Prevalence of drug-resistant TB is increasing. Treatment regimens have to be taken, typically, for two years and have poor outcomes. Most second-line TB medicines have poor evidence to support their use and are associated with terrible side effects. In 2010, no new class of TB drug had been approved in several decades. Based on the historical examples of campaigns for HIV medicines in the 1980s and 1990s in Europe and the US, the Global TB Community Advisory Board, TAC and other organisations began campaigning for pre-regulatory approval access to an experimental drug called bedaquiline. I will discuss the complex scientific and ethical challenges brought to the fore by this campaign
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This paper discusses a community-led fencing project in the Koup, an arid predominantly sheep farming district in the South African Karoo. It highlights the role of supportive government officials in sourcing funding and the importance of committed individuals in overcoming collective action problems amongst participating farmers. The project had a strong empowerment dimension in that fencing team leaders were drawn from the ranks of unemployed people in Laingsburg town and they were responsible for recruitment into the project and for the day to day management of the work. Comparative analysis of the socio-economic position of the fence workers with data from the 2011 population census for coloured people living in Laingsburg town suggests that the fence workers were relatively poor and that the project was appropriately targeted for a poverty alleviation programme. This was in part because workers were required to camp on farms for two weeks at a time, thereby resulting in the project automatically selecting for those most committed to earning additional income. The study revealed that the fencing workers identified themselves as general agricultural workers but had skills and experience from other sectors including construction and services. Urban-based agricultural work has existed in Laingsburg for at least three decades i.e. that it preceded the shift of workers off farms that took place across South Africa after 1990. The study sheds light this long-standing, but under-studied dimension of urban poverty and on the diverse strategies (including reliance on government grants) that people use to combat it in the Karoo
Welfare regimes in Anglophone Africa were in the final phase of colonial rule and the first phase of post-colonial rule characterised by an agrarian approach, focused on preserving or strengthening the peasantry. These later gave way to an approach focused on non-contributory transfers of cash (or food) to the deserving poor through social assistance, food aid and public employment programmes. Social insurance, focused on workers, played a marginal role. This paper first examines the distinctiveness of these welfare regimes in a comparative perspective, and then examines the politics of welfare-state-building through a series of country case-studies. The case of Mauritius reveals the obstacles to adopting social insurance. The case of Zambia reveals the obstacles to adopting social assistance. The cases of Zimbabwe and Malawi reveal how and why democratisation might matter.
This presentation examines the argument that the relationship between democracy and Islam, and between democracy and religion more broadly, is a contingent relationship. The contingency derives from variations in (a) the salience of religion as a basis of social cleavage relative to the salience of other bases of social cleavages (e.g. class, ethnicity, race, region, language), and (b) the multifaceted ways in which religion becomes institutionalized in politics and governance. These variations suggest four possible outcomes: (1) High institutionalization of religion, independent of social cleavage patterns, will endanger democracy. (2) High institutionalization combined with high social salience of religion at the expense of other sources of social cleavage will weaken the prospects of democracy. (3) Moderate institutionalization of religion combined with cross-cutting social ethnic, language and religious fractionalization will facilitate democracy. (4) Low institutionalization and low social salience of religion reinforced by cross-cutting social cleavages will strengthen democracy.
The most important practice through which marriages are constituted in many African communities in South Africa today is ilobolo, often translated as bridewealth. Meanwhile, marriage rates in such communities are sharply declining, and many locals view ilobolo as a key contributor to this collapse. Through intensive ethnographic research in a quasi-rural KwaZulu-Natal community, this article explores the puzzle of how ilobolo maintains its authority over marriage even as many today see it as preventing more marriages than it produces. Drawing on the concepts of legal consciousness scholarship, I argue that the contemporary practice of ilobolo often enacts multiple, even contradictory understandings of marriage. But rather than undermining support for ilobolo, these diverse meanings actually help shore up its support by providing multiple legitimating narratives of the practice suited to varying social positions in a context of ideological, legal, political, and economic change. In particular, I argue that orthodox "affinal" understandings framing ilobolo as a practice for bringing two extended families together in marriage are increasingly supplemented by less explicitly recognized "conjugal" understandings framing ilobolo as a practice that helps produce marriage as a dyadic, intimate, and even egalitarian union of two individuals.
In this article I explore whether members of South Africa's emerging black middle class exhibit different political values,evaluations, and behaviours than the other black citizens. Futhermore, I explore whether the impact of class is due to physiological security or higher levels of education, as well as whether the impact of either of these markers of class are greater for yournger middle class blacks who have grown up under conditions of abundance or with higher education. I find that the attitudinal consequences of indicators of the middle class are inconsistent and sometimes contradictory. There is little evidence that the emerging black middle class is either more or less loyal to the governing ANC,though they are more positive in their evaluations of government action. The are signs however, that they are less likely to take part in a range of campaign, and inter-election democratic activities.
Metaphors may be harmful or helpful, but they are probably inevitable where people wish to draw attention to social or medical issues. In this paper, I discuss the role of metaphor within epidemiology, and the work of artists and cultural activists both in challenging and crafting alternative metaphors about HIV/AIDS.
Much of the ethnic politics and African politics literatures repeatedly find that people vote for their co-ethnics. These literatures are generally silent on the role ethnicity plays for those who do not have a co-ethnic candidate for whom to vote and often implicitly assumes ethnicity does not matter for such individuals' political behaviour. However, on average, 40% Africans, on average, will face a presidential election in which they have no co-ethnic candidate. How does ethnicity influence these voters' preferences? This paper uses the concept of ethnic proximity along the dimensions of language, race, religion, and region to understand the behaviour of such voters. This paper is part of a larger project that is the first to seriously conceptualize and operationalize ethnicity as continuous. I measure ethnic proximity for the Coloured population in South Africa and find that racial proximity to candidates significantly predicts the voting preferences of members of this ethnic group.