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The Rat Race Against The silent Killer

Tuberculosis is a silent killer; now there is a greater chance of people dying from it. A strengthening superbug is defying drugs and sending African hospitals into the red. Doctors are calling it a ticking time bomb and all that stands in its way are new pills, new technology and a rat pack.

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Seven months ago, Daniel, not his real name, was so tired he couldn’t walk and at night he would wake up sweating. He was so thin people thought he was on tik (crystal meth). He hadn’t worked for two years.

At the time, Daniel thought he had a bad cold, so he went to his clinic in Bonteheuwel, a township in Cape Town, to get medicine. To his horror the nurses told Daniel he was suffering from what they call extensively drug resistant tuberculosis (XDR-TB) – a virulent strain of multidrug resistant tuberculosis (MDR-TB). A mere four years ago, this would have been a death sentence.

In Africa, tuberculosis (TB) is called the poor man’s disease – it strikes in overcrowded homes and overcrowded taxis.

Professor Andreas Diacon

“I didn’t know anything about TB. I didn’t know anything about MDR or XDR. I didn’t realize TB was a disease that could kill you… [Death] hung at the back of my mind. I wouldn’t sit next to people who had it… I was scared of them. Now, it’s the opposite. I was the one who had it,” says Daniel.

It hit home hard over Christmas. Daniel was allowed out of hospital, but his family refused to sit with him. Many others are ostracized by their own people largely because of the relationship between HIV/Aids and TB; half of South Africa’s TB patients also have HIV.

“In my community people believe TB can change to HIV. But that’s not true. TB stays TB and those who have HIV can get TB. They told me to sit outside and drink by myself, alone,” says Daniel.

Daniel is one of millions in a worldwide TB epidemic. It’s been called the world’s number one infectious killer disease, taking more lives than HIV and malaria in 2015, according the World Health Organization (WHO). In that year alone, 1.8 million people died from TB. That is a third of the people living in Cape Town and more than a small country like Gabon.

The problem is, over the last 40 years, TB has sharpened its teeth, yet hospitals haven’t. In 2015, an estimated 480,000 people developed MDR-TB alone, according to the WHO.

This is because MDR-TB has become a superbug.

For those who do survive, it means up to two years of expensive treatment; in which you swallow almost 15,000 pills and in which you take daily injections that can make you deaf.

Thanks to a revolutionary drug called bedaquiline, Daniel’s death sentence has been stayed.

It was discovered in 2005 by Belgian veterinarian Koen Andries, a pharmacist at Janssen pharmaceutical company. This was the first TB drug to be registered in 40 years in 2012.

It proved so promising that a mere month later it was being handed out in South Africa at the behest of the country’s Minister of Health, Aaron Motsoaledi.

Just 15 kilometers from where Daniel still lies in hospital, Motsoaledi sits in the oak-furnished offices of Parliament, in Cape Town. Motsoaledi is keen to push his point for the war against TB – he is a qualified doctor who has seen its effect firsthand.

Bedaquiline is helping to save the lives of 4,385 people living in South Africa, like Daniel. To this day 60% of all the people taking bedaquiline are treated in South Africa, according to Motsoaledi.

The effectiveness of TB treatment is measured by a patients’ sputum culture – infections in the respiratory system – converting from positive to negative. The South African government says the number of people with MDR-TB cured is 79.7% for those on bedaquiline; up from 39%.

“[TB] is a silent killer that does so in an undramatic way, so nobody notices. In 2009, 80 members of the National Union of Mineworkers died in rock falls, everybody knew about it. But in that same year 1,500 of their members died of TB. They are all deaths, it’s a loss. But the 80 made the most noise. The 1,500 died a silent death in a bed,” says Motsoaledi.

Motsoaledi is trying to convince the world as board chair of the Stop TB Partnership, a United Nations project. He is exasperated that TB has not been debated in a general assembly of the United Nations, based in New York. Even though it is part of the Millennial and Sustainable Development Goals, which hopes to eradicate TB by 2030, it was only recently amended to be on the agenda for 2018.

 

“TB is not bringing a lot of fear to people. But look at the figures, when Ebola broke out it killed 11,000 people during its time of existence. But almost every human being on the planet heard about Ebola and got worried. But during the same period TB killed 1.5 million. I am not trying to say Ebola was not a big scare, but these 1.5 million hardly made a blip on the radar screen,” he says.

In the yellow hallways of the Brooklyn Chest Hospital, in Cape Town, is the grim proof of the statement. Here, Doctor Paul Spiller is one of the people standing against the tide. He looks laidback, in an open neck shirt, but his job is far from so. He has been Manager of Medical Services at Brooklyn Chest Hospital for six years and says the new drug has transformed treatment.

“Before these new drugs became available, [Brooklyn] was a very depressing place. XDR-TB survival was less than 10%, we had a 90% mortality rate. It was like trying to fight a war with a peashooter,” says Spiller.

The downside is XDR-TB could also bankrupt a country.

“The difference in costs are oceans apart. To treat a person with normal TB you spend between R300 ($20) to R400 ($30) for treatment. Once you get MDR-TB its goes to R400,000 ($30,000) per patient. Once you get XDR-TB its R800,000 ($60,000) per patient. It’s a 1,000 times more expensive to treat someone who has MDR-TB than a person with ordinary TB,” says Motsoaledi.

The expensive battle continues.

 

An Idea Born Of A Sheet Of  Paper And A Fist Full Of Bucks

What makes Daniel’s story even more remarkable is that it all started with a flimsy piece of paper, R200 ($15) and a doctor-turned-entrepreneur with a truckload of perseverance.

The proving ground was a company called TASK Applied Science, headquartered in Bellville, Cape Town. It was the brainchild of the full-of-life Professor Andreas Diacon, a Swiss-born lung doctor – pulmonologist – who came to Africa looking for a job. He is every inch the eccentric nutty professor with a joke on his lips and hope in the eyes. He is also a man on a mission.

“If you read in the newspaper that bedaquiline is reducing the mortality by many many percent. Then we know, without [TASK], all these people would have died,” says Diacon.

Diacon deals firsthand with South Africa’s overburdened public health system. He is a consultant in pulmonology who works in the Internal Medicine and ICU units at Tygerberg Hospital, in Cape Town. It was here that Diacon came across the Afrikaans saying ‘a farmer makes a plan’ – it became his mantra in taking down TB.

“As opposed to being a doctor in Switzerland, being a doctor here in an intensive unit, in a public hospital, people die. This is a job that drains you… There is too much disease for too little resources. The system is just not big enough.”

APOPO laboratory

The idea to start TASK came by chance in a fast crowd. Diacon came across retiring Professor Peter Donald, a renowned TB researcher also living in Cape Town, at a lecture in 2002.

“I had seen all his work. I was fascinated by it. I, in Europe, in my medical training, had read about it. He is the leading researcher of TB for the last 30 years. Suddenly this man is here and he is giving a lecture in front of five people, and I was one of them.”

On the day, Diacon asked who would continue Donald’s research. Donald’s reply was straight forward and bleak: there was little future for research in a disease where there was no money; no revolutionary new drugs and no interest.

“Two weeks later, Donald gets a phone call from a drug company called Tibotec (now known as Janssen). They said they had this new drug called bedaquiline, at the time it was called TMC207. It was a completely experimental compound. They were desperately looking for someone to test it in people. Donald had just cleaned up his office, so… he called me,” says Diacon.

It was the sort of challenge Diacon had been looking for. Donald handed Diacon a pamphlet with trial protocols; the rest was up to him.

“[South African hospitals] needed new TB drugs, why should I ever say no? From my point of view it’s imperative that every drug that people have, that might work, must be tested. It’s the only way we can get control of the problem.”

It wasn’t easy. Diacon struggled to find the beds; hospitals turned him down saying they had no space and they didn’t want TB to spread. After months of looking, Diacon found the sympathetic ear of Professor Frans Maritz, who was head of the Karl Bremer Hospital, also in Cape Town.

“It didn’t take longer than five minutes. He said to me ‘Andreas, this is the most important research I’ve ever heard of in my career. You can have my private ward here,'” says Diacon.

Then there was the matter of finding the budget. Diacon secured upfront funding and with R200 ($15) – enough to put petrol in your car – opened a bank account to pay his four employees.

“Then we got this drug. It was the first time I did anything like this. And somehow we did [the trials] well. And then the drug worked. And we could show that the drug works. It was the first new TB drug that showed some signs that it could do something. It was not as strong as people had hoped, but it was there,” says Diacon.

TASK’s bedaquiline trials started with 180 patients, on a two-week course in 2010. It took seven years, five months and five days to go from discovery to FDA approval – Diacon counted. What is significant is that drugs can take up to 15 years to develop, but in this case bedaquiline was fast-tracked, because of its necessity. Without Diacon’s research, the drug could have taken a lot longer to make it to FDA approval by 2012.

“For a drug manufacturer, getting FDA approval is like being knighted. If you are a chemist, that leads to marketing approval of a drug. It gives them patent protection for 10 years,” says Diacon.

“But for TB drugs it’s a bit of the opposite because nobody has any money to buy it. The development cost will never be covered. So in return the FDA offer a voucher system, whereby if [a drug company] develop a drug under these circumstances, then the FDA agrees to fast-track another drug they develop.”

“With only data from 180 patients, there I was presenting the story to the FDA… it wasn’t a strong case. [The FDA] agreed to a special situation where people with really drug resistant TB would be allowed to be registered, under the condition that it was researched further.”

TASK began tests with more patients over longer periods with bedaquiline.

“Suddenly we became the hub where everyone went to with their new TB drugs,” says Diacon.

Still, hospitals were reluctant to trial the drug. Diacon managed to eke out eight beds in an empty building at the Brooklyn Chest Hospital, in Milnerton.

“We renovated [the building] ourselves. We even went to an old bed store in Brooklyn and welded the beds together out of broken parts. We didn’t have the money to buy beds… Then one morning the groundsman came and took four of our beds saying the head nurse needed them elsewhere in the hospital.”

As the drug showed signs of working, he needed more patients to test over longer periods of times. So he walked the hallways of the hospital looking for candidates that met the trial’s rigid requirements.

TASK’s current MDR facility is on site at Brooklyn, and can accommodate up to 10 patients overnight.  Daniel is one of hundreds to have undergone trials and on the road to being cured.

The company has grown from four employees to more than 150, and so have the facilities. Among them, Diacon converted an abandoned mosque into a trial center in Bellville. TASK also opened sites in Delft and Mfuleni, and is building one in Scottsdene, which are extremely rural townships on the fringes of Cape Town. You could say that he is building up his own clinical empire in TB.

“TB is curable. It’s a bacterium that can be killed. If the shortest time it can be killed is six months, then there will always be people not sticking to treatment. We need to get a once-off injection, or a two-week course of antibiotics. It needs to be affordable and we need to be able to make sure people are swallowing the drugs and not infecting anybody else,” says Diacon.

Diacon’s company has emerged as the leading clinical trial company to do research into this overlooked killer. Thanks to R200, a pamphlet and making a plan like a farmer.

 

The Ticking Time Bomb That Kills

The fight against TB in Africa has only just begun and it will be rats and machines on the frontline.

New research on TB resistance was published in the New England Journal of  Medicine by a team led by Dr Sarita Shah, of United States-based Centers for Disease Control and Prevention (CDC). The study was done in KwaZulu-Natal, a province with many cases of XDR-TB. Findings suggested at least 69% of XDR-TB patients caught it in an overcrowded house or an overcrowded taxi.

The research contradicts previous opinion where it was believed patients acquired XDR-TB though failing to take their pills. The research also shows why South Africans, like Daniel, are suffering from a tenfold increase in XDR-TB cases since 2002, says the CDC. Key statistics have led researchers to call XDR-TB a ticking time bomb.

Early detection is key to diffusing this bomb. According to the WHO, more than a third (4.3 million) of people with TB go undiagnosed or unreported, some receive no care at all and for others, access to care is questionable.

Dr Florian von Groote-Bidlingmaier

“After one week, [patients] would disappear forever. Then the person who is diagnosed with TB wouldn’t come back and is spreading it. You try to track the person down but by the time you have tracked them down, they have infected many more people,” says Motsoaledi.

To combat the spread, scientists have racked their brains to find ways of detecting the disease faster. One of them is the diagnostic machine, the GeneXpert, deployed by the South African government since 2011. This can test for TB in just two hours, instead of weeks in a laboratory.

“Our figures of TB are very high. In terms of what we had five or seven years ago, the numbers are going down. We used to be the number one country in the world with TB. Now, we are sixth. In 2008, we had 70,000 dying of TB, now the number is below 40,000. Obviously, that is very significant. In 2008 the cure rate was 67% [for normal TB]. It is now 85%,” says Motsoaledi.

“Because of the GeneXpert, we are picking up more people and it is helping to pick up the people who would not have been diagnosed before.”

By 2016, just over 10 million specimens have been processed, says the South African National Health Laboratory Service.

The GeneXpert is expensive. The most common model is the GX4 which costs $17,000 per unit. This machine can test four cartridges in two hours; the subsidized cost for each cartridge is around $10.

“In terms of rand for rand, the GeneXpert is more expensive. But it’s faster and more efficient. Also, for microscope testing, you have got to be a qualified medical technician, or microbiologist. [With] the GeneXpert, you can be trained in 15 minutes. The machine does the work for you,” says Motsoaledi.

Motsoaledi says the results of combining this early warning system with advanced trial treatment of bedaquiline has been a game changer.

If cost is the problem, TB detection can border on the bizarre. African scientists at APOPO, an NGO in Tanzania, have found the African giant pouched rat to be very good at sniffing it out.

“By using rats alongside conventional methods we have raised partner clinic detection rates by 40%. One rat can take 20 minutes to test up to 100 samples, this would take a clinic technician, using conventional microscopy, up to five days,” says James Pursey, Head of Communications at APOPO, from their TB research and training facilities in Morogoro, Tanzania.

Since 2005, APOPO has trained over 80 rats to sniff out TB in the sputum of patients. Each one costs $6,500 and takes nine months to train. Once trained, they can screen as much as 1,500 sputum samples a month.

The rats are trained on a click-reward system. They learn to associate the smell of TB with a click in its ear and are given a bite of a banana as a reward. The rats are given samples and when TB is detected they hover or scratch over the sample for three seconds. The sputum is then verified at APOPO’s laboratory within 24 hours for the patients to given their results – much faster than standard microscopic testing.

“A clinic technician usually gets through 10 to 20 samples a day. The difference is that conventional microscopy is 20 to 60% accurate so around 50% of TB patients in sub-Saharan Africa go home misdiagnosed, where they can infect up to 15 other people in a year. The rats are an addition to the current method and they are effective because they are so fast at screening the samples that the clinic already tested. This gives doctors time to then check a much reduced sample base using better methods (concentrated smear LED microscopy) which the clinics can’t afford in time or cost,” says Pursey.

March saw the opening of a new TB-detection program in Addis Ababa, Ethiopia, funded by the Skoll Foundation. It aims to increase the number of identified TB patients by at least 35% in the short term, in the heart of the city, with 30 rats in training.

In addition to Morogoro, APOPO operates out of Dar es Salaam, Tanzania, and Maputo, Mozambique. To date the rats have found over 11,000 TB-positive patients missed by clinics.

It’s not all good news – the rats do have their limitations. Pursey says they can’t tell the difference between types of TB. Using rats is also a new science, there are many questions surrounding how or what the rats are smelling and whether they are able to detect the TB.

“The smell is a bouquet of volatile organic compounds and we are currently carrying out research to find out exactly what the rats are targeting,” says Pursey.

Their scientists have also been left bemused when their research showed that a number of rats were picking up a bunch of seemingly false positives in samples of many patients who went on to develop TB.

“It turned out the rats might be able to detect the TB up to six months in advance. [Our scientists’] working theory is the rats may be more sensitive to the volatile organic compounds released by the TB,” says Pursey.

African solutions to world problems – an expensive machine in South Africa that can tell you have TB in a matter of hours and rats in Dar es Salaam that can sniff out in a trice. Where else but in Africa?

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Lifting The Heavy Veil On Wedding Costs

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With pockets as deep as gold mines, how far are couples willing to go to have the picture-perfect luxe wedding?


The lagoons overlook the snow-white beaches with its swaying coconut trees, embraced by the turquoise waters of the sea in the island nation of Mauritius. It’s a scene straight out of a movie, with a couple cavorting in the distance.

Over 100 guests from South Africa have also gathered on these sands for the weekend wedding of businessman Lebo Gunguluza and his long-term girlfriend Lebo Mokoena. 

The total cost of this union: almost $300,000. 

“I didn’t mind exceeding the budget, because you only do this once,” says new bride Mokoena.

The couple flew over 30 guests and provided them with five-star accommodation at the LUX* Grand Gaube.  Part of the guest contingency included the behind-the-scenes crew for the wedding, as well as the speakers who had to spend four to seven days in Mauritius to prep up.

“We did not want to have a local wedding because we wanted our guests and family to have a different experience. We also wanted our family members who did not have passports and have never flown out of the country to experience a different country,” Gunguluza says.

Snow-white beaches of Mauritius. Picture: Supplied

The weekend celebrations started on a Friday last September with a cocktail meet-and-greet party. Belly dancers who were dressed in floral red and yellow danced the evening away with guests, with a local band taking them to the all-white party on Saturday.

This was just a build-up to the romantic wedding reception with shades of blush, ivory, and gold which was to take place on Sunday at 4PM.

“Every time I think about that day, I want to do it again,” the new bride says.

The couple chose not to have bridesmaids and groomsmen and the guests were encouraged to dress in black and white.

“I didn’t have bridesmaids because it makes you choose between your friends. I felt that if you got an invite to our wedding, you were worthy enough. So, we wanted everyone to be bridesmaids and groomsmen. I think we made it intimate and everybody felt like they were VIPs,” says Mokoena.

Everything fit perfectly as the bride’s two white wedding dresses were designed by Antherline Couture.

For the ceremony, she wore a white ball gown with a diamanté top heavily embellished with beads; while the groom looked dapper in a white tuxedo jacket designed by Master Suit SA.  

The color white was indeed conspicuous.

“I have always felt that white is pure and because I was signing my life away, I felt I needed to be pure, hence I said my husband needed to wear white as well,” she adds.

The lavish white wedding was organized by renowned wedding planner Precious Tumisho Thamaga who ditched her seven-year career in Public Relations & Marketing to become an event planner.

Thamaga organizes events and weddings for affluent clients such as the Gunguluzas.

“They are busy people and they don’t have time to do the administration and the back and forth of vetting in suppliers,” Thamaga says, as she takes over the pain of wedding planning.

Lebo Mokoena and Lebo Gunguluza (middle) with wedding guests in Mauritius. Picture: Supplied

While working in the corporate world, she had attended many weddings that she felt were put together in a way that created a disconnect between the guests and the wedding couple.

“So I saw an opportunity in the fact that there were not a lot of wedding planners that were black,”  Thamaga says. 

She decided to focus on corporate clients in order to turn her passion into a profitable business.

“A lot of people did not expect a black person to be professional and take the business seriously.

“It was not just a hobby or someone helping out a family. It was an actual business and I made sure that I got taken seriously from the onset,” Thamaga says.

In order for Precious Celebrations (the name of her company) to prosper, she had to have a business strategy in place.

“I made sure that I put a lot of time and effort and strategized properly what it was that I wanted to actually focus on, and find a niche [in]. I believed that would separate me from somebody that was already in the industry,” Thamaga says.

However, her job is not always alluring.


Lebo Mokoena and Lebo Gunguluza’s wedding in Mauritius. Picture: Supplied

“When I started in the industry there weren’t so many wedding planners and now it is a different story and everyone thinks it is easy-peasy and it is glamorous,” she says. 

Planning a luxurious wedding takes eight to 12 months and can cost anywhere between R300,000 ($20,813) to R4.5 million ($312,203).

The most expensive wedding Thamaga planned was for a public figure she cannot disclose the name of. 

“It was a destination wedding and the experience from when the guests arrived to the wedding day was memorable. When they arrived, we had a cocktail party and we had activities like canoeing and on Sunday we had an all-white party. [This is] so that people don’t depart on Sunday and may leave on Monday.” 

Only the affluent sign up.

“The smallest wedding that I have had to plan had 80 people and it cost R2 million ($138,000),”  Thamaga says.

She has turned away some clients in the past because their budget was insufficient for the type of wedding they envisioned. 

Thamaga organizes 26 weddings, on average, annually, from countries such as Mauritius, Zimbabwe, Swaziland, Botswana and now she plans on taking her bespoke company global.

One of the unique aspects of her business is that she has maintained a good relationship with the suppliers she has in each country, and has kept her expenses to a minimum.

“The wedding planning-event planning industry is quite lucrative if you do it right. I am not the type that would have too much inventory because I want to feel like the inventory belongs to me; that would limit my creativity,” she says.

“I make sure that I don’t have a lot of expenses, I have coordinators that I have worked with for years and they have full-time jobs.”

Thamaga’s greatest challenge so far was whether or not to outsource other wedding planners when her business was increasing.

“It can be a bit daunting to realize that your business is growing,” she says.

But she opted to remain boutique.

“I had to decide that it is not about the money. I am building an empire where I want a legacy and an ongoing relationship with my clients.” 

She involves her clients every step of the way to bring their vision to an unforgettable reality, and believes that weddings are expensive because of the growing aspirations of the young.

“It is not just in South Africa, it is worldwide,” she says.

Despite the tangible costs of conducting these dream events, the wedding industry in South Africa is largely unregistered as it is a fluid market where services and costs are difficult to track and document accurately.

Fred Elu Eboka, a Nigerian designer who dresses delegates as well as the rich and famous. Picture: Supplied

Africans, no doubt, spend millions per year on costs associated with marital ceremonies. This is the reality of the unregistered wedding industry. Despite the recession and slow economic growth, the wedding industry continues to attract many entrepreneurs to its lucrative opportunities.

As, people never stop getting married.

The Marriages and Divorces report released by Statistics South Africa last May shows an upward trend in civil marriages. Civil marriages increased by 0.6%, from 138,627 marriages registered in 2015 to 139,512 in 2016.

A wedding dress is an important part of a celebration and the bridal couture market continues to show growth.

Wise Guy Reports Database Global Wedding Dress Market Insights, forecast to 2025, states: “The wedding market demand grows continually, and the wedding garments market has notable increase every year. In this case, the competition is also very intense among companies. The involved companies should seize the opportunities to expand the gold mine.”

A previous client of Thamaga’s has spent R200,000 ($13,876) on two wedding dresses and this is nothing for Fred Elu Eboka, a Nigerian designer who dresses delegates as well as the rich and famous. 

He moved to South Africa in 1992 at a time when African designs were not being celebrated globally. 

Twenty years ago, Eboka sold wedding dresses for R15,000 ($1,041) a piece, and now sells for R250,000 ($17,344) a piece, depending on the design. 

“A designer of my caliber in South Africa is undersold because there are people in the United States selling wedding gowns for $250 and I am here selling them for maybe $80, it just doesn’t make sense. It shows that our economy is really bad because a designer of my caliber should be operating on the same level as them, or very close,” Eboka says.

He is a luxury designer. 

“When you think of luxury, it is not just the product, it is not just the textile – it is the whole experience from when you drive in, to when you sit down and have the designer talk to you and learn about your life. The whole artistic process contributes to the cost value of the gown.”

He says that the reason wedding gowns are expensive is because they are meant to be timeless pieces.

“Traditionally, wedding gowns are classical couture. It is not like the normal evening dress that you wear to look beautiful on one night. A wedding dress is like training for the Olympics. You train for them for the rest of your life,” he says.

Eboka also says when designing a wedding gown, you need to take time to know the client, family and their fancies in order to meet the clients’ need.

The material of the wedding gown is usually expensive because he sources the textiles from across the world, and he takes two to three months to create a gown, depending on the embellishments.

Fred Elu Eboka, a Nigerian designer who dresses delegates as well as the rich and famous. Picture: Supplied 

“My designs have a lot of artistry,” he says.

Eboka is a wealthy man but he still believes that the industry is not as lucrative as it could be.

“But we do well, without being arrogant about it… You have to be fully aware of the industry and have the intellectual capacity to understand the potential of the market,” he says.

Pictures are an important element of a wedding because they capture the moment for life.

International award-winning photographer Daniel West meets his clients in a restaurant so he can get to know them better and learn the history of their relationship.

“We, as photographers, need to click with each couple, it is actually vital because we are going to be in their space from the beginning to end.

“So, when we do not gel, we are going to find ourselves in an awkward situation on the day because we, as photographers, are also problem-solvers. We don’t just take pictures on the day,” West says.

His packages start from R18,000 ($1,248) to R60,000 ($4,163) and he says it is because the couple is paying for the quality of the work. His packages include waterproof genuine leather-bound photo albums that he says last a lifetime, as well as 500 images that are both edited and unedited. He also arranges the location for the photoshoots.

“It is more than about taking pictures on the day, anybody can take pictures but the work that I do has more of a boutique feel,” he says.

“You pay to have something like this on the table that will last you a lifetime,” West says.

He does not only take pictures on the day but the photoshoots can take up to three months.

“Each couple that I take pictures of has a different story and that is where I draw my inspiration.”

West says that it takes a while for the business to get to a point that is profitable because photographic equipment is expensive.

“In the beginning, it is unfortunately not lucrative because you have to look into getting the equipment that is up to standard, however, it took me about seven years where I could get to a point that I could make a business out of it,” West says.

International award-winning photographer Daniel West with his clients. Picture: Supplied

His annual turnover before expenses is R800,000 ($55,502) and he has about 25 clients a year.

He believes that the industry is regarded as valuable in South Africa and it is growing because people are becoming more enlightened about the photography industry. And social media has become an important motivator driving this industry.

“It is vital to have a good photographer for your wedding, because you as a bride are not quite educated of what is out there and what is not [in terms of photography].”

A good photographer needs to have foresight.

“The quality and charisma of your photographer is really one of the most important things you pay for because if something were to go wrong on your wedding, like rain, what does your photographer do? Do they stand back or make a plan?” he says.

Other luxe services associated with weddings include limos and chauffeur services, and florists, live music bands and gourmet caterers flown from around the world. The more money you are willing to throw, the more sparkling the champagne, crystal and caviar on the beach

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Why Science Matters So Much In The Era Of Fake News And Fallacies

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Democracy and social progress die without science and fact-based knowledge. Science and facts are the foundational basis for rational and logical disputation and the possibility of reaching some truths.

Fake news, on the other hand, is a calculated assault on democratic freedoms.

The power of the notion of fake news and of its practitioners is demonstrated by how we have all quickly come to accept that there is a category of news called fake news. By doing so, we are running the real risk of being complicit in its legitimisation. My point is: if it’s fake then it’s not news. There is news, and then there is fake stuff, dodgy facts, distortions and lies.

So what’s the connection between science, knowledge and facts?

What makes good science

Science is one important means of producing knowledge and getting to what approximates the truth. Good science results from rigorous processes. Part of the rigour in science and knowledge creation is the peer review process, which is a means of ensuring not only the correctness of facts, but also transparency.

Science must generally also meet the test of replicability. These days data used in scientific experiments often also has to be preserved so it can be assessed or analysed if results are disputed. Ethical norms also govern scientific experiments to prevent harm.

Science is not the absolute truth. Scientific findings are the beginning, not the end, of the quest for truth. Empirical data used in science that can be verified forms a sound basis for robust discussion, debate and decision-making. Science brings a degree of rationality that creates a higher probability that the best interest of society or the public interest will be taken into account in, for example, decision-making.

Science, then, is the habit of exercising the mind to help think through especially difficult and complex phenomena.

This makes science important in the exercise of democracy. This isn’t possible without facts and information that enable – or aid – voters to make an informed choice in elections, for example, or help the making of sound policies that best promote the public interest. Science also enables discerning members of the public to make sense of their worlds and the world.

So-called fake news

Fake news, on other hand, is a set of at worst, manufactured or concocted facts that are a perversion of reality. It is the direct antithesis of science.

But fake news isn’t new. It’s as old as news itself and has a variety of aims, including propaganda and spin doctoring. It can be argued that the growth of spin doctoring in the 1990s is the precursor to the exponential growth of fakery. It has also been enabled by the decline of content that enriches public discourse in the context of commercialisation and concentration of media since the 1980s.

These developments led to a decline in the influence of public interest media or media that strikes the balance between commercial enterprise and the public good. And this has led to the reduction in the kind of news and media content that focuses on science.

Science journalism and investigative journalism, in particular, have seriously declined. This has meant that the ability to shine a light on the dark areas of lack of knowledge, superstition, and myths has seriously been diminished.

Specialist reporting is now confined to the content-rich ghettos of those who are highly educated or interested.

Another reason for the growth of fake news and its increasing influence is the loss of confidence in public institutions, including media institutions and the profession of journalism. Fakery has risen to fill the vacuum, driven by individuals and political organisations who position themselves as messiahs with instant solutions to multiple social crises. In their discourse knowledge institutions, science, facts, evidence, experts and reason or rationality are thrown out of the window as the sophistry of the elite.

The role of social media

Digital technologies and social media have made it much easier to produce and disseminate fake news. It is a paradox: unprecedented scientific advances and technologies are enabling us to transcend traditional constraints of distribution and literally place information at people’s fingertips. Yet these same technologies seem to facilitate more fake news and information that doesn’t necessarily advance the public good.

In addition, social media largely exists outside the professional norms of fact checking and the use of evidence to support assertions, arguments and positions taken in relation to social phenomena.

Fact checking and peer review are more important than ever because of the reality that false information now flows freely. This can be extremely harmful, particularly in public health campaigns.

The attraction of fake news is its apparent simplicity. It has a ring of truth around its claims, even when these are outlandish, and its ability to seem to resonate with what people think are their life-worlds or everyday life. Its ability to reinforce stereotypes, including prejudices, makes a bad situation even worse.

Science, facts and knowledge will save humanity

Science journalism and investigative journalism which seek to pursue the truth rather than just the reporting of events, are critically important in this age of fake news and fallacies.

It is not an exaggeration to say that the sustainability of the idea of humanity and the environment in the broadest sense of the word depends on science – or the respect for facts, evidence and experts.

Science that allows the public to have a nuanced understanding of life is important to building inclusive, open societies that enable public participation in decision making and progressive social agendas. Science disseminated in ways that are understood by the public and resonate with their life-worlds is important for building trust in reformed institutions and creating new forms of social cohesion in diverse societies.

Tawana Kupe; Vice-Chancellor and Principal of the University, University of Pretoria

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Entrepreneurship Funds In Africa: Distinguishing The Good From The Bad

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Entrepreneurs have a pivotal role to play in Africa’s unemployment crisis. Today over a third of the continent’s young workforce (those aged 15-35) are unemployed. Another third are in vulnerable employment. By 2035, Africa will contribute more people to the workforce each year than the rest of the world combined. By 2050 it will be home to 1.25 billion people working aged.

To absorb these new entrants, Africa needs to create over 18 million new jobs each year. Governments need to put in place policies that drive economic growth and competitiveness. These in turn, will enable the growth of small and medium-sized enterprises (SMEs). This is important because they currently play a significant role in low-income countries, representing nearly 80% of jobs. They are also responsible for 90% of new ones created each year.

The challenge for countries is how to support the growth of SMEs. Various African governments have experimented with ways to help address the US$140 billion funding gap for startups and SMEs. For example, one approach has been to set up entrepreneurship funds.

Based on my experience of watching their performance over the past 18 years, I would issue some words of caution. Some entrepreneurship support models work better than others. And how they are set up – particularly the governance structures put in place to manage them – is key to their success, or failure.

Funding gap

Access to financing is consistently listed as the biggest obstacle to business for SME’s in African countries. They often face double digit interest rates from local banks. And venture capital penetration is still extremely low. Top end 2018 estimates put it at about $725 million for the whole continent.

To tackle the problem, African countries continue to start new entrepreneurship funds. In July 2017 Ghana launched the National Entrepreneurship and Innovation Plan. The aim is to provide integrated national support for start-ups and small businesses.

Almost a year later, Rwanda secured a $30 million loan from the African Development Bank for the establishment of the Rwandan Innovation Fund. This will focus on investments in tech-enabled SMEs.

As new funds are started, African countries must look to the successes and failures of both global and regional funds to replicate best practices and avoid common pitfalls. African governments should explore replicating models similar to Small Enterprise Assistance Funds and the USAID backed enterprise funds. Both include robust investment selection criteria for funds.

In doing so, African government-backed entrepreneurship funds would operate as fund-of-funds – where a fund invests in another private equity or venture fund rather than directly in businesses themselves – as do many development finance institutions globally such as the UK’s CDC or FMO of the Netherlands.

The what and the how

The fund of funds structure creates an arm’s length relationship between the government agency that houses the entrepreneurship fund and the businesses that eventually receive investment. In between, sits a professional fund manager that earns the majority of its income from making good investments, growing companies and exiting them after a period of five to seven years. In this way, there are natural disincentives for corruption and market-based selection criteria for the entrepreneurs who receive investment.

How the fund managers are selected also matters. To ensure true investment independence from the government, fund managers and board members must be chosen in a transparent and competitive process. And once selected, representatives of the government entrepreneurship fund agency can sit on the investment committee for oversight purposes but should respect the fund managers’ independent decision-making.

There are examples of funds being set up without the necessary independent, accountable fund managers. One is the YouWin program in Nigeria. Created in 2016, it was set up to help youth entrepreneurs grow businesses. But senior civil servants handed out awards to friends and relatives.

Government supported fund managers through the FoF model can also catalyse additional investment. By operating in markets and sectors often ignored by traditional private equity funds, Small Enterprise Assistance Funds and enterprise funds have mobilized additional capital for investment-starved companies. African government-backed entrepreneurship funds could do the same by participating in blended finance deals with development finance institutions, social-impact investment funds, local banks and other market players to back growing firms.

Measuring success

While not actively managing the funds’ portfolio investments, governments have a key role to play in guiding the funds priorities. Priorities may vary by country and given Africa’s growing rates of unemployment, funds should prioritise job creation by evaluating investment on key performance indicators. These would include the number of jobs created per dollar invested, indirect jobs created per dollar invested, and average salary of job. In addition to job creation, governments can direct funds to focus on specific sectors either in need of increased capital or high-growth areas in local economies.

Beyond establishing investment criteria, government-backed funds should prioritise rigorous measurement of investment results and long-term data tracking to inform future investment decisions. The UK British Bank regional growth fund found the cost per job created varied considerably by project from £4,000 to over £200,000. It concluded that a better allocation of funds could have led to thousands more jobs created for the same resources.

Data driven investments can not only lead to a better results, but further curtail issues around potential mismanagement of funds.

Tackling Africa’s job creation challenge requires innovative thinking and initiatives that support private sector-led growth. Looking to the model of Small Enterprise Assistance Funds and enterprise funds, African governments can spur local ecosystems and drive new private capital to regions today seen as unfriendly or too risky to outside investors.

Properly structured investments today could yield much larger dividends tomorrow.

-Aubrey Hruby; Senior Fellow, Africa Center, Georgetown University

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