If you want to know of the damage and desperation of debt, just ask 63-year-old Memory Oosthuizen.
Oosthuizen and her partner, Carol, felt the wrath of the 2008 recession when they lost their jobs. Money was tight and the going tough. They used up R750,000 ($56,000) of their retrenchment packages, retirement funds and even took up a second bond on their home to start a car washing business. It ushered in more financial problems.
“The business wasn’t doing so well because money was tight for a lot of people. We had to pay 10 of our staff members and pay our own bills. We also had to pay R25,000 ($1,900) rent at the business premises,” she says.
They turned to credit cards and loans to keep the business running.
“I had three credit cards and my spouse also had three credit cards. We got them so easily. I know that we have to be in control but when you are in a situation like that, it’s so easy to see it as a way out. You can have a credit card without a credit check in just a day. They would call you and say you have been pre-approved, even if you haven’t applied,” says Oosthuizen.
In just a year, the pair racked up R1.2 million ($90,000) in debt. Their landlord took their car washing equipment in lieu of unpaid rent.
“It was the toughest time of our lives. We struggled and had nothing. It was quite a humiliating situation… We managed to get out of debt through debt counselling but it took us years. I never want to be in debt again. Funnily enough, just the other day, I got an SMS from a bank offering me a credit card of R50,000 ($3,800). The banks tempt you by sending you such messages when you are in a bad situation.”
It may be tough to say no, but there is help. The two dug themselves out through debt counselling that is becoming a boom industry.
There is also a volunteer, Nicolette Mashile, who left her nine-to-five job to teach people how to handle money.
“I noticed people sign up for these financial products but they don’t really know what they are, what they will pay out or when they will pay out. I once had a policy with Old Mutual. It was the easiest thing to get into. I just filled in a contact form on the internet, they asked for my ID and all of a sudden I had a policy. The day I wanted to withdraw my money, it was a struggle,” says Mashile.
The worst thing, according to Mashile, is that qualified people are the most vulnerable. They have a salary and qualify for loans.
“A friend of mine wanted to buy a home and she got an approval at 16%. The prime at the time was 10.25%. Banks have a target to reach but remember sometimes it can be at your expense.”
Mashile, a social entrepreneur and self-taught financial literacy educator, says the problem is people don’t learn how to handle money at a young age.
“Most of us grow up in homes where it is cool to be in debt and they perpetuate the idea that everyone is in debt and it’s easy to get loans. Even at the ATM, there are options you can click to get a quick loan. You also find many people who have never had money and all of a sudden, they start working and they have R25,000. Why would they not buy a car? The other issue is that people don’t prioritize. Our attitude towards debt is a problem, we wish it away,” says Mashile.
She says people have to talk openly about debt and money, ask questions before taking credit, read contacts, understand their financial situation and live within their means.
“If you can’t afford something, you can’t afford it. Don’t become a slave to debt. Also don’t agree to interest rates that are high. Remember the bank needs you more than you need it,” says Mashile.
The big picture is frightening.
Statistics from the National Credit Regulator (NCR) show that, in South Africa alone, about 25 million people have active credit records and 10 million are in severe arrears. In the 2015/2016 financial year, total consumer credit in the country amounted to R1.66 trillion ($125 billion), an increase of 2.94% year-on-year.
South Africa saw a shift when government introduced the National Credit Act (NCA), in June 2007, to open up credit to those who struggled to get it. It worked, but problem is, it also steered the country down a slippery slope of debt. South Africa is one of the most over-indebted consumer nations in the world.
“The designers of the NCA naively thought this credit would be spent on ‘wealth creating assets’. What has transpired over the last 10 years is that the increase in mortgages and use of credit in funding businesses has been relatively dismal, and the vast majority of the increase in credit has been in expensive unsecured credit that has been spent on consumption with the recipients having very little, if anything, to show for it at the end of the last 10 years,” says DebtBusters CEO Ian Wason.
Wason says approval rates, for borrowing, have slowly been falling and are currently around 50% with some credit providers having approval rates in single figures. The regulators believe credit shouldn’t be given to those who can’t afford it. What is happening is some credit providers look at their books of business and ignore the individual’s affordability to pay.
“A good example is the furniture sector which tends to have 50% non-performing loans and the difference is those who pay are charged high interest and fees thus in the end making the business profitable. What is deeply frustrating is that the NCR has the power to increase the minimum expenses threshold that the credit providers have to use, currently at around 9% and less, and it has not done so,” he says.
At first glance, South Africans look relatively financially healthy with the debt to income ratio at 74%, compared to the UK at 145%. The difference is, the bulk of this debt, in developed nations like the UK, is backed by bricks and mortar, through mortgages, typically at interest rates around 2% and, in South Africa, unsecured debt is the big boom in town.
“Nearly 50% of South Africans’ debt is in expensive unsecured credit over shorter terms. Of the consumers that approach DebtBusters for help, they are spending an average of 98% of their income on debt repayments,” says Wason.
The World Bank’s Global Findex database found that, between 2013 and 2014, 86% of South Africans borrowed money. According to the survey, which interviewed 150,000 people over the age of 15 from 140 different economies, sub-Saharan Africa had the highest number of borrowers at 54%, with 42% using family and friends as sources of new loans. It’s not always the consumer’s fault. Lack of financial literacy and unscrupulous credit providers are some of the causes of Africa’s personal debt problem.
African Bank was arguably one of South Africa’s notorious biggest lending banks. At its worst, in August 2014, the bank had a loan book of around R60 billion ($4.5 billion). According to the Myburgh Report, the bank was receiving 60 to 80 complaints of reckless lending a month, mostly from debt counsellors, and was granting between 100,000 and 120,000 loans monthly.
That’s not all.
Capitec Bank, founded by one of Africa’s richest people and FORBES AFRICA cover, Michiel Le Roux, recently found itself in the headlines when consumer watchdog, Summit Financial Partners, served the bank with High Court papers. It was about the banks former multi-loan practices which relied on one prime agreement that gave the consumer 12 different payday loans.
“Their product was most certainly illegal in that it was either reckless, because no proper affordability assessment was done, or charged initiation fees incorrectly… Unsecured credit in South Africa charges interest on a fixed rate basis, thereby not affecting the consumer when rates increase. However, interest, initiation and service fees on these payday loans mean the total cost of such multi-loans vary between 150% and 450% making prime rate adjustments immaterial. Capitec has been able to create a few billionaires sitting in Stellenbosch by charging such ludicrous rates on payday loans, since their inception, to the financially ignorant masses who don’t understand the consequences of such high yields. Further, we have many cases where Capitec actually prey on these ignorant, vulnerable groups to get stuck in debt spirals thereby relying on Capitec’s monthly payday loans to stay afloat,” says Clark Gardner, CEO at Summit Financial Partners.
There is more.
In March this year, the NCR announced that it had referred Wesbank, a division of FirstRand Bank, to the National Consumer Tribunal, for alleged breaches of the National Credit Act 34 of 2005, after an investigation found that Wesbank, through its debt collection agents, coaxed defaulting consumers into surrendering ownership of their motor vehicles.
“Consumers are reminded that a credit provider can only repossess a motor vehicle from the consumer if there is a court order authorizing the credit provider to do so,” says Jacqueline Peters, NCR’s Manager for Investigations and Enforcement.
Wesbank says it respects the NCR’s decision to refer the matter to the National Consumer Tribunal, however, disagrees with the conclusions.
“This referral does not constitute non-compliance with the National Credit Act but is instead a result of differing interpretation of the applicable legislation. WesBank has a strong commitment towards achieving fair treatment of our customers and will continue to cooperate with the National Credit Regulator and the National Consumer Tribunal,” it says in a statement.
Small credit providers are also guilty.
In September 2015, the National Consumer Tribunal cancelled the registration of credit provider, Mayibuye Cash Loans, following a lengthy investigation that found the company failed to conduct affordability assessments; to provide copies of pre-agreement statements and quotations; and charged interest and fees in excess of the prescribed rate.
It can destroy lives.
Maybe it’s time you get your head out of the sand.
‘You Can’t Borrow Your Way Out Of Debt’
The tale of an entrepreneur who saw money in the keys that free people from debt slavery.
Imagine working all your life and more than 98% of your income goes towards debt? Maybe it was that luxury car you knew you couldn’t really afford or that fateful day you said yes to a credit card?
Ten million people, in South Africa alone, plus millions more across the continent, are in severe debt according the National Credit Regulator. On the other side of the coin, smart entrepreneurs have seen a gap.
Neil Roets saw an opportunity to make money, from people without money, when the National Credit Act was introduced in 2007. At the time, he was in conveyancing where he saw the ravages of a tough recession and struggling economy.
“I experienced first-hand how people were struggling to pay their bills and couldn’t get loans. I realized people needed debt counselling so I did a course, and thereafter went on the quest to start Debt Rescue,” says Roets.
Debt Rescue makes a repayment plan, through budget advice and negotiation with credit providers, for reduced payments and the restructuring of debts.
The difficulty for the business was very few people knew about debt counselling.
“Coming out of a legal background, I understood the process but just getting the word out to people, so they know there is help out there, was the most difficult… because of the name, people sometimes think debt counselling is just sitting on a couch and talking but that’s not the case,” he says.
Another problem was people didn’t understand how debt counsellors make money from helping people who are already struggling to pay their bills.
“The fees are regulated and worked out based on what you can afford to pay your credit provider on a monthly basis. After we have worked out what your monthly instalment would be, the first instalment comes to us, and is capped at R6,000 ($450). We also have an aftercare fee of 5% of the amount that needs to go to the credit provider which is also capped at R400 ($30).”
Debt counselling is big business. Debt Rescue, alone, signs close to 1,000 clients a month and employs 110 people. Imagine how much debt that is? Roets feels a lot more people should be under debt review.
“The National Credit Regulator statistics show that 45% of all credit active consumers are over-indebted meaning that they are in areas with at least three payments on one of their accounts. That amounts to more than 9 million credit active consumers in South Africa that can benefit from debt counselling but currently there are close to about 300,000 people under debt review,” he says.
Many of these consumers are in a fix because credit providers are pushing unsecured credit.
“People are financing their lives, and even buying clothes and food, through credit. That’s very worrying because you should never finance your life through credit. If you can’t afford it, you can’t afford it. People forget that if you finance it now, you have to pay it back with interest meaning next month you will be in a worse situation. You can’t borrow your way out of debt,” says Roets.
There may be a business opportunity in the debt counselling industry but Roets warns it needs entrepreneurs of steel, who also understand legal processes.
“There are over 3,000 registered debt counsellors but you only really see the big five companies featuring all over. The process is not easy, you have to form relationships with the credit providers otherwise you won’t get a good deal for your client.”
Debt is not going to go away, in Africa, in the 21st century.
Did you know?
To qualify for debt counselling, you need to be over-indebted as defined by the National Credit Act – that is, you can’t repay your minimum monthly instalments. This is determined by a debt counsellor. While you are on debt review, you can’t take out further debt.
Tips To Avoid The Debt Trap
- Say no to a credit card
- Check your interest rates
- Don’t buy without a budget
- Look for best value when making purchases
- Don’t finance living expenses and luxury goods with credit
- Never take out a loan
- Have an emergency fund
- Pay bills on time
- Save and buy cash
- Always read your terms and conditions and understand your contract before signing on the dotted line
Daughter Of Debt
The life of a college graduate who grew up watching her mother pile up debt, and feels the pain 30 years later.
Debt reaches down through the generations. At just 30 years old, Luba Dube* has seen enough debt for three lifetimes. It all started when she was in primary school, when her parents separated.
“At first it was subtle. I remember on payday, my mom would buy us a lot of things and three days later we would be broke again… She would send us to go borrow small amounts like R50, or send us to return money she had borrowed,” she says.
When Dube went to high school, it got worse.
“My sister, at the time, had just started working and wasn’t making a lot of money but a lot of responsibility fell on her. I was a weekly boarder and she even had to pay R250 per week towards my boarding fees.”
Dube realized something was seriously wrong. Her mother never had money. She searched for a way out – there was none. Debt loomed ever larger.
“There were times we had to suddenly move because of unpaid rent… Whenever it was approaching the first of the month, I could see there was a lot of tension and stress in the house. We, as kids, would also get stressed because the landlord would come ask for rent and we would have to open the door when mom wasn’t home. Sometimes she would come home very late at night trying to dodge the landlord and we were the ones who had to answer,” she says.
Older sisters tried to help. They moved Dube’s mother to a cheaper house where she would use one bedroom, and have tenants in two others, so she could pay as little as R1,000 ($75) in rent. It didn’t help.
“Even though the tenants paid rent, she collected the money but it wasn’t going where it was supposed to. I realized that if the relationship with money doesn’t change, it doesn’t matter what we do to try and help.”
According to Dube, the worst thing was that her mother appeared desensitized to borrowing money that she never returned. Her children ended up more worried about the debt than she was.
“She would even borrow someone else’s rent money with the promise to return it, in time, knowing she might not be able to. I have not been able to understand her lack of respect for other people’s money,” says Dube.
In Dube’s view, when her over-indebted mother needs to get money, she tries to get it at all cost. One of the worst examples was when her mother spent close to a R100,000 ($7,500) of her client’s money. She was supposed to put the money in a trust so her client could buy a home. To make matters worse, this was money from a disability pay out.
“These were people’s livelihoods. We just had to do what we could to make sure the people got their money back. I had to borrow money I had no intention to borrow. For a good year, my stuff was on hold so I could pay that back.”
It wasn’t the first time Dube has bailed her mother out.
“Sometimes I have had to say ‘no’ because her relationship with money still hasn’t changed. When I was a kid there was nothing I could do but now, because I’m a grownup, I try to have these conversations with her but it’s very difficult because of the child/parent relationship,” she says.
So, if you are in debt up to your ears, it’s not only you who is suffering; just ask your daughter.
How Your Socks Can End Up Around Your Ankles
Sbusiso Ngwenya jumped for joy when he made the FORBES AFRICA 30 under 30 list with his money-making colourful socks. What you don’t know is that, last year, he lost it all in a dangerous dance with debt.
It all began, so innocently, with a golden opportunity to put his socks on the shelves.
“I was so excited when Stuttafords gave me the opportunity to list my products. I was so happy I signed the contract out of trust only to find that, by listing my products there, it means that I agree to only buying retail space… I signed a deal I didn’t understand that just emptied my pockets,” he says.
It cost a pretty penny to buy shelf space at Stuttafords, one of South Africa’s top retailers. Sock sales came to about R40,000 ($3,000) a month at best and a mere R2,000 ($150) or R1,000 ($75) at worst.
“There was also a big spend on making sure we market the products and drive traffic to the store. At the time, the store itself wasn’t doing well and less and less people were going there… it was tough but we tried to keep up appearances for it to seem like we are doing well,” says Ngwenya.
It was expensive. He started taking money from his corporate division, that distributes bulk unbranded socks, to finance Skinny Sbu Socks. The problem was he was also living a life of a rock star, traveling, partying and buying gifts for girls; all through the business account.
“Stuttafords was taking a big percentage of the money and all in all, in just a year, all these things cost me R800,000 ($60,000).”
The whole business suffered. He tried to take up speaking engagements to supplement the income. It didn’t help.
“I started borrowing money from friends and family just to survive. I lost my apartment, car and everything. I couldn’t afford the life I was living anymore and my debts kept piling.”
He moved back home, to Tsakane, a township east of Johannesburg, with his grandmother. It humbled him. It was time to start over.
“My sister went out of her way and took a huge personal loan to help me. My uncle also played a huge role in helping me. I needed someone who could look out for the numbers of the business so we didn’t mismanage the money,” says Ngwenya.
His uncle was what he needed. He helped him revive the dying business.
“We did a whole turn around to make sure we build up the business again. I am now very careful with every rand. It was a huge character-building experience that taught me not to rush into things and not to treat a business account as a personal account.”
Together with his uncle, they are also reassessing the business marketing strategy and ensuring Ngwenya concentrates on the creative design of the socks.
“I am happy this happened now rather than in 10 years when I have a family and larger responsibilities. Someone once said to me ‘you didn’t go to school to study what you are doing. This mistake was your school fees. You needed something that was going to wake you up’. Unfortunately I had to pay close to R1 million ($76,500) for my fees,” says Ngwenya.
Let’s hope he pulls up his socks.
Did You Know?
- If you default on your debts your credit provider can, and will, take legal action against you which will result in a judgement and can involve an emolument attachment order, or garnishee order as it is more commonly known, where the court can order your employer to deduct a payment from your salary every month to pay your debt.
- A default will stay on your credit record for six months, and sometimes up to 12 months. Judgements are on there for 30 years unless you repay the debt! If you do repay a judgement then it has to be removed from the bureaus within seven days.
- If you spend money you don’t have, on things you don’t need, to impress people you don’t even like, maybe it’s time to get help.
What does it mean to be HIV-undetectable or to have a suppressed viral load?
With medication and technology, science is increasingly improving the lives of people living with HIV and reducing new infections.
On August 8, 2018, a day before Women’s Day in South Africa, 23-year-old Saidy Brown observed six years of being on antiretroviral (ARV) treatment.
We meet Brown in her hotel room in Benoni in the East Rand in the South African Province of Gauteng.
She sits still, reflecting on her life after a long and busy day. She has just returned from a group meeting with other young HIV activists.
Her t-shirt is unapologetic and as loud as her activism. “HIV POSITIVE #TEST & TREAT,” it reads. In the dim light of her room, she recollects her dark journey to becoming an HIV activist.
Brown was diagnosed with HIV at birth. However, she only found out she had it at the age of 14.
Brown grew up in a small town called Itsoseng in the North West Province of South Africa. In June 2009, while attending a youth day event, Brown and some of her friends decided to get tested for free.
The eager teen received some pre-counselling from one of the nurses.
“I remember getting into that room and the lady asked me two questions, ‘what would you do if you find out that you are HIV negative’?”
“I would continue living,” Brown said.
“What will you do if you find out you are HIV positive?”
“I would go out there and educate people living with HIV,” she said to the nurse.
Brown tested positive. Her whole life changed in the space of five minutes.
“After she told me, the first thing I said was ‘how? I didn’t do anything, I am only 14’.”
While her friends were discussing their results, Brown broke the news to them. They were all surprised.
“I then told them ‘no, I’m kidding, I am negative’.”
Brown was ashamed and could not confide in anyone.
“I really wanted to go home and cry. Like, I didn’t even know where I got it from,” Brown says.
She was afraid of what her family, friends and community would think of her. For months, she kept it to herself. But the secret about her health was too overwhelming.
Later that year, Brown joined a drama club. They rehearsed for a play to be staged on World AIDS Day, on December 1. She played the daughter of a woman who was HIV positive.
Little did her peers know that Brown was actually telling her real life story. A few days later, conversations with Brown’s drama teacher got her to divulge her secret.
She later gathered up the courage to confide in her aunt. Her aunt then revealed that Brown’s late parents had indeed been HIV positive.
“I was angry at my aunt for not having tested me earlier on, I was angry at my parents for having died before me knowing, I was angry at God, I was just angry at everyone,” she says.
She turned to writing to cope. The first piece she wrote was titled An Open Letter To HIV.
“I will always remember this line because I paused there and I cried so much. There is a line where I said, ‘because of you I feel less pretty’.”
This marked the beginning of her activism. She shared the letter on social media and it reached thousands.
For 14 years, Brown had lived a healthy life with the disease without any treatment. Brown disclosed her status to close friends and received huge support.
It was only when she turned 18 that her health began to deteriorate. Hesitant to start treatment, Brown thought about the rumors she heard about the side-effects of ARV.
When she went for blood tests, she was told her CD4 count had dropped. According to experts, when the CD4 count drops below 200, a person is diagnosed with Acquired Immunodeficiency Syndrome (AIDS).
“I think that was when reality started kicking in that ‘you need to be on treatment’,” she says.
In 2012, she finally started ARV treatment. Since then, Brown has been living a healthy life
She uses her experience to encourage others living with HIV and to break the stigma. In June 2017, she recited An Open Letter To HIV at the eighth South African AIDS Conference addressing HIV/AIDS and gender-based violence.
She held governments and societies accountable.
The same year, she received the Red Ribbon Foundation Youth for Change HIV/AIDS Activist Award.
In 2018, she was recognized as one of the Mail & Guardian 200 Young South Africans, for her work as an activist.
Brown considers herself an “HIVictor” and reaches thousands on her social media platform spreading awareness about the disease.
“There is life after an HIV diagnosis,” Brown shared with her followers on Twitter.
Today, Brown is HIV-undetectable.
She has been virally suppressed for two years now.
According to a report by UNAIDS in 2018, being undetectable means that the virus is un-transmittable.
This means that people who are HIV positive with an undetectable viral load cannot transmit HIV sexually.
This was proven in 2017.
Dr Sindisiwe van Zyl is a clinician and general practitioner with a special interest in HIV and women’s health.
She also uses her social media to spread awareness on the disease.
“The aim of ARV treatment is to achieve an undetectable or suppressed viral load. What is the viral load? It is the number of HIV copies in the blood. HIV uses CD4 cells to make copies of itself. If one is taking ARV treatment, the efficacy of the treatment is proven by an undetectable viral load. You’re still living with HIV, but you’re taking the treatment so well that the virus cannot make copies of itself,” she tells FORBES AFRICA.
“The viral load blood test tells us when undetectable levels have been reached and it takes 12 to 24 weeks to achieve this,” Van Zyl says.
Three significant studies were done between 2007 and 2016 on sexual transmission of HIV among thousands of couples.
According to UNAIDS: “In those studies, there was not a single case of sexual transmission of HIV from a virally-suppressed person living with HIV to their HIV-negative partner.”
“For many people living with HIV, the news that they can no longer transmit HIV sexually is life-changing. In addition to being able to choose to have sex without a condom, many people living with HIV who are virally suppressed feel liberated from the stigma associated with living with the virus,” UNAIDS says.
However, the stigma still does exist.
A 28-year-old millennial, who requested not be named, tells FORBES AFRICA that she had never heard of what it means to ‘undetectable’.
When asked if she would be willing to have sexual relations with someone who was HIV positive but their viral load was undetectable, she says she is unsure.
“I would but I would be worried because mistakes happen. What if medical practitioners thought it was undetectable but they made a mistake and now my life is at risk,” she asks.
She is not alone in thinking this way.
From a quick social media search, it is evident many users are not well-informed about what an undetectable viral load means.
Some social media users who disclosed to be living with HIV said that even their own doctors had not informed them about what it meant to be ‘HIV undetectable’.
Through hashtags such as #UequalsU and #UndetectableEqualsUntransmittable, awareness around being ‘HIV undetectable’ has spread globally, giving freedom to many HIV positive people to share their status.
“[These are] the hashtags of the century, in my opinion! What does #UequalsU mean? If the viral load is undetectable, then one cannot transmit HIV!” Van Zyl says.
It is such activism that has contributed to the strides in HIV research.
A doctor from the Wits Donald Gordon Medical Centre in Johannesburg agrees.
“I think that’s what makes the HIV space unique. Those activists are crucial… When patients talk, they talk as if they don’t have a voice, but with the activists, they have a voice and they are taken seriously and I think that has also been one of the big drivers,” Dr June Fabian, a nephrologist and clinical researcher at the medical center, tells FORBES AFRICA.
Transplanting to save a life
Two years ago, doctors from the transplant unit at the Wits Donald Gordon Medical Centre performed what is believed to be the world’s first HIV positive liver transplant.
Currently, the center is the only transplant program doing transplants from one living person to another in southern Africa.
The liver of a mother living with HIV was transplanted into her critically-ill HIV negative child.
After the transplant, the child was monitored and the doctors were not able to find HIV within the child’s system.
The child had been on a waiting list for more than 180 days and was frequently admitted for life-threatening complications of end-stage liver disease.
Professor Jean Botha led the procedure.
He was approached by the child’s mother to consider using her as her baby’s donor.
“We have had a case where we proposed the idea but the mom said, ‘I cannot live thinking that I’ll give HIV to my child’, and she said ‘no’, and the baby died,” Fabian, who was a part of the team, says.
It was a very complex situation.
They reviewed the implications of the transplant, consulted with other experts and then spoke to the ethics committee at the University of the Witwatersrand (Wits).
“They came back and said, ‘if you are weighing up this child dying versus giving the child HIV then do it because, obviously, you want to prevent the child from dying’,” Fabian explains.
With the go-ahead, the team proceeded with the operations and assumed that the child would have the virus after the procedure.
But their assumptions were wrong.
“After the transplantation, we saw a seroconversion event. What that means is that the child became HIV positive,” Professor Caroline Tiemessen from the Wits School of Pathology and Centre for HIV and STIs, National Institute for Communicable Diseases, said in a report.
Soon after, they observed that the virus was no longer detectable. They then monitored the child’s antibodies and tested the viral load, however, she said it has remained undetectable since.
They have since not been able to trace the virus within the cells of the child.
“The liver is an immune organ so it’s the liver’s job to kill bugs… so I think in a way we might have struck it lucky with the liver. I don’t know if we can say what happened here is going to happen with a heart, a kidney or a lung,” Fabian says.
Despite not being able to detect the virus, the child was placed under ARV treatment.
Fabian says the only way to know for sure that there is no HIV in the child is if they completely stop treatment.
However, it would be a risk.
In 2017, a similar case was announced where a nine-year-old South African who had been diagnosed with HIV at a month old, received treatment, and then maintained remission after suppressing the virus for almost nine years without the treatment since 2008.
It has been more than a year since the liver transplant took place and both the mother and child are recovering well.
According to Fabian, they plan to continue doing more tests.
HIV Positive: The New Living Donor Pool?
At a time when South Africa is experiencing a shortage of organ donors, this may be a solution to the problem if people living with HIV may be able to donate organs.
In the early 2000s, Fabian’s work dealt with organ transplants and HIV before ARVs were created.
“We started seeing the disease untreated, and there was a lot of kidney disease so that was what sparked my interest and I started a study in the clinic with patients with HIV and kidney disease,” she says.
However, HIV patients back then were excluded from transplantation.
“We were basically throwing away organs from HIV-positive donors because we weren’t using them,” she says.
With a shortage of organ donors, Fabian says they lost 25 children on the waiting list.
According to an article by theSouthAfrican.com, there are around 4,300 people waiting for organ donations in South Africa in need of new livers, kidneys, lungs or hearts.
“The inclusion of HIV-infected people as living donors created the new living donor pool,” say experts from the Wits Donald Gordon Medical Centre.
This means that people like Brown who have been living with an undetectable viral load could be eligible as donors after tests have been done.
As for whether or not HIV-positive patients could potentially become blood donors, more work needs to be done in that field.
At the moment, Fabian does not think it is possible.
“I don’t know if you would put someone on life-long antiretroviral for a blood transfusion. I don’t think the benefit outweighs the risk when you can source blood from non-infected donors and the person isn’t going to die if they don’t get the transfusion,” Fabian says.
The evolution of ARVs
The first ARV treatment trial happened in the 1990s and in 2004, South Africa first rolled out its ARV program to people living with HIV.
ARV treatment has gone from taking several tablets a day to one pill daily.
Now, patients, particularly in South Africa, can receive free treatment.
According to a report on HIV and AIDS financing by the South African Health Review, South Africa has the largest number of persons living with HIV and on ARV-treatment in the world, with this figure scaling up by approximately 400,000 persons per annum.
UNAIDS estimates there are 20% of people on ARV therapy globally.
HIV-related deaths have been decreasing as the number of people receiving ARVs is growing.
In 2008, the death rate was about 220,000 to 260,000 in South Africa.
In 2016, estimates between 96,000 to 140,000 of AIDS-related deaths in the country were reported.
“I think what is underappreciated is how much people’s lives have changed with ARVs and with access to ARVs and how much the science and the funding with ARVs has driven it from being a very complicated regimen to one tablet a day,” Fabian says.
And now, access to obtaining ARVs has become easier and they are getting smaller.
“The tablet is getting smaller and smaller, which is great for storage, great for carrying, makes it cheaper, it’s also easier to swallow,” says Professor Francois Venter, the Deputy Executive Director at the Wits Reproductive Health and HIV Institute.
Last year, South Africa saw the introduction of an ATM which uses electronic and robotic technology to dispense medication.
This allows patients to collect medication without having to queue at hospitals.
On the continent, clinical trials of injectable ARV drugs are currently underway.
This is part of a large-scale trial that will be conducted in six other countries –Kenya, Malawi, Botswana, Zimbabwe, Uganda and Swaziland.
According to a news report in The East African, the aim of the study is to introduce an injection once every two months.
“They are starting to work on a new implant. It is very early days but it is very, very exciting. So instead of taking your ARVs you just get an implant every year,” Venter says.
“ARVs are looking more and more like hormonal contraception … It is like having several choices.”
He predicts that they will become available in the next five to 10 years.
Other new developments include the HIV vaccine trial (please read more on pages 44-47).
As HIV research grows rapidly, Fabian says that other chronic disease studies can gain from its developments.
“If you look at how we manage TB [tuberculosis], there is very little progress that has been anywhere as rapid as HIV, in terms of making treatment accessible and simple for people,” Fabian says.
Venter agrees: “The funny thing is people with HIV are now living longer than the general population in certain spaces.”
A study in the United States found this to be true.
In 2014, an estimated 45% of those HIV-infected were older than 50, amounting to 428,724 people, while 27% were older than 55 and 6% were 65 and older, according to the Centers for Disease Control and Prevention.
However, more work still needs to be done in this regard.
Venter says that technology has significantly aided HIV research.
“There are new ways to measure HIV which are getting more available and the price is coming down,” he says.
“There are also new ways for testing for HIV which are very exciting.”
“Because the cost of antiretrovirals has gone down so dramatically, HIV is actually relatively cheap to treat, compared to diabetes,” he says.
“It also keeps people away from the medical system which is very expensive,” he adds.
Despite the great strides taken to improve HIV treatment, a cure is still nowhere to be found.
“I think we are getting closer [to a cure] with vaccines,” Fabian says, hopeful.
Venter, on the other hand, believes we are still far from discovering a cure.
“I am not particularly hopeful because I think the scientific challenges of it are so hard that I am not sure it is going to be possible, but I hope I am wrong,” Venter says.
He says that there have been large amounts of money diverted to looking for a cure and that we are learning more about the immune system.
“Even if we may not find a cure, we are going to learn a lot about vaccines and the complexity of the human body,” he says.
For now, the importance of spreading awareness is still essential. Activists like Brown and Van Zyl can attest to that.
The world has gone from a deadly epidemic, to undetectable victories and vaccines in three decades.
We are witnesses to history in the making. Where will you be when a cure is found?
Software Pirates Use Apple Tech To Put Hacked Apps On iPhones
Software pirates have hijacked technology designed by Apple Inc to distribute hacked versions of Spotify, Angry Birds, Pokemon Go, Minecraft and other popular apps on iPhones.
Illicit software distributors such as TutuApp, Panda Helper, AppValley and TweakBox have found ways to use digital certificates to get access to a program Apple introduced to let corporations distribute business apps to their employees without going through Apple’s tightly controlled App Store.
Using so-called enterprise developer certificates, these pirate operations are providing modified versions of popular apps to consumers, enabling them to stream music without ads and to circumvent fees and rules in games, depriving Apple and legitimate app makers of revenue.
By doing so, the pirate app distributors are violating the rules of Apple’s developer programs, which only allow apps to be distributed to the general public through the App Store. Downloading modified versions violates the terms of service of almost all major apps.
TutuApp, Panda Helper, AppValley and TweakBox did not respond to multiple requests for comment.
Apple has no way of tracking the real-time distribution of these certificates, or the spread of improperly modified apps on its phones, but it can cancel the certificates if it finds misuse.
“Developers that abuse our enterprise certificates are in violation of the Apple Developer Enterprise Program Agreement and will have their certificates terminated, and if appropriate, they will be removed from our Developer Program completely,” an Apple spokesperson told Reuters. “We are continuously evaluating the cases of misuse and are prepared to take immediate action.”
After Reuters initially contacted Apple for comment last week, some of the pirates were banned from the system, but within days they were using different certificates and were operational again.
“There’s nothing stopping these companies from doing this again from another team, another developer account,” said Amine Hambaba, head of security at software firm Shape Security.
Apple confirmed a media report on Wednesday that it would require two-factor authentication – using a code sent to a phone as well as a password – to log into all developer accounts by the end of this month, which could help prevent certificate misuse.
Major app makers Spotify Technology SA, Rovio Entertainment Oyj and Niantic Inc have begun to fight back.
Spotify declined to comment on the matter of modified apps, but the streaming music provider did say earlier this month that its new terms of service would crack down on users who are “creating or distributing tools designed to block advertisements” on its service.
Rovio, the maker of Angry Birds mobile games, said it actively works with partners to address infringement “for the benefit of both our player community and Rovio as a business.”
Niantic, which makes Pokemon Go, said players who use pirated apps that enable cheating on its game are regularly banned for violating its terms of service. Microsoft Corp, which owns the creative building game Minecraft, declined to comment.
SIPHONING OFF REVENUE
It is unclear how much revenue the pirate distributors are siphoning away from Apple and legitimate app makers.
TutuApp offers a free version of Minecraft, which costs $6.99 in Apple’s App Store. AppValley offers a version of Spotify’s free streaming music service with the advertisements stripped away.
The distributors make money by charging $13 or more per year for subscriptions to what they calls “VIP” versions of their services, which they say are more stable than the free versions. It is impossible to know how many users buy such subscriptions, but the pirate distributors combined have more than 600,000 followers on Twitter.
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Security researchers have long warned about the misuse of enterprise developer certificates, which act as digital keys that tell an iPhone a piece of software downloaded from the internet can be trusted and opened. They are the centerpiece of Apple’s program for corporate apps and enable consumers to install apps onto iPhones without Apple’s knowledge.
Apple last month briefly banned Facebook Inc and Alphabet Inc from using enterprise certificates after they used them to distribute data-gathering apps to consumers.
The distributors of pirated apps seen by Reuters are using certificates obtained in the name of legitimate businesses, although it is unclear how. Several pirates have impersonated a subsidiary of China Mobile Ltd. China Mobile did not respond to requests for comment.
Tech news website TechCrunch earlier this week reported that certificate abuse also enabled the distribution of apps for pornography and gambling, both of which are banned from the App Store.
Since the App Store debuted in 2008, Apple has sought to portray the iPhone as safer than rival Android devices because Apple reviews and approves all apps distributed to the devices.
Early on, hackers “jailbroke” iPhones by modifying their software to evade Apple’s controls, but that process voided the iPhone’s warranty and scared off many casual users. The misuse of the enterprise certificates seen by Reuters does not rely on jailbreaking and can be used on unmodified iPhones. -Reuters
-Stephen Nellis and Paresh Dave
Earth’s Earliest Mobile Organisms Lived 2.1 Billion Years Ago
Scientists have discovered in 2.1-billion-year-old black shale from a quarry in Gabon the earliest evidence of a revolutionary development in the history of life on Earth, the ability of organisms to move from one place to another on their own.
The researchers on Monday described exquisitely preserved fossils of small tubular structures created when unknown organisms moved through soft mud in search of food in a calm and shallow marine ecosystem. The fossils dated back to a time when Earth was oxygen-rich and boasted conditions conducive to simple cellular life evolving more complexity, they said.
Life emerged in Earth’s seas as single-celled bacterial organisms perhaps 4 billion years ago, but the earliest life forms lacked the ability to move independently, called motility. The Gabon fossils are roughly 1.5 billion years older than the previous earliest evidence of motility and appearance of animal life.
The Gabonese shale deposits have been a treasure trove, also containing fossils of the oldest-known multicellular organisms.
“What matters here is their astonishing complexity and diversity in shape and size, and likely in terms of metabolic, developmental and behavioral patterns, including the just-discovered earliest evidence of motility, at least for certain among them,” said paleobiogeochemist and sedimentologist Abderrazak El Albani of the University of Poitiers in France.
The identity of these pioneering mobile organisms remains mysterious. The fossils did not include the organisms themselves.
The tubular structures, up to 6.7 inches (170 mm long), originally were made of organic matter, perhaps mucus strands left by organisms moving through mud.
The researchers said the structures may have been created by a multicellular organism or an aggregation of single-celled organisms akin to the slug-like organism formed when certain amoebas cluster together in lean times to move collectively to find a more hospitable environment.
“Life during the so-called Paleoproterozoic Era, 2.5 to 1.6 billion years ago, was not only bacterial, but more complex organisms had emerged at some point, likely only during some phases and under certain environmental circumstances,” El Albani said.
In comparison, the first vertebrates appeared about 525 million years ago, dinosaurs about 230 million years ago and Homo sapiens about 300,000 years ago.
The evolutionary experimentation with motility may have encountered a setback relatively soon after the Gabon organisms lived because of a dramatic drop in atmospheric oxygen 2.08 billion years ago.
The research was published in the Proceedings of the National Academy of Sciences. -Reuters
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