 27 February 2013 (IRIN) - New data from the World Bank has revealed that African migrants pay more to send money home to their families than any other migrant group in the world.</td></tr></table>]]></content:encoded></item><item><title>Analysis: Refugees aim for self-reliance, not hand-outs</title><pubDate>Wed, 06 Feb 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201302050829070263t.jpg" />]]>JOHANNESBURG 06 February 2013 (IRIN) - On the streets of inner-city Johannesburg, refugees and asylum-seekers are participants in a thriving informal economy, plying their trade as tailors, barbers and street vendors.</description><body><![CDATA[JOHANNESBURG 06 February 2013 (IRIN) - On the streets of inner-city Johannesburg, refugees and asylum-seekers are participants in a thriving informal economy, plying their trade as tailors, barbers and street vendors.

South Africa’s laissez-faire policy towards its refugee population means they have little choice but to fall back on their own skills and creativity to survive. And despite the many challenges they face - from xenophobic locals and corrupt officials to limited access to social and financial services - many succeed.

Take Thierry Madiatu, a 42-year-old refugee from the Democratic Republic of Congo, who abandoned his law studies because of insecurity in his home country and moved to South Africa over a decade ago. He eventually found a job as a manager at a small Johannesburg hotel, but with seven children and a wife to support, he started selling fruit on the street to supplement his income. Four years later, his fruit stand has become a small supermarket and café employing five people. 

“Everybody needs help,” he told IRIN. “But freedom is also helping. In other countries they don’t give you that freedom.”

Most countries in the region confine refugees to camps where they lack freedom of movement or the freedom to earn their own living. Instead, they are dependent on the charity of governments and humanitarian agencies. The logic underlying this traditional model of refugee protection stems from a view of refugees as people in need of short-term, emergency assistance. 

Increasingly, however, refugee crises are protracted, and camps can become refugees’ homes for decades. Not surprisingly, more and more refugees hoping to avoid this predicament are moving to urban areas where they have a better chance of becoming self-sufficient [ http://www.irinnews.org/Report/97203/The-urban-challenge-for-refugees ]. 

With self-reliance, sustainability 

Governments and humanitarian groups are start to recognize that treating refugees as passive recipients of aid is both out-dated and - considering dwindling donor support - unsustainable. They are increasingly turning to an alternative model that focuses on supporting refugees’ untapped potential for innovation and self-reliance.

A number of organizations are already shifting their emphasis from giving refugees aid to helping them support themselves. In South Africa, for example, Jesuit Refugee Service (JRS) is offering training and start-up grants to refugees interested in opening or expanding small businesses.

At the end of a four-day business skills course, which includes sessions on book-keeping, marketing and registering for a trading license, the most promising participants are awarded amounts no more than 10,000 Rand (US$1,123) to meet some of the costs of renting retail space or buying stock and equipment.

“After that, they’re basically on their own,” explained Kanabo Skhosana, livelihoods coordinator for JRS’s Gauteng Province operation, which covers Johannesburg and Pretoria. “We just check up on them quarterly for a year to see if they need any other technical support.”

Madiatu used the training and grant to build up his existing business. “I learned how to run a business properly,” he said. “I thought I knew, but when I went [for the training], I realized there were things I didn’t know.”

The grant money went towards buying a chip fryer, tables and chairs so that he could offer hot food in addition to the basic groceries he was already selling.

“As refugees, we don’t get any help from the government,” he pointed out, adding that refugees also struggle to secure bank loans. 

JRS’s livelihoods initiative is relatively new and has so far reached only 88 refugees in Johannesburg and Pretoria - “a drop in the ocean in terms of need,” according to David Holdcroft, Southern Africa director of JRS. He believes a change in mindset is needed among organizations working with refugees. 

“NGOs have got to stop thinking like they’re welfare organizations… They’ve got to put refugees in touch with elements of South African society, like the commercial world, the business world. There’s no doubt in my mind that self-reliance is a mechanism whereby protection rights can be provided.”

The extent to which self-reliance is possible, however, depends to a large extent on a host government’s refugee policy.

In countries with an encampment policy, promoting self-reliance is clearly more difficult. Politics and security concerns often contribute to such policies, but they are reinforced by the perception that refugees represent a financial burden and are best put in camps where they will be largely under the care of the international donor community. 

Innovation

The Humanitarian Innovation Project (HIP) [ http://www.oxhip.org/ ], a recently launched initiative of Oxford University’s Refugee Studies Centre, aims to change this perception. In partnership with a new unit of the UN Refugee Agency (UNHCR) called UNHCR Innovation, HIP is researching the role that innovation, technology and the private sector can play in refugee protection. HIP, together with UNHCR Innovation, will track innovations already happening within the sector, often at the field level, and disseminate best practices. 

A pilot study conducted by HIP in Uganda - a country that allows refugees to work and actively promotes self-reliance - found that the majority of refugees living in the capital, Kampala, survived with very little humanitarian assistance by building livelihoods based on local demands.

“Politics doesn’t disappear, and the regulatory environment of the host governments changes what can be done dramatically, but if you can gradually start to show that in countries like Uganda, refugees can represent an economic opportunity for the host state and population, you might have the hope of changing the regulatory environment,” said Alexander Betts, HIP’s director and a lecturer at Oxford University’s Department of International Development. 

Even in countries where refugees continue to be restricted to camps, many find a way to generate an income by operating small businesses selling goods and services to each other. Technological advances are further expanding livelihood opportunities in camps by opening the way for online learning and “virtual” work. At the Dadaab refugee complex in Kenya, a two-year pilot project run by San Francisco-based non-profit Samasource outsourced small computer-based tasks - part of larger projects from Silicon Valley companies - to refugees who had received basic computer training.

Dadaab’s security challenges prevented the project from being extended, but Betts believes there is potential for far more private sector engagement in the refugee sector, not only in the form of philanthropy and social responsibility, but through innovative partnerships that are mutually beneficial. He gives the example of a company called Technology for Tomorrow, started by a Ugandan engineer, which employs both Ugandans and refugees to produce environmentally friendly sanitary pads that are sold to UNHCR for distribution in Uganda’s refugee settlements.

Refugees have their own ideas about how they would like to become self-reliant, but they often lack the skills or resources to get businesses up and running. One of the goals of HIP is to establish Refugee Innovation Centres - a physical space where refugees, alongside locals, could access vocational training, mentorship, microcredit and computer facilities.

“The vision is very much for a bottom-up approach where the kind of self-reliance activity would be determined by them,” said Betts. “It can’t just be things parachuted in from the outside.”

ks/rz

]]></body><link>http://www.irinnews.org/Report/97418/Analysis-Refugees-aim-for-self-reliance-not-hand-outs</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201302050829070263t.jpg"/></td><td valign="top">JOHANNESBURG 06 February 2013 (IRIN) - On the streets of inner-city Johannesburg, refugees and asylum-seekers are participants in a thriving informal economy, plying their trade as tailors, barbers and street vendors.</td></tr></table>]]></content:encoded></item><item><title>Frederik Ngubane, stateless in South Africa: &quot;It&apos;s like my future is on hold&quot;</title><pubDate>Wed, 30 Jan 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201301290857430407t.jpg" />]]>PRETORIA 30 January 2013 (IRIN) - Frederik Ngubane, 22, returned to South Africa, the country of his birth, in 2009, after spending his entire childhood in Kenya and Uganda. An orphan, Ngubane had lost all contact with his South African relatives, and soon after arriving in the country he also lost his birth certificate, the only document proving his South African nationality. He has spent four years living as a stateless person, and is now losing hope that his situation will ever change.</description><body><![CDATA[PRETORIA 30 January 2013 (IRIN) - Frederik Ngubane, 22, returned to South Africa, the country of his birth, in 2009, after spending his entire childhood in Kenya and Uganda. An orphan, Ngubane had lost all contact with his South African relatives, and soon after arriving in the country he also lost his birth certificate, the only document proving his South African nationality. He has spent four years living as a stateless person, and is now losing hope that his situation will ever change.

“My mother was South African and so was my father, but he died in 1993, and then my mother [and I] moved to Kenya. I grew up there until my mother died in 2002, and then I moved to Uganda with my aunt.

“When my aunt died, I came back to South Africa to try to connect with relatives. I wasn’t in contact with them, but I knew where they lived; I thought it would be easy.

“I didn’t have a passport, only a [South African] birth certificate. It took four months to get here from Uganda. Unfortunately, everything got lost when I was taken hostage in Tonga, about 40km from the [Mozambican] border. They kept me overnight; they wanted a phone number of a relative they could call to ask for money, but I ran away.

“I went to Newcastle [in KwaZulu-Natal Province] to find my father’s family - that’s when I got arrested. I went to the police station to ask for help, and I met a cop with the same last name. He took me to his home and then to [the Department of] Home Affairs. They interviewed me and then they kept me at the police station for three weeks before transferring me to Lindela [Repatriation Centre].

“They tried to deport me. They called the Ugandan embassy, but they said no. Then they tried Kenya, but they also said no. So after three months, they released me.

“After I was released, I went to Home Affairs in Johannesburg, but they just chased me away. I also tried applying for asylum but they said no because I was born in South Africa.

“I can’t even count how many times I’ve been to Home Affairs. One guy from there told me last week that someone with money could get nationality. Even in Newcastle, they said if I had money, I could be helped. If you don’t have money, you suffer.

“I’ve been arrested several times. It can happen when you’re just walking in the CBD [Central Business District]. But when they call Home Affairs, they say my case is being handled and they release me.

“I’ve moved around a lot; I’m not settled. Now I’m staying in a shelter in Pretoria. Occasionally I get piece work, but for most jobs, they want an ID. 

“I started coming to Lawyers for Human Rights in 2010. They’ve helped me apply for an exemption to get permanent residency, but I don’t see any progress.

“It’s too hard. It’s like my future is on hold and I can’t move forward. I’m absolutely hopeless.

“There are people who’ve lived all their lives in South Africa and don’t have documents, so I don’t think my chances are good. I would go to any country that would help me.”

ks/rz

]]></body><link>http://www.irinnews.org/Report/97373/Frederik-Ngubane-stateless-in-South-Africa-quot-It-apos-s-like-my-future-is-on-hold-quot</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201301290857430407t.jpg"/></td><td valign="top">PRETORIA 30 January 2013 (IRIN) - Frederik Ngubane, 22, returned to South Africa, the country of his birth, in 2009, after spending his entire childhood in Kenya and Uganda. An orphan, Ngubane had lost all contact with his South African relatives, and soon after arriving in the country he also lost his birth certificate, the only document proving his South African nationality. He has spent four years living as a stateless person, and is now losing hope that his situation will ever change.</td></tr></table>]]></content:encoded></item><item><title>Solving statelessness in Southern Africa</title><pubDate>Wed, 30 Jan 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2008/2008022736t.jpg" />]]>JOHANNESBURG 30 January 2013 (IRIN) - Frederik Ngubane was born in South Africa to South African parents 22 years ago but, lacking any proof of his origins or nationality, he lives a shadowy, marginal existence. He cannot travel, study or secure formal employment and has lost count of how many times he has been arrested for being undocumented.</description><body><![CDATA[JOHANNESBURG 30 January 2013 (IRIN) - Frederik Ngubane was born in South Africa to South African parents 22 years ago but, lacking any proof of his origins or nationality, he lives a shadowy, marginal existence. He cannot travel, study or secure formal employment and has lost count of how many times he has been arrested for being undocumented.

Not considered a national by South Africa or by Kenya or Uganda - the two countries where he grew up - Ngubane is stateless, a predicament he shares with an estimated 12 million people worldwide, according to the UN Refugee Agency (UNHCR), which is mandated with trying to reduce that figure. 

Nationality confers a host of rights that stateless individuals cannot access, from education and healthcare to the ability to register a marriage or a birth. As a result, statelessness is often passed from one generation to the next. 

As early as 1954, the international community, under the auspices of the UN, adopted the Convention Relating to the Status of Stateless Persons [ http://www.unhcr.org/3bbb25729.html ], which defined who is a stateless person and established a framework for their international protection. A second international convention adopted in 1961 focused on reducing cases of statelessness [ http://www.unhcr.org/3bbb286d8.html ], primarily by requiring participating states to grant citizenship to children born on their territory who would otherwise be stateless. However, the majority of countries in Africa have not ratified either convention [ http://www.irinnews.org/pdf/Africa_ConvStateless54_61_detail_A3PC_01-10-2012.pdf ], leaving them under no obligation to pass national legislation that would address the issue. 

Regional issue

An individual can end up stateless for a variety of reasons. Orphans whose births were not registered before their parents died and unaccompanied child migrants who arrive in a foreign country without documents are particularly vulnerable. Laws still in place in several African countries, including Malawi and Madagascar, that prevent married women from passing nationality to their children also contribute to the problem.

According to Sergio Calle-Norena, deputy regional representative for UNHCR, laws allowing for only one nationality and the denial of citizenship to certain groups are the main causes of statelessness in the Southern Africa region.

In Zimbabwe, for example, following an amendment to the citizenship act passed in 2001, individuals with dual nationality were given six months to renounce their foreign citizenship or lose their Zimbabwean nationality. The new law affected countless Zimbabweans whose parents had migrated to the country from Zambia, Mozambique or Malawi at a time when white-owned farms and mines offered plentiful employment. Most did not, in fact, hold citizenship in their parents’ countries, making it impossible for them to renounce it, while many were simply unaware of the new law, which was widely viewed as a means for the ruling ZANU-PF party to disenfranchise opposition supporters.

“I think they didn’t want people like me to vote,” said Promise*, who was born and raised in Harare, the capital, to a Malawian father and a mother with Mozambican parentage. “Most people in high-density areas of Harare are in the same situation, and most are anti-Zanu-PF.”

The new law stripped both Promise and her mother of their citizenship. They now live in South Africa, where the asylum-seeker system offers them a temporary and precarious form of documentation. 

“I just kept renewing my asylum-seeker permit every six months, but I decided to take action last year,” said Promise, who is in her early twenties. “I was tired of having no nationality. It was limiting my opportunities. Most universities need a study permit, and I want to study law.”

Waiting

Promise approached Lawyers for Human Rights (LHR), a South African NGO that, with funding from UNHCR, has been running a project to provide legal services to stateless individuals since 2011. UNHCR is also funding the international faith-based NGO Caritas to run a similar project in Mozambique, another country with a large burden of statelessness following years of civil war that displaced hundreds of thousands of its citizens.

South Africa has pledged to sign and ratify the two UN conventions on statelessness by the end of 2013, and both LHR and UNHCR are advocating for this pledge to be honoured and for relevant legislation to be established. In the meantime, LHR is assisting stateless clients on a case-by-case basis. 

Of the 736 stateless clients that LHR helped in 2012, over a third were born in Zimbabwe; many of them lost their nationality like Promise.

Another 150 were born in South Africa but are struggling to access nationality in any country. Jessica George, a legal counsellor with LHR, explained that this group of stateless individuals does not qualify for asylum, and they have no way to access legal immigration status other than through an exemption for permanent residence, a process that allows the Home Affairs Minister to grant permanent residency to foreigners with special circumstances. 

However, exemption applicants can wait up to three years for a decision. “In the meantime, they’re given no temporary permit, so they’re subject to detention, which tends to be prolonged because they can’t be deported,” said George. 

Ngubane spent three months at Lindela Repatriation Centre, South Africa’s largest holding facility for undocumented migrants awaiting deportation, after being arrested at a Home Affairs Department office while trying to replace a lost birth certificate. The document was his only proof of South African nationality; he had lost both his parents and all contact with his South African relatives during his time in Kenya and Uganda.

With help from LHR, Ngubane has applied for a permanent residency exemption, but so far he has received no response. In fact, according to George, only one of LHR’s stateless clients has received a decision on permanent residency exemption in the past two years, and it was negative.

Reforms, training needed

“I think some training is required in addition to law reform, because it’s clear there’s a misunderstanding about who is a stateless person,” said George. “Currently there are no guidelines in the law on how to identify a stateless person and what rights they’re entitled to.” 

In cases where a client has a claim to foreign nationality, LHR approaches the country’s embassy for assistance securing citizenship. However, few embassies or consulates provide such services, and for most stateless people, travelling to the country where they have a nationality claim is unaffordable and unfeasible given their lack of travel documents.

“One of the easiest ways to prevent statelessness would be if consulates provided certain services, so people wouldn’t have to leave South Africa in order to access their citizenship,” said George.

Calle-Norena of UNHCR says that, besides ratifying the two conventions on statelessness, addressing the problem requires political will. He noted, for example, that South Africa’s Citizenship Act grants nationality to any child born in the country who would otherwise be stateless, but that non-nationals without documents struggled to register their children’s births. “There should be a mechanism that allows [the law] to be applied, but in practice this is not yet operational,” he told IRIN.

Through a combination of luck and persistence, Promise has succeeded in convincing the Malawian authorities to grant her citizenship. She has never been to Malawi but plans to move there as soon as she receives her passport. 

Ngubane says he has tried applying for Kenyan citizenship, “but the embassy said there’s no way they can help me.” 

Numerous visits to home affairs offices in several provinces have not yielded any results, other than several attempts by corrupt officials to solicit bribes in return for a birth certificate or refugee status.

“If you don’t have money, you suffer,” he said. 

*not her real name

ks/rz

]]></body><link>http://www.irinnews.org/Report/97372/Solving-statelessness-in-Southern-Africa</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2008/2008022736t.jpg"/></td><td valign="top">JOHANNESBURG 30 January 2013 (IRIN) - Frederik Ngubane was born in South Africa to South African parents 22 years ago but, lacking any proof of his origins or nationality, he lives a shadowy, marginal existence. He cannot travel, study or secure formal employment and has lost count of how many times he has been arrested for being undocumented.</td></tr></table>]]></content:encoded></item><item><title>South Africa searches for solutions to shack fires</title><pubDate>Wed, 23 Jan 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201301181357410767t.jpg" />]]>CAPE TOWN 23 January 2013 (IRIN) - One of the worst informal settlement fires in the history of Cape Town, South Africa, took place on New Year’s Day in the sprawling township of Khayelitsha, laying bare the complexities undermining efforts to end these frequent disasters.</description><body><![CDATA[CAPE TOWN 23 January 2013 (IRIN) - One of the worst informal settlement fires in the history of Cape Town, South Africa, took place on New Year’s Day in the sprawling township of Khayelitsha, laying bare the complexities undermining efforts to end these frequent disasters.

As more people migrate to the country's towns and cities, new informal settlements regularly spring up unannounced.  The high density of these urban areas, and the flammability of the materials used to build in them, make spontaneous and rapidly spreading conflagrations a constant threat.     

At least five people died and over 4,000 more were made homeless in Khayelitsha in the early hours of 1 January when a wall of fire, aided by strong winds, tore through an informal settlement called BM Section. Over a thousand shacks were burned to the ground.

Bongolweth Mpakama, 15, told IRIN he had never seen anything like the ferocity of the blaze that destroyed his family home within minutes. “We didn’t think the fire would come to us, but when it approached, we started to take our possessions out of the shack and put them in a place where they were safe. 

“But the fire quickly spread behind us and destroyed the place where we put our things,” he said during an interview at Khayelitsha’s Oliver Tambo Hall, where up to 2,000 victims of the disaster were given emergency shelter. 

According to statistics from the City of Cape Town, the disaster brought the number of people made homeless by shack fires between 1 December 2012 and 8 January of this year to nearly 5,200. 

The South African government has struggled to keep up with the demand for low-income housing and in cities like Cape Town, many people live in informal settlements for years while they wait for government housing. For newly arrived migrants and the unemployed, shacks are also the only affordable accommodation in urban areas. According to census data, 9 percent of all South African households now live in informal settlements where access to electricity, water and sanitation is poor or non-existent. 

Dispute over services

The BM Section fire has highlighted the need for a more holistic approach to the prevention of shack fires that includes better planning of informal settlements and enforcement of legislation that prohibits so-called land invasions, particularly in high fire-risk areas.

Researcher Warren Smit, from the University of Cape Town's African Centre for Cities programme, says the upgrading of all informal settlements is key to reducing the threat of shack fires, but that those trying to tackle the issue face a web of problems linked to institutional capacity, financial constraints and access to land.

“What makes progress even more difficult is the fact the role players have different perceptions of what the key issues are, and this creates a sense of mistrust between them,” said Smit.

Jared Sacks of community development organization Children of South Africa, which works in Khayelitsha, says that the lower levels of service delivery in poor communities are partly to blame for the continued devastation caused by shack fires. “If a fire takes place in a wealthy area it is tended to immediately, but when it happens in a poor area the emergency services are much slower. 

“Khayelitsha residents claim that it took up to two hours for the first fire truck to arrive on scene at BM Section… despite the fact that the local fire station is only one kilometre down the road. A much smaller fire in Camps Bay [a wealthy suburb] on New Year’s Eve was responded to in a matter of minutes,” he told IRIN.

However, Cape Town officials insisted that fire trucks were on the scene at BM Section within half an hour of the fire being reported but that the informal settlement’s high density and random planning prevented them from reaching the worst of the blaze.

JP Smith, a member of Cape Town’s Safety and Security Committee, pointed out that since his party, the Democratic Alliance, secured political power in Cape Town in 2006, large-scale investment had greatly improved the provision of emergency services in the city.

“We have more than doubled the number of firemen from 450 to 980 since 2006, and our fire mortality rate is down from 7.9 per 100,000 in 2006 to 4.3 per 100,000 today. We are doing much better, and the bulk of the gains are in informal settlements,” he told IRIN.

Statistics supplied by Cape Town’s Disaster Risk Management department show the annual death toll from shack fires fell from 131 in 2011 to 80 in 2012.   

Preventative approach

Smith said a city task team was now implementing a more preventative approach to shack fires, aimed at making informal settlement communities more resilient. The approach includes fire safety education, training a large number of community reservists in fire fighting, distributing fire extinguishers to households in high-risk areas, and exploring the use of fire retardant paint and other products.   

An approach to regulating informal settlements called “re-blocking” will also be used in BM section. Plots for re-building will be assigned in rows with three metres between them to facilitate the delivery of essential services and access for emergency vehicles.

However, this solution will reduce the number of people who can be accommodated in the settlement by at least 20 percent, and residents of BM Section displaced by the fire fear they will be moved to one of the temporary relocation areas on the outskirts of the city, far from public transport and work opportunities.  The approach has also had a limited impact when used in the past, according to Wilfred Solomons, deputy head of Cape Town's Disaster Management Centre.

Solomons noted that following a devastating fire in Joe Slovo informal settlement in Langa, another Cape Town township, in 2005, city authorities carefully managed the rebuilding of shacks by residents to ensure adequate gaps between them. "This worked well for six months, after which residents gradually started expanding their structures until devastating fires started again," he said, adding that attempts to police the situation were met with considerable resistance.

bc/ks/rz

]]></body><link>http://www.irinnews.org/Report/97313/South-Africa-searches-for-solutions-to-shack-fires</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201301181357410767t.jpg"/></td><td valign="top">CAPE TOWN 23 January 2013 (IRIN) - One of the worst informal settlement fires in the history of Cape Town, South Africa, took place on New Year’s Day in the sprawling township of Khayelitsha, laying bare the complexities undermining efforts to end these frequent disasters.</td></tr></table>]]></content:encoded></item><item><title>Widespread flooding hits Southern Africa</title><pubDate>Tue, 22 Jan 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2013/201301221052470924t.jpg" />]]>JOHANNESBURG 22 January 2013 (IRIN) - Several Southern African countries are dealing with the effects of flooding following heavy rains over much of the region in the past week.</description><body><![CDATA[JOHANNESBURG 22 January 2013 (IRIN) - Several Southern African countries are dealing with the effects of flooding following heavy rains over much of the region in the past week.

In South Africa’s northern Limpopo Province, floodwaters claimed 10 lives and left hundreds stranded after the Limpopo River burst its banks. By 22 January, the rain had subsided, but rescue operations were still underway in Musina, near South Africa’s border with Zimbabwe, said Tseng Diale, spokesperson for the province’s Disaster Management Centre.

Across the border, in Zimbabwe’s Beitbridge District, the rains damaged roads and left some areas impassable, according to state-owned newspaper The Herald, which reported that since the onset of the rainy season, floods and lightning strikes had claimed 124 lives.

In Mozambique, a UN situation report estimated that by 20 January, nearly 20,000 people throughout the country had been affected by the heavy rains. Nearly 6,000 had been displaced, the majority of them in the capital, Maputo, where the drainage system was overwhelmed by 157mm of rain falling in less than 24 hours. Nine temporary shelters have been set up in the city, and authorities have declared an “orange alert”, with the aim of scaling-up monitoring measures and strengthening preparedness in case the situation worsens. 

Northern Botswana also experienced heavy downpours that resulted in severe flooding of the Dukwi Refugee Camp, about 130km outside the city of Francistown. According to the UN Refugee Agency (UNHCR),  about 120 refugee homes were inundated by floodwaters, and pumps have stopped working, leading to a shortage of clean water in the camp. Skillshare International, an NGO that provides vocational training programmes in the camp, is sheltering 400 of the displaced in its classrooms, and UNHCR is providing food and trying to establish temporary ablution facilities.

ks/rz

]]></body><link>http://www.irinnews.org/Report/97305/Widespread-flooding-hits-Southern-Africa</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2013/201301221052470924t.jpg"/></td><td valign="top">JOHANNESBURG 22 January 2013 (IRIN) - Several Southern African countries are dealing with the effects of flooding following heavy rains over much of the region in the past week.</td></tr></table>]]></content:encoded></item><item><title>In Brief: Staples, not export crops, key to tackling Africa’s poverty – report</title><pubDate>Fri, 18 Jan 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201202241255060114t.jpg" />]]>NAIROBI 18 January 2013 (IRIN) - Africa could reduce its poverty levels faster by focusing more on the production of staples rather than export crops, according to a study by the International Food Policy Research Institute (IFPRI).</description><body><![CDATA[NAIROBI 18 January 2013 (IRIN) - Africa could reduce its poverty levels faster by focusing more on the production of staples rather than export crops, according to a study [ http://www.ifpri.org/sites/default/files/publications/ib73.pdf ] by the International Food Policy Research Institute (IFPRI).

Authors of the study, conducted in 10 countries south of the Sahara, noted, “One important finding is that producing more staple crops, such as maize, pulses and roots, and more livestock products tends to reduce poverty further than producing more export crops such as coffee or cut flowers.”

According to the study, while more public resources would be required to generate more agricultural growth, “such public investment in staple sectors is probably cost effective”.

The authors argued that growth in the staple sector was more likely to benefit the poor than growth in the agricultural export sector.

Enoch Mwani, an agricultural economist at the University of Nairobi, concurred. “The agricultural export sector is generally associated with large corporations, but the poor rely predominantly on staples to survive.”

Mwani added that growth in staples had the effect of not only reducing poverty but also ensuring food security.

“[Governments that] invest in staples have the opportunity to increase food availability and, at the same time, create wealth for smallholders,” Mwani told IRIN.

To spur development in sub-Saharan Africa, the study’s policy conclusions call for a focus on accelerating agricultural growth; promoting growth in large agricultural subsectors; supporting growth across several agricultural subsectors; and promoting growth in subsectors with strong linkages to the overall economy and the poor.

ko/rz

]]></body><link>http://www.irinnews.org/Report/97278/In-Brief-Staples-not-export-crops-key-to-tackling-Africa-s-poverty-report</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201202241255060114t.jpg"/></td><td valign="top">NAIROBI 18 January 2013 (IRIN) - Africa could reduce its poverty levels faster by focusing more on the production of staples rather than export crops, according to a study by the International Food Policy Research Institute (IFPRI).</td></tr></table>]]></content:encoded></item><item><title>South Africa bolsters its troops in the Central African Republic</title><pubDate>Tue, 08 Jan 2013 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201005261538140561t.jpg" />]]>JOHANNESBURG 08 January 2013 (IRIN) - South Africa has deployed 200 troops in the strife-torn Central African Republic (CAR), which some see not simply as an effort to assist CAR’s army but also as a move to counter French military influence in the region.</description><body><![CDATA[JOHANNESBURG 08 January 2013 (IRIN) - South Africa has deployed 200 troops in the strife-torn Central African Republic (CAR), which some see not simply as an effort to assist CAR’s army but also as a move to counter French military influence in the region. 

The deployment comes as rebel groups - acting together under the Séléka coalition - make rapid territorial gains in CAR. Since December 2012, rebels have seized key towns and mining areas in the absence of any significant resistance from CAR’s national army. According to reports, they are poised just outside the capital, Bangui. 

The rebels’ gains have been accompanied by reports of widespread looting and violence among a poor and vulnerable population, creating fears of a burgeoning humanitarian crisis [ http://www.irinnews.org/Report/97175/CENTRAL-AFRICAN-REPUBLIC-Rebel-advance-worsens-humanitarian-crisis ].

But South Africa’s troop deployment was “coincidental to the context”, South African National Defence Force (SANDF) spokesperson Siphiwe Dlamini told IRIN. He said the soldiers’ purpose is to train CAR’s defence forces rather than engage rebel fighters. 

Military cooperation agreement 

South African presidential spokesperson Mac Maharaj said in a statement on 6 January that President Jacob Zuma had “authorized” the deployment of 400 soldiers between 2 January 2013 and 31 March 2018, as part of a military cooperation agreement. The authorization means the South African force could be doubled at short notice, without any procedural delays. 

South Africa and CAR signed a military cooperation agreement in 2007, which was renewed for a further five years in December 2012. That agreement is providing CAR’s army with an array of military training, from infantry, artillery and special forces training to logistics and driving courses, as well as “refurbishment” of military infrastructure in Bouar and Bangui. South Africa’s military has also supported disarmament, demobilization and reintegration (DDR) programmes, and it assisted in CAR’s 2011 elections. 

After the signing of the military cooperation agreement - and before the recent deployment - the numbers of SANDF personnel had fluctuated by between 20 and 46 soldiers, Dlamini said. 

He declined to comment on any operational or equipment details, but said that according to rules of engagement, South African troops could act in self-defence and also “protect property we [South Africa] have there.” 

In February 2011, the South African government said, in a written reply to an opposition party parliamentary question, “South Africa’s involvement in the security of the Central African Republic followed President Francois Bozize’s request to South Africa to assist the Central African Republic’s Defence Force to upgrade their military capabilities.” A SANDF special forces unit was also provided for “VIP protection to President Bozize.” 

Bolstering military presence 

A host of other countries are also bolstering their military presence in CAR after the rebels’ recent successes. 

Ugandan troops, with the support of US special forces, are operating in the country in pursuit of Lord’s Resistance Army (LRA) leader Joseph Kony [ http://www.irinnews.org/report/95083/SECURITY-Fighting-Kony-with-beer-spy-planes-and-YouTube ]. About 100 US special forces have been advising and coordinating the fight against Kony for more than a year, operating in CAR, the Democratic Republic of Congo (DRC), South Sudan and Uganda; the majority are thought to be in CAR. US President Barrack Obama has reportedly ordered an additional “standby security force” of 50 troops to CAR owing to the “deteriorating security situation”. 

About 500 troops from Economic Community of Central African States - the majority of them from neighbouring Chad - are also in the country. Chad’s government has reportedly pledged a further 2,000 troops to support Bozize’s government. Bozize came to power in a 2003 coup supported by Chad’s President Idriss Deby; he has been elected twice since, although the 2011 poll was dismissed by opposition parties as fraudulent. 

However, it was France’s recent move to boost its troops in CAR from 250 to 600 that may have provoked South Africa’s increase in its own military presence, David Zoumenou, a senior conflict analyst at the Pretoria-based Institute for Security Studies (ISS), told IRIN. 

Since CAR achieved its independence from France in 1960, the former colonial power has maintained an almost continuous military presence in the country. France’s habit of stationing troops in its former colonies has always been a contentious issue for the African Union (AU) and its predecessor, the Organisation of African Unity (OAU). 

Diplomatic wars 

Zoumenou said, “We are asking why South Africa has deployed so many troops [to CAR].” It can been viewed as “a new battlefield between France and South Africa”. 

South Africa, the continent’s powerhouse, has championed the AU’s mantra of “African solutions to African problems,” and is increasingly becoming involved in Francophone Africa, Zoumenou said. It is an open secret that tensions exist between France and South Africa over how to deal with Madagascar’s nearly four-year-old political crisis. 

South Africa’s troop deployment to CAR can also been seen as a new foreign policy direction for the country, whose focus on the continent is changing from the human-rights-based agenda that held sway under former presidents Nelson Mandela and Thabo Mbeki towards strategic interests, such as mineral concessions and markets for South Africa’s arms industry. 

But there are drawbacks to South Africa’s use of military influence - particularly capacity issues, according to Zoumenou. The country is “overstretched” by its commitments to the continent in AU and UN missions, and it is handicapped by its force design, he said [ http://www.irinnews.org/Report/94597/Analysis-South-Africa-paper-tiger-of-African-peacekeeping-operations ].

go/rz 

]]></body><link>http://www.irinnews.org/Report/97194/South-Africa-bolsters-its-troops-in-the-Central-African-Republic</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201005261538140561t.jpg"/></td><td valign="top">JOHANNESBURG 08 January 2013 (IRIN) - South Africa has deployed 200 troops in the strife-torn Central African Republic (CAR), which some see not simply as an effort to assist CAR’s army but also as a move to counter French military influence in the region.</td></tr></table>]]></content:encoded></item><item><title>IDPs: African IDP Convention comes into force</title><pubDate>Thu, 06 Dec 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2008/200807227t.jpg" />]]>NAIROBI 06 December 2012 (IRIN) - The African Union Convention for the Protection and Assistance of Internally Displaced Persons (IDPs) 2009, also known as the Kampala Convention, came into force on 6 December; it is the world’s first legally binding instrument to cater specifically to people displaced within their own countries.</description><body><![CDATA[NAIROBI 06 December 2012 (IRIN) - The African Union Convention for the Protection and Assistance of Internally Displaced Persons (IDPs) 2009, also known as the Kampala Convention, came into force on 6 December; it is the world’s first legally binding instrument to cater specifically to people displaced within their own countries.

Adopted at an AU summit in the Ugandan capital, Kampala, the Convention [ http://www.africa-union.org/root/au/Conferences/2009/october/pa/summit/doc/Convention%20on%20IDPs%20(Eng)%20-%20Final.doc ] required ratification by 15 member countries before it could enter into force; Swaziland became the 15th country to do so on 12 November, joining Benin, Burkina Faso, Central African Republic, Chad, Gabon, Gambia, Guinea-Bissau, Lesotho, Niger, Nigeria, Sierra Leone, Togo, Uganda and Zambia. At least 37 AU members have also signed [ http://www.internal-displacement.org/8025708F004BE3B1/(httpInfoFiles)/979113CFF0292E97C1257ACB006315D4/$file/map-au-signed-ratified-countries-with-numbers.pdf ] the Convention but have yet to ratify it.

Among other things, the Convention aims to "establish a legal framework for preventing internal displacement, and protecting and assisting internally displaced persons in Africa".

UN High Commissioner for Refugees Antonio Guterres hailed the development as "historic" and said in a statement that the Convention "puts Africa in a leading position when it comes to having a legal framework for protecting and helping the internally displaced".

Stephen Oola, a transitional justice and governance analyst at Uganda's Makerere University Refugee Law Project, noted that the most important parts of the Convention were the clauses relating to the prevention of internal displacement. "The principle requiring the prevention of IDPs is absolutely necessary and should be the guiding principle for all state and non-state actors implementing the Convention," he said.

Just the beginning

Oola also stressed the need for the letter of the law to be translated into practice.

"In Uganda, we have had an IDP policy since 2004, but in many cases we find that the government still seems ill-prepared to deal with displacement," he said. "The existence of a law is rarely the conclusion of a policy... It will be important for this continental commitment to be matched by action on the ground for people who, for one reason or another, find themselves displaced," he said.

Africa has 9.7 million IDPs, according to the UN Refugee Agency, UNHCR. The Democratic Republic of Congo, Somalia and Sudan collectively have more than five million IDPs.

Noting that the situation of IDPs can affect the stability of states, UN Special Rapporteur on the Human Rights of Internally Displaced Persons Chakola Beyani said the Convention could "contribute to stabilizing displaced populations through the specific obligations it sets out to states and other actors, such as obligations relating to humanitarian assistance, compensation and assistance in finding lasting solutions to displacement as well as accessing the full range of their human rights".

"The unique 'added value' of this Convention stems from how comprehensive it is and the manner in which it addresses many of the key challenges of our times and, indeed, of Africa," he said in a statement. "If implemented well, it can help states and the African Union address both current and potential future internal displacement related not only to conflict, but also natural disasters and other effects of climate change, development, and even megatrends such as population growth and rapid urbanization."

The International Displacement Monitoring Centre (IDMC) [ http://www.internal-displacement.org/kampala-convention ] noted that, while the Convention signalled an important step in addressing the plight of IDPs, many countries were not legally bound by it.

"The countries which have not yet adopted the Convention must do so, as a legal framework is the very basis of ensuring the rights and well-being of people forced to flee inside their home country," Sebastian Albuja, head of IDMC's Africa department, said in a statement.

According to Nuur Sheekh, board member of the Kenya-based Internal Displacement Policy and Advocacy Centre [ http://www.idpacafrica.org/ ], some states expressed reservations about signing the Convention because "the issue of displacement is highly politicized, and some states saw it as a criticism of their human rights and governance records". He noted, however, that the Convention would have an influence, even on those countries that have not signed or ratified it.

"The AU will now also be able to use the Convention for advocacy, to encourage member states - even those who have not ratified it - to implement its principles... Kenya, for instance has not signed it but has developed an IDP policy that borrows heavily from the Kampala Convention," he told IRIN. "States now need to domesticate the Convention and develop IDP policies that reach from the central government to all lower levels of government so that the Convention can work in practice."

kr/rz

]]></body><link>http://www.irinnews.org/Report/96984/IDPs-African-IDP-Convention-comes-into-force</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2008/200807227t.jpg"/></td><td valign="top">NAIROBI 06 December 2012 (IRIN) - The African Union Convention for the Protection and Assistance of Internally Displaced Persons (IDPs) 2009, also known as the Kampala Convention, came into force on 6 December; it is the world’s first legally binding instrument to cater specifically to people displaced within their own countries.</td></tr></table>]]></content:encoded></item><item><title>SOUTH AFRICA: Treatment programme by numbers</title><pubDate>Fri, 30 Nov 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/20068115t.jpg" />]]>JOHANNESBURG 30 November 2012 (IRIN) - South Africa has recently made huge strides in HIV treatment, scaling-up the number of people on antiretroviral (ARV) drugs while also improving its national treatment guidelines.</description><body><![CDATA[JOHANNESBURG 30 November 2012 (IRIN) - South Africa has recently made huge strides in HIV treatment, scaling-up the number of people on antiretroviral (ARV) drugs while also improving its national treatment guidelines. 

IRIN/PlusNews offers a glimpse at what else the country has been working on: 

2.7 - The percentage of babies born to HIV-positive mothers who contract the virus. In 2008, eight percent of babies born to HIV-positive mothers contracted HIV. Four years later, the country has announced that the rate of mother-to-child HIV infections had fallen to under three percent. The country has also moved to adopt the World Health Organization’s (WHO) Option B, under which all HIV-positive expectant mothers will get triple ARV therapy while pregnant and breastfeeding, regardless of their CD4 count (a measure of immune health). 

3,000 - The number of public health facilities where treatment is available. In February 2010, 490 additional facilities were accredited to dispense ARVs. Less than two years later, this figure now stands at 3,000, although steady supply of ARVs remain a problem, with stock-outs being reported in Gauteng and the Eastern Cape provinces [ http://www.scribd.com/doc/114742090/Press-Statement-for-Immediate-Release ].

10,000 - The number of nurses certified to initiate ARV treatment. To deal with its scarcity of doctors and expand access to HIV treatment, the country moved to introduce a cadre of ARV-initiating nurses in 2010 [ http://www.plusnews.org/Report/91383/SOUTH-AFRICA-Nurses-step-into-ART-breach ]. In its first year, the country trained 250 nurses on starting and managing ARV patients; the number has since ballooned. 

1.7 million - The number of HIV patients on treatment this year, according to the South African government. South Africa introduced earlier treatment in 2011, allowing HIV-positive people to access treatment at the higher CD4 count of 350. This move brought the country in line with the latest WHO recommendations. A year later, the country also introduced its first three-in-one combination ARV for the low cost of about US$10 per patient per year [ http://www.irinnews.org/Report/96930/SOUTH-AFRICA-New-ARV-tender-drops-prices-changes-treatment ].

20 million - The number of people who have been tested for HIV. In April 2010, Health Minister Aaron Motsoaledi and President Jacob Zuma launched a national voluntary HIV counselling and testing campaign, with a goal of testing 15 million people over 12 months [ http://www.irinnews.org/Report/90410/SOUTH-AFRICA-National-HIV-testing-campaign-disappoints ]. The Department of Health now estimates that 20 million South Africans have since been tested. Of these, two-thirds were women and about five percent were children. 

$672 million - The price of the country’s 2012 antiretroviral tender. After years of paying some of the world’s highest prices for antiretrovirals (ARVs), the Department of Health, with the help of the Clinton Health Access Initiative, did a price comparison of ARVs globally and increased competition, leading to the negotiation of a better tender in 2010. This cut the price of treatment for the country by about 50 percent, saving the country about $523 million. In the 2012 tender, the country saved about $251 million.

llg/kn/rz

]]></body><link>http://www.irinnews.org/Report/96935/SOUTH-AFRICA-Treatment-programme-by-numbers</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/20068115t.jpg"/></td><td valign="top">JOHANNESBURG 30 November 2012 (IRIN) - South Africa has recently made huge strides in HIV treatment, scaling-up the number of people on antiretroviral (ARV) drugs while also improving its national treatment guidelines.</td></tr></table>]]></content:encoded></item><item><title>SOUTH AFRICA: New ARV tender drops prices, changes treatment</title><pubDate>Fri, 30 Nov 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/200442t.jpg" />]]>JOHANNESBURG 30 November 2012 (IRIN) - The South African government has negotiated savings of about US$250 million in its latest antiretroviral (ARV) tender, which is the first to include a three-in-one tablet. This triple fixed-dose combination ARV will now allow the country to move to new, simpler HIV treatment and prevention of mother-to-child HIV transmission (PMTCT) guidelines in April 2013.</description><body><![CDATA[JOHANNESBURG 30 November 2012 (IRIN) - The South African government has negotiated savings of about US$250 million in its latest antiretroviral (ARV) tender, which is the first to include a three-in-one tablet. This triple fixed-dose combination ARV will now allow the country to move to new, simpler HIV treatment and prevention of mother-to-child HIV transmission (PMTCT) guidelines in April 2013. 

South Africa’s newly announced tender, worth about US$672 million, is the first to include a fixed-dose combination (FDC) ARV that, by combining multiple pills into one, helps reduce patient pill burdens and improve adherence. Under the new tender, an FDC containing tenofovir, efavirenz and emtricitabine will be available to patients starting in April. 

Although doctors will be responsible for deciding which patients can switch to the new FDC, Francesca Conradie, president of the HIV Clinicians Society, estimates that at least 80 percent of the country’s ARV patients will be eligible to make the switch. 

The FDC will now help the country roll-out new, simpler PMTCT guidelines. From April, all HIV-positive expecting mums not already on treatment will be started on the FDC during pregnancy and kept on the drug combination until they stop breastfeeding, regardless of CD4 count - a measure of the immune system’s strength. 

Previously, only expecting mums with CD4 counts of 350 and below started treatment. Those with higher CD4 counts received shorter, dual ARV therapy to prevent vertical (mother-to-child) transmission of the virus. 

Prices come down 

With an HIV prevalence of about 18 percent, South Africa runs the world’s largest HIV treatment programme. Its 1.7 million ARV patients comprise 21 percent of the global market for the drugs, but the country has only recently been able to begin to bring the costs of these drugs down. 

Before its 2010 ARV tender, the country - with the help of the Clinton Health Access Initiative - negotiated a 53 percent reduction in drug prices and saved the country almost US$250 million [ http://www.plusnews.org/Report/91406/SOUTH-AFRICA-New-ARV-tender-halves-drug-prices ].

With 2.5 million people expected to be on ARVs in the country by 2015, policymakers had expected the tender to cost about 25 percent more than the final price. According to Minister of Health Aaron Motsoaledi, South Africa is now paying the lowest price for that specific FDC of any country in the world. 

“There’s major benefits in terms of compliance, logistics and, we’re told by experts, that there are fewer side effects,” Motsoaledi told IRIN/PlusNews. “The FDC is more effective than dual therapy for pregnant women… and because we’ll be saving two billion rand in the next two years, we can afford to treat more patients with the same budget.” 

FDCs will now be provided by three companies - Aspen, Mylan and Cipla Medpro - reflecting a trend within the tender towards multiple suppliers, according to Motsoaledi. In 2011, the country experience shortages of the ARV tenofovir after suppliers failed to meet demand; this latest tender expands the number of suppliers to prevent a repeat of this problem. 

Conradie welcomed the second consecutive tender to slash ARV prices, noting that the newly negotiated prices, which cut the costs of some ARVs like tenofovir by almost 50 percent, were lower than she could have dreamed. 

“In this era of financial austerity, every rand must be seen as an investment… Every rand spent on HIV must be used effectively,” said Catherine Sozi, the UNAIDS country director for South Africa, who added that the move to FDCs is about more than money. 

“One pill a day is better than an amalgamation of pills,” she added. “Now the delivery mode (of treatment) is rationalized, the regimen is simplified and all of this is geared towards the country’s primary healthcare re-engineering policy.” [ http://www.plusnews.org/Report/95840/SOUTH-AFRICA-National-Health-Insurance-falls-short-on-health-workers ]

llg/kn/rz 

]]></body><link>http://www.irinnews.org/Report/96930/SOUTH-AFRICA-New-ARV-tender-drops-prices-changes-treatment</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/200442t.jpg"/></td><td valign="top">JOHANNESBURG 30 November 2012 (IRIN) - The South African government has negotiated savings of about US$250 million in its latest antiretroviral (ARV) tender, which is the first to include a three-in-one tablet. This triple fixed-dose combination ARV will now allow the country to move to new, simpler HIV treatment and prevention of mother-to-child HIV transmission (PMTCT) guidelines in April 2013.</td></tr></table>]]></content:encoded></item><item><title>HIV/AIDS: Despite progress, HIV efforts fall short</title><pubDate>Tue, 20 Nov 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201209031112180900t.jpg" />]]>JOHANNESBURG 20 November 2012 (IRIN) - Record progress in reducing the number of new HIV infections and lowering the numbers of people dying from AIDS-related causes indicate that the end of AIDS is &quot;entirely feasible&quot;. But the epidemic is not over in any part of the world, and is gaining pace in some.</description><body><![CDATA[JOHANNESBURG 20 November 2012 (IRIN) - Record progress in reducing the number of new HIV infections and lowering the numbers of people dying from AIDS-related causes indicate that the end of AIDS is "entirely feasible". But the epidemic is not over in any part of the world, and is gaining pace in some. 

This was the message UNAIDS officials drove home with the release of the agency’s newest figures, in the 2012 World AIDS Day Report The report notes that at the end of 2011, around 34 million people were living with HIV around the world. In 2011, 1.7 million people died from AIDS-related illnesses - a 24 percent decline in AIDS-related mortality compared with 2005 [ http://www.unaids.org/en/resources/campaigns/20121120_globalreport2012/ ].

“The pace of progress is quickening - what used to take a decade is now being achieved in 24 months,” said Michel Sidibé, executive director of UNAIDS. “We are scaling-up faster and smarter than ever before. It is proof that with political will and follow through we can reach our shared goals by 2015.” 

A mixed bag 

UNAIDS says that half the global reductions in new HIV infections in the last two years have been among newborn children. “It is becoming evident that achieving zero new HIV infections in children is possible,” said Sidibé at the launch of the report. “I am excited that far fewer babies are being born with HIV. We are moving from despair to hope.” 

But while the incidence of HIV infections continues to fall globally, the report expressed concerns about HIV trends in the Middle East and North Africa, where the number of people newly infected has increased by more than 35 percent. 

Evidence indicates that the incidence of HIV infection in Eastern Europe and Central Asia began increasing in the late 2000s after having remained relatively stable for several years," it added. 

In sub-Saharan Africa - still the most heavily affected area, new HIV infections have dropped by 25 percent in the past eight years. 

Southern Africa, in particular, has recorded dramatic reductions since 2001; the rate of new HIV infections fell by 73 percent in Malawi, 68 percent in Namibia and 41 percent in South Africa. 

"It’s a combination of two things: the number of people initiated on treatment (we've seen recent scientific evidence that people on treatment are able to lower their viral loads and reduce the risk of transmission) and, secondly, there has been progress in prevention, particularly among young people," Mbulawa Mugabe, deputy director of UNAIDS Regional Support Team for Eastern and Southern Africa, told IRIN/PlusNews. 

Room for improvement 

There remains much room for improvement. According to the report, recent data from surveys in Benin, Burkina Faso, Côte d’Ivoire and Uganda indicate declines in condom use. And the United Nations Population Fund (UNFPA) estimates that only nine donor-provided male condoms were available for every man in sub-Saharan Africa last year, and only one female condom was available for every 10 women. 

Progress on male circumcision has also been slow in east and southern Africa. In six countries - Malawi, Mozambique, Namibia, Rwanda, Uganda and Zimbabwe - less than 5 percent of the targeted number of men had been circumcised by the end of 2011. 

"The biggest challenge has been that the demand has not been as quick as we wanted it to be - except in a few localized situations like KwaZulu-Natal and Kenya. Where there has been progress, it's not necessarily been in the groups targeted, such as sexually active men. We need to do a little bit more," said Mugabe. 

In addition, the report found that prevention among men who have sex with men (MSM) remained "inadequate", with fewer than 1 in 3 men being tested in the past 12 months in South and South-East Asia and Western and Central Europe, areas where MSM play a significant role in country epidemics. Stigma against MSM often discourages them from seeking treatment or prevention services. 

By the end of 2011, 8 million people in low- and middle-income countries were receiving antiretroviral treatment - a 20-fold increase since 2005. But 6.8 million people - nearly half of those eligible - still did not have access to the drugs. "Half will die within 24 months if they don’t start antiretroviral therapy," UNAIDS warned. 

“Must move faster” 

Despite considerable increases in domestic funding, countries continue to rely on external development assistance for their HIV response. International funding accounted for more than half of spending in 59 countries and contributed more than 75 percent of spending in 43 of the 102 low- and middle-income countries. 

"Recent progress on HIV treatment and prevention is terrific news, but if we're serious about ending AIDS we must move faster. If ending AIDS were a marathon, we'd already be behind pace at the first mile marker. In 2013, we must aggressively expand HIV prevention to stay on track to bring new infections to zero,” Mitchell Warren, executive director of the AIDS Vaccine Advocacy Coalition (AVAC) Global Advocacy for HIV Prevention, told IRIN/PlusNews. 

“Priorities must include speeding access to powerful tools like treatment as prevention, voluntary medical male circumcision and pre-exposure prophylaxis, and continuing to invest in new solutions like a vaccine," he said. 

kn/rz 

]]></body><link>http://www.irinnews.org/Report/96830/HIV-AIDS-Despite-progress-HIV-efforts-fall-short</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201209031112180900t.jpg"/></td><td valign="top">JOHANNESBURG 20 November 2012 (IRIN) - Record progress in reducing the number of new HIV infections and lowering the numbers of people dying from AIDS-related causes indicate that the end of AIDS is &quot;entirely feasible&quot;. But the epidemic is not over in any part of the world, and is gaining pace in some.</td></tr></table>]]></content:encoded></item><item><title>SOUTH AFRICA: Western Cape farmworkers join strikes</title><pubDate>Fri, 16 Nov 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2012/201211060949040345t.jpg" />]]>DE DOORNS 16 November 2012 (IRIN) - Farm labourers are the latest group to join a wave of strikes across South Africa in recent months as food price increases outstrip the official inflation rate.</description><body><![CDATA[DE DOORNS 16 November 2012 (IRIN) - Farm labourers are the latest group to join a wave of strikes across South Africa in recent months as food price increases outstrip the official inflation rate. 

The strikers, mainly non-unionized farm workers in the wine and fruit producing province of the Western Cape, are demanding a more than doubling of their day rate to R150 (US$17). 

The minimum daily wage established by the ruling ANC government’s labour department for farmworkers is R69 ($7.8). 

The official 2012 inflation rate is about 6 percent - a figure generally used as a yardstick for annual pay increases. But recently cooking oil, meat and sugar prices have been rising by an annualized rate of more than 10 percent, according to the latest survey by the University of South Africa’s Bureau of Market Research. 

The price of the staple maize meal in 2012 increased by between 41.3- 63.9 percent, according to the survey, which also found that among the country’s poorest households (with annual earnings of up to the equivalent of $6,130) expenditure was 21.4 percent higher than incomes - the gap being bridged by unsecured loans. 

The Dust Country informal settlement on the fringes of De Doorns, a rural town 148km east of Cape Town, is at the epicentre of the strike, which has seen vineyards and warehouses torched. 

Sean Yanta, a 27-year-old father of three who has been working on a De Doorns farm as a grape picker for the past five years, has to take care of his three children and girlfriend on his income of R69 (US$7.76) per day. 

Yanta said he works from 6am to 6pm seven days a week during the picking season, but still struggles to pay for everyday necessities. 

“There are a lot of times when there is no food in the house and trying to buy clothes for a young family is very difficult. I would like to work at something else so that I can earn more money, but the only job for most people in this area is farm work,” he told IRIN. 

Static wages 

Farm labourer Rosemary Filandre, 47, who joined the strike on 5 November, earns R10 (US$1.12) more a day than Yanta at another farm in the area, but the extra income does not go far in the current economic climate, she said. 

Despite having worked for her current employers for six years, Filandre said she has never received a pay rise, even though she has sought one on many occasions. 

“We have to take our own food for breakfast and lunch, and we must pay for fruit if we want to take some home. Even though we work all day in the sun, there are no little benefits like some free fruit at the end of a week,” she said. 

The agricultural strike began on farms producing table grapes, largely earmarked for the export market, and has spread to other parts of the fruit and wine producing region, which is a major foreign currency earner for the country. Strikers argue exports provide higher returns so they should have higher wages, but farmers say weak international demand for table grapes has seen the price drop by nearly 25 percent. 

There are tentative proposals by government for farmworker minimum wages to be determined by the profitability of each sector within commercial agriculture. A call by government for a two-week suspension of the strike - to provide time to draft new minimum wages - has largely been ignored. 

Low wages and poor working and living conditions have blighted South Africa’s agriculture sector for decades. A 2011 Human Rights Watch report entitled Ripe For Abuse [ http://www.hrw.org/reports/2011/08/23/ripe-abuse-0 ] catalogued the desperate lives of farmworkers. 

“Despite their critical role in the success of the country’s valuable fruit, wine, and tourism industries, farmworkers benefit very little, in large part because they are subject to exploitative conditions and human rights abuses without sufficient protection of their rights,” the report said. 

Fairtrade Label South Africa [ http://www.fairtradelabel.org.za/ ] said in a statement to IRIN: “Instead of blame-shifting and politicizing the situation, it is time that policymakers look at the facts. The reality is that farmworkers are among the worst paid employees in South Africa whose working and living conditions are still below standard. Fairtrade certification has had [a] positive impact on the lives of farm dwellers at certified farms in South Africa.” 

A socially responsible company? 

Fairtrade International [ http://www.fairtrade.net/ ], an organization recognizing ethical business practices, certified the Western Cape’s Bosman Family Vineyards in 2009, in recognition that “the conditions of production and trade of our wine grapes are socially and economically fair and environmentally responsible,” the wine producer says on its website [ http://www.bosmanwines.com/ ].

Managing director Petrus Bosman told IRIN their business had adopted a social responsibility ethos, which had seen the transfer of property ownership of 438 hectares of vineyards to their employees. 

The wine company has built 120 staff houses on their 11 estates, provides crèches for employees’ children, pays for extra primary school lessons to improve literacy and numeracy skills, and gives financial support for high school and tertiary education.

The lowest paid farmworker has a day rate of R80 ($9), but also receives a range of benefits, such as free accommodation and private healthcare insurance, which Bosman says “in monetary terms” is equivalent to an additional R160 ($18) a day.

bc/go/cb 

]]></body><link>http://www.irinnews.org/Report/96805/SOUTH-AFRICA-Western-Cape-farmworkers-join-strikes</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2012/201211060949040345t.jpg"/></td><td valign="top">DE DOORNS 16 November 2012 (IRIN) - Farm labourers are the latest group to join a wave of strikes across South Africa in recent months as food price increases outstrip the official inflation rate.</td></tr></table>]]></content:encoded></item><item><title>Easy patents cost patients*</title><pubDate>Mon, 05 Nov 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2010/201009201358370125t.jpg" />]]>JOHANNESBURG 05 November 2012 (IRIN) - South Africa grants almost every patent application it receives, making its patent regime one of the world’s most lenient. While pharmaceutical companies cash in, patients face staggering healthcare costs, and medicines like cancer treatments, third-line antiretrovirals (ARVs) and treatments for drug-resistant tuberculosis (DR-TB) are often priced out of reach.</description><body><![CDATA[JOHANNESBURG 05 November 2012 (IRIN) - South Africa grants almost every patent application it receives, making its patent regime one of the world’s most lenient. While pharmaceutical companies cash in, patients face staggering healthcare costs, and medicines like cancer treatments, third-line antiretrovirals (ARVs) and treatments for drug-resistant tuberculosis (DR-TB) are often priced out of reach. 

A form of intellectual property protection, patents are typically awarded to companies that can prove their product is new. Not so in South Africa, say activists and researchers, who claim the country’s patent system allows pharmaceutical companies to apply for new patents on existing drugs based on immaterial changes - like adding table salt to a formulation or changing a pill’s colour [ http://www.scribd.com/doc/112153927 ].

According to activists from Médecins Sans Frontières’s (MSF) Campaign for Access to Essential Medicines and the South Africa AIDS lobby group the Treatment Action Campaign (TAC), easy patents mean companies can extend their exclusive right to manufacture and sell certain drugs, a process known as evergreening [ http://www.youtube.com/watch?v=_dm7tGRbP4M ].

With competition eliminated, drug prices stay high - often out of reach of South African patients, activists argue. 

Substantial costs 

In South Africa, third-line ARVs - all under patent - costs about US$4,000 per patient per year in private-sector health facilities [ http://www.plusnews.org/Report/91161/ZAMBIA-Ephraim-Banda-The-third-line-drugs-we-don-t-have ]. This high cost means patients in need of these medicines, which are considered drugs of last resort, often go without. The medicines aren’t offered by public health facilities, according to MSF and TAC. 

Additionally, the country diagnoses about 7,500 cases of multidrug-resistant TB (MDR-TB) annually [ http://www.scribd.com/doc/112154586 ], but one of the few drugs available to treat MDR-TB, linezolid, costs about $2,500 per month of treatment because of patent protection [ http://www.msfaccess.org/content/linezolid-treatment-complicated-drug-resistant-tuberculosis-systematic-review-and-meta ]. Linezolid is also not available from public sector healthcare providers. 

While its patent expires in 2014, a patent on a crystallized form of the drug may block generics from entering the South African market until 2022. An Indian generic, currently restricted because of linezolid’s patent, costs about $70 per month. 

The country is preparing a new draft policy on intellectual property, so now is the time to fix the patent laws that allow for these high prices, said Vuyiseka Dubula, TAC’s secretary general. 

“In the past 13 years, we have been fighting [patents] drug by drug. Today is about fixing the problem once and for all, to deal with our issues and ensure access to ARVs and DR-TB drugs,” Dubula told IRIN/PlusNews. “I’m saying this as a person openly living with HIV who is alive today because of access to affordable medicines.” 

Patent reform will likely have implications for the government’s efforts to initiate local ARV production and implement national health insurance - policy decisions announced by the National Department of Health. The health department has little control over the country’s new intellectual patent policy, which is largely the domain of the Department of Trade and Industry (DTI). 

Easy come, easy go? 

How easy is it to get a patent in South Africa? The Mailman School of Public Health, at Columbia University in the US, examined about 2,400 patent applications filed with European Union, US and South African patent regulators between 2000 and 2002. While European and American officials approved about 60 percent of these applications, South African patent administrators approved almost every application submitted, according to the study’s preliminary findings, which were recently presented in Johannesburg by associate professor Bhaven Sampat. 

A study by South Africa’s University of Pretoria found that 80 percent of patents in South Africa would not have been granted if the country actually scrutinized patent applications [ http://repository.up.ac.za/handle/2263/17574 ]. Study authors also found that country’s patent laws did not widely support local innovation, but instead facilitated exploitation by foreign companies and created substantial social costs. 

The most recent review of South African patents, conducted in 2008 by Yousuf Vawdaw, a professor of law at South Africa’s University of KwaZulu-Natal, found that about half of all South African patents that year were granted to US companies, followed by companies from the UK, Germany and France. 

New policy to be released in December 

The DTI’s draft of the new intellectual property policy is set to be submitted to the cabinet on 5 December. A three-month period of public comment on the policy will then be opened before the policy becomes a bill, according to MacDonald Netshitenzhe, the department’s chief director of policy and legislation. 

Despite calls from organizations such as TAC and MSF, the draft policy has not yet been made public, but Netshitenzhe says provisions to oppose patents are in the draft policy. Vawdaw and other experts say they hope the policy includes provisions to dissuade evergreening and to allow for compulsory licences. 

When the World Trade Organization (WTO) was created, it introduced standards to protect intellectual rights through its Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). Aware that the protection of intellectual property rights might hinder access to public health resources such as generic medicines, the WTO, in 2001, reaffirmed governments’ right to use TRIPS’s built-in flexibilities to increase access to public health resources such as essential medicines. 

Compulsory licences are one of the most commonly used TRIPS flexibilities. When it is in the national interest, governments in countries with insufficient pharmaceutical manufacturing capacity can authorize the use of a patent-protected invention without the consent of the patent-holder. Patent holders are then compensated, usually in the form of royalties. 

Although historically opposed to compulsory licenses, the US issued one for the drug Ciprofloxacin, an antibiotic used to treat anthrax, in the wake of the September 11 attack. But DTI’s Andre Kudlinski has argued compulsory licenses are unnecessary when large pharmaceutical companies like Aspen have received voluntary licenses on ARVs in the past. 

The ‘BRICS’ group of advanced emerging countries - Brazil, Russia, India, China and South Africa - is coming under increased pressure to impose stricter patent laws, particularly through fair trade agreements, and Leena Menghaney, head of MSF’s Access Campaign in India, warns that the choices South Africa makes now may set the tone for discussions in countries like Brazil and India. 

llg/kn/rz 

]]></body><link>http://www.irinnews.org/Report/96712/Easy-patents-cost-patients</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2010/201009201358370125t.jpg"/></td><td valign="top">JOHANNESBURG 05 November 2012 (IRIN) - South Africa grants almost every patent application it receives, making its patent regime one of the world’s most lenient. While pharmaceutical companies cash in, patients face staggering healthcare costs, and medicines like cancer treatments, third-line antiretrovirals (ARVs) and treatments for drug-resistant tuberculosis (DR-TB) are often priced out of reach.</td></tr></table>]]></content:encoded></item><item><title>SOUTHERN AFRICA: Governments failing to address cervical cancer</title><pubDate>Wed, 31 Oct 2012 00:00:00 GMT</pubDate><description><![CDATA[<img src="http://www.irinnews.org/images/2011/201104281135310153t.jpg" />]]>JOHANNESBURG 31 October 2012 (IRIN) - Cervical cancer is the leading cause of cancer death among women in southern Africa, but new research reveals that governments’ attempts to address the disease have been inadequate. Access to cervical cancer screening services is minimal, few countries in the region have policies on the disease, and treatment remains a major challenge.</description><body><![CDATA[JOHANNESBURG 31 October 2012 (IRIN) - Cervical cancer is the leading cause of cancer death among women in southern Africa, but new research reveals that governments’ attempts to address the disease have been inadequate. Access to cervical cancer screening services is minimal, few countries in the region have policies on the disease, and treatment remains a major challenge. 

The study, based on regional desktop research and field research in Namibia and Zambia by the Southern Africa Litigation Centre (SALC), assessed the state of cervical cancer services in southern Africa, particularly in Namibia and Zambia, finding that many women access medical assistance only when they have advanced cervical cancer, which is more difficult to treat and can be extremely painful [ http://www.southernafricalitigationcentre.org/uploads/CERVICAL%20CANCER%20Report.pdf ].

"The failure to provide access to cervical cancer services results in the violation of fundamental rights and in the loss of countless lives. There is a serious and urgent need to improve services for cervical cancer in the southern Africa region," the report warned. 

Guidance needed 

The HIV/AIDS epidemic in southern Africa may have contributed to the high number of cervical cancer deaths; women infected with HIV are more likely to develop cervical lesions that can become cancerous. 

But there is still a lack of clear and comprehensive national cervical cancer management guidelines and policies in the region. Neither Namibia nor Zambia has comprehensive guidelines on the management of the illness. Where guidance is available, it tends to be inadequate, focusing on screening, with limited guidance about other forms of prevention or treatments. 

"The piecemeal approach to addressing cervical cancer in national policies results in inconsistent commitment," the report added. 

According to Nyasha Chingore, HIV project lawyer with SALC and the author of the report, Botswana is one of the few countries with a broad, accessible cervical cancer policy. As a result, more women in the country have access to Pap smear screenings - in which a sample of cervical cells is collected and checked for abnormalities. The number of screenings has increased from 5,000 per year before 2002 to 32,000 per year in 2009. 

Where there are no policies, or where policies are not easily accessible by health systems, women are not made aware of the services that are available to them. "With HIV, we all know that when you test positive, they must do a viral load test and CD4 count test... Everybody knows the policy. We have material in our support groups. But with this cervix cancer thing, we don’t know what we are entitled to," said a study participant. 

The report found "a significant amount of misinformation" in Namibia, where most of the young women interviewed reported being informed - incorrectly - by healthcare workers that contraceptives cause cervical cancer or are a risk factor for the illness. 

Stigma is also a major challenge. "It's not an easy topic to talk about. You have to talk about sex, and you develop sores in places no one wants to talk about," Chingore told IRIN/PlusNews. 

Access to screenings in Zambia is determined by geographical location, with few if any screening services available outside of the capital, Lusaka. While cervical cancer services seem to be generally available in Namibia, access is limited by factors such as the lack of prioritization of cervical cancer screening by health workers. 

Treatment and vaccines 

"The treatment of invasive cervical cancer continues to be a major challenge in the region due to the lack of surgical facilities, skilled providers, chemotherapy and radiotherapy services. In Namibia and Zambia, there is a dearth of treatment options, with hysterectomy being the most prevalent form of treatment. There are few treatment options available to women who want to preserve their fertility," the report said. 

Because of structural problems, including inadequate laboratory facilities and personnel shortages, patients and health workers often choose treatment options without having proper diagnoses or adequate information, it added. 

Two vaccines against the human papillomavirus (HPV) - a sexually transmitted virus that can cause cervical cancer - are currently available, but the cost of the vaccines has made it difficult for countries to introduce vaccination campaigns. "Governments need to think about how to make vaccines easily available... Whether it's through parallel importation or compulsory licensing, there are options, they just need to be explored," Chingore told IRIN/PlusNews. 

So far, Zambia and Lesotho are the only countries in the region rolling out free HPV vaccination programmes, the report noted. 

In June 2011, Merck announced it would provide the vaccine Gardasil to the Global Alliance for Vaccines and Immunization (GAVI), for US$5 per dose, a reduction of nearly 70 percent. Eligibility for GAVI support, however, is determined by national income; while Lesotho, Malawi, Mozambique, Zambia and Zimbabwe are eligible, Angola, Botswana, Namibia, South Africa and Swaziland are not. 

SALC urges southern Africa governments to integrate cervical cancer screening into existing sexual and reproductive health services, to allocate adequate resources to the management of cervical cancer, and to establish cancer registries to assess the impact of cervical cancer screening programmes. 

kn/rz 

]]></body><link>http://www.irinnews.org/Report/96676/SOUTHERN-AFRICA-Governments-failing-to-address-cervical-cancer</link><content:encoded><![CDATA[<table cellpadding="3"><tr><td valign="top"><img src="http://www.irinnews.org/images/2011/201104281135310153t.jpg"/></td><td valign="top">JOHANNESBURG 31 October 2012 (IRIN) - Cervical cancer is the leading cause of cancer death among women in southern Africa, but new research reveals that governments’ attempts to address the disease have been inadequate. Access to cervical cancer screening services is minimal, few countries in the region have policies on the disease, and treatment remains a major challenge.</td></tr></table>]]></content:encoded></item></channel></rss>