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The Complex And Contentious Land Reform

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South Africa’s land expropriation debate continues to roil everyone from farmers to foreign investors and financial institutions. What has the government done to address land reform?  

It’s a five-hour drive from Johannesburg to Smithfield in the Free State province of South Africa. As we arrive, the sun is shining its warm golden hue over 1,200 hectares of Eddie Prinsloo’s land. As we drive on the long dirt road towards the farm house, the smell of manure hangs thickly in the air. On the right is a beautiful view of the mountains towards Lesotho. It is quiet and peaceful here but debates about white-owned farms are getting louder and louder.

The issue of land in South Africa is big. Many black South Africans were pushed off commercial farms and even denied opportunities to own land during white colonial rule. In a democratic South Africa, it has caused heated debates around dinner tables, in political party headquarters, and parliament and even had United States President, Donald Trump, tweeting. It has also given birth to opposition political parties like Julius Malema’s Economic Freedom Fighters (EFF) and Andile Mngxitama’s Black First Land First (BLF).

Most black South Africans say they want land. The African National Congress (ANC) government agrees. It wants to change the Constitution to make it possible to take land from white farmers and give it back to black South Africans. It is calling it expropriation of land without compensation.

“The ANC will, through a parliamentary process, finalize a proposed amendment to the Constitution that outlines more clearly the conditions under which expropriation of land without compensation can be effected. The intention of this proposal is to promote redress, advance economic development, increase agricultural production and food security,” said South Africa’s President, Cyril Ramaphosa after the ruling party’s two-day National Executive Committee (NEC) Lekgotla in South Africa’s capital, Tshwane.

This news sent shivers down the spines of farmers, banks and some investors. The government is however adamant expropriation without compensation should happen to give opportunities to the blacks who had land unjustly taken from them.

Prinsloo, a white man who started sheep farming in 1974 when he inherited the farm from his father, says he is one of the few farmers already trying to empower blacks. We meet him in his thatched office. Awards and photographs of sheep hang on the wall.

Two years ago, he asked the government to buy one of his four farms on condition it will give it to his nine workers.

“In 1994, I wanted to give my people a farm because they sell a lot especially to the Lesotho people. That is their part of the business… In 2016, I offered the 1,500-hectare farm to the government on condition that my workers will be the new owners and they get title deeds,” says Prinsloo.

The process took two years. It worked. Currently, the farmworkers have 49% shareholding in the farm, while Prinsloo retains 51%.

“I will help them by training them on the business side of farming and letting them use my equipment for their sheep. Black farmers are good farmers, they do all the work but they don’t know about accounting and other stuff but these things can be taught. I want them to know every aspect of this business so that they are able to run their own farms,” says Prinsloo.

According to Prinsloo, who is fourth generation South African, the longest-serving workers will get more shares to the farm compared to newcomers.

“The government was very supportive. It just took too long and I almost sold the farm to another farmer who wanted to do this with my employees.”

Asked about his views on Ramaphosa’s plan for expropriation of land without compensation, Prinsloo does not appear worried.

“It has never scared me. I believe that before the elections, [the ANC] makes a lot of scary announcements but I have never been scared. I think it will just go on as we farm now. I don’t think it’s fair to expropriate land without compensation. Seventy five percent of all black people want to become a part of agriculture but only one percent wants to farm,” he says.

Prinsloo says his fear is that when people get things without paying for them, they would not value or look after them.

“The government must now give the black people who want farms a low interest rate so they can be able to buy land. In the old days, there was Agri bank. It helped poor farmers who couldn’t get a loan from the land bank. The government must bring it back.”

Prinsloo however says he is against farmers who have land here but are living overseas leaving the land unattended.

“Those farms should be taken and given to black people, like my staff members, who deserve it.”

Palesa Phantsi is one of Prinsloo’s workers set to benefit from this deal with the government. She has worked as a maid for Prinsloo since January 2012.

“I am so happy that I am getting land. I never thought this would ever happen in my life. Now, I will grow and be able to do many things I couldn’t do before,” says Phantsi.

Lebogang Phomane is another employee set to benefit from this initiative. He walks us around the sheep kraal showing us what his day-to-day work with sheep entails. He has worked for Prinsloo for 30 years and knows most of the work except the administrative side.

Lebogang Phomane. Photo by Motlabanna Monakgotla.

“I am so happy because a lot of farmers don’t do this kind of thing. When he started talking about it two years ago, I didn’t believe him. Now he is helping us create our own legacy. I stopped going to school in grade nine so this is going to be life-changing,” says Phomane.

Prinsloo says he will train these soon-to-be land owners on the business side of sheep farming and even help them with equipment and a place to sell their sheep or wool.

This initiative has won him a lot of support but also criticism. One of those against his actions is BLF, a South African political party founded in 2015.

“This is a scheme by whites to hide the fact that the likes of Prinsloo gets paid for stolen land. There is no prescription for historical land theft – and the white Prinsloo still benefited by selling the stolen land. This is a clear indication of the impunity with which whites continue to act – they will never return land without receiving payment,” says Free State Chairperson Luyolo Busakwe.

Millions of people lost land during colonisation in South Africa.

According to Professor Ruth Hall, from the University of the Western Cape’s Institute for Poverty, Land and Agrarian Studies, between 1984 and end 1993, 1,832,000 blacks were displaced from commercial farms and 737,000 were evicted from farms.

Professor Ruth Hall.

The numbers get worse. From 1994 to the end of 2004, 2,351,000 people were displaced from farms and 942,000 were evicted. After attaining democracy, the government started a land reform initiative to give land to those who had lost it. Some of the displaced were placed in other farms but 3,716,000 were permanently displaced and 1,586,000 permanently evicted.

In the Free State, where Prinsloo lives, there hasn’t been a lot of land redistribution. It is number three from the bottom on the list of land distribution numbers across South Africa’s nine provinces. Only about 400,000 hectares of land have been redistributed here. For some of those who received land, it ushered in years of court proceedings, pain, fear and poverty.

In QwaQwa, a part of the Free State province, 560 kilometers from Prinsloo in Smithfield, is Mmabatho Mphuthi. She is in the autumn of her life but spends her days moving from court to court trying to fight for her farm.

Mmabatho Mphuthi. Photo by Motlabanna Monakgotla.

We meet her as the sun sinks behind the rugged mountains. Mphuthi says she fears dying without ever being able to make good money from her farm.

She was given land by the government in 1994 under the land reform program.

“The ANC said if you have 15 members, they would give you land. I organized people who were willing to join me and in total we are 17. We went to government and they gave us a big farm which was divided among us to work as small holder farmers,” recalls Mputhi.

Mputhi, and the other small holder farmers, moved into the farm on December 16, 1997. They were given title deeds to the land and were trained by the department of agriculture on how to farm and sell. They also learned how to supply milk to big dairies around the province.

“I was so happy because finally, after so many years of struggle under the white rule, we had our land back and could earn a living,” she says.

Trouble came when a white farmer moved into their property.

“One day in the year 2000, I was busy with my own work and saw trucks come in. A white man was moving into the other end of our farm. He said the department of rural development had given him a lease on the property. I don’t know how that happened because I had the title deeds to the farm and we are the rightful owners.”

Mphuthi says she tried and failed to get help from all departments in the area.

“At first, I was told that he was coming to help us while we were being educated on how to farm but that never happened. Instead, he came in and terrorized us. He closed us off from the areas around the farm that we needed… Everything we farm gets destroyed by the rain because we don’t have access to the equipped area of the farm,” she says, as tears roll down her wrinkled face.

“How can you lease someone a farm that belongs to someone else? That is wrong. I am the one getting bills for services and taxes but I can’t farm or use the land because someone else has taken it over,” she says.

Mphuthi says her efforts to seek help have been futile.

“I have paid agents thousands of rands over the years to get help and get a lawyer for this to be fixed but each time, the case gets postponed. When I go to the police, they tell me to go to the public protector but no one responds. He even got a protection order that prevents me from going to that part of the farm yet I have the title deeds of the land in my hand and it seems there is nothing I can do about it.”

Mismanagement, like this, of the redistribution processes is one of the big apprehensions.

“Over the years, the government has failed to effectively redistribute land to blacks and now they want to change the Constitution yet they have failed to use the Constitution they already have. First, government must clean out corruption and then understand what land it owns, what land has already been redistributed and iron out any ongoing cases on redistributed land before trying to change the Constitution,” says Mphuthi.

That is exactly what the government has been trying to do.

According to Professor Hall, South Africa has 122 million hectares of land and 86 million hectares of that is private commercial agricultural land. That is 67% of the land in the country held by white South Africans.

Another problem is, since 1994, the government has only redistributed 9.7% of commercial farmland to blacks under the land reform program.

“For many South Africans, this pace is too slow. There is frustration because not much land reform has happened. Land reform can and should be made to work. There is a huge demand for small holdings by black emerging farmers. To meet the demand for land, will mean the need to acquire land held by private owners,” says Hall.

It is true. During the ruling party’s public hearings on the matter, many blacks indicated they wanted land. The government says it now wants to make sure this happens faster and more effectively than it has in the past.

“We want to now work on providing greater clarity on how expropriation without compensation can be effected. The proposal (to amend the Constitution) is informed by the views of our people that have been expressed in the public hearings that have been taking place,” said President Ramaphosa in Parliament.

Currently, Section 25 of the South African Constitution allows for expropriation without compensation but says there should be an equitable balance between public interest and those affected. Ramaphosa says he has appointed an inter-ministerial committee on land reform led by the deputy president to work on clarifying how expropriation will take place and under what circumstances.

“The acceleration of land redistribution is necessary not only to redress a grave historical injustice but also to bring more producers into the agricultural sector and to make more land available for cultivation,” says Ramaphosa.

Hall is however of the opinion that the problem is not the Constitution but the failure to use the Constitution as expropriation is already allowed by the Constitution.

“This can be justified in many cases, for example, when state expropriates land, when it wants to build roads or other public infrastructure. Expropriation isn’t new. What is new is the idea that the state will take property without paying compensation. This is not likely to happen in the majority of cases. We may only see it in cases where the state can justify why there is no compensation,” says Hall.

According to Hall, the kinds of cases that would require expropriation without compensation for example would be an abandoned city building, land left unoccupied and unoccupied land where informal settlements have grown in that property.

“There are a small number of landowners who have absolutely not been using their land, who may lose out in the process of land expropriation without compensation. My view is that they are very few in number and I have no doubt they will contest each case in court,” she says.

There is also a question of motive on behalf of the ANC.

Dumisani Nyembe, an ordinary South African who wants land to farm crops, says he thinks the ruling party is only doing this now because of the upcoming 2019 elections.

“I wonder why the ANC hasn’t been doing this for the past two decades. They can see that EFF is gaining a lot of traction because they are the most vocal about the land issue and all of a sudden they are promising us land expropriation without compensation. Whatever they are trying to do is EFF policy and not ANC policy. I don’t trust them a bit and I wouldn’t be surprised if this amendment of the Constitution isn’t passed come elections,” he says.

According to Hall, another problem is money.

“The land reform process is being hampered by corruption and mismanagement. If we sort out those problems, there will be funds to provide basic support to the new farmers being given access to farmland. The land reform budget has always been a very small part of the total fiscus. Right now, the land reform budget is at 0.4% of the total budget. If money is spent well and appropriately, funding would be available,” she says.

Sheep farming in South Africa is part of the country’s R132 billion agriculture industry. Demands are growing for radical land reform to redress dispossession during apartheid. Photo by Motlabanna Monakgotla.

Ramaphosa however reiterates in most conversations about land expropriation that the intention of the proposed amendment is to strengthen the property rights of all South Africans and to provide certainty to those who own land, to those who need land to those who are considering investing in the country.

The ANC will need a two-thirds majority in parliament to be able to amend the Constitution.

“I don’t think this will be hard to get because if they join forces with the EFF, this amendment can be passed. The EFF can’t be seen going against this because it has been their main message since foundation,” says Nyembe.

Hall, however, insists that even when passed, expropriation without compensation is most likely not going to be the norm but likely applied selectively on a case-by-case basis and the courts will review every case.

Even if that is the case, another big fear with this amendment is the potential loss of Foreign Direct Investment (FDI) into the country.

According to David Nathanson, a global equity specialist at Bellwood Capital, investors are concerned.

“South African investors are really over-invested in South Africa and they are worried about many things in the country such as our debt situation, how we are very close to junk rating and the talk of expropriation without compensation. They are concerned about property rights where they are invested,” he says.

Although Nathanson says he doesn’t think investors think their houses will be confiscated in the short-term, they are worried because the country is dependent on foreign investment and when the government talks about land expropriation without compensation, it will make it more difficult to get foreign investment which will make it even more difficult to fix South Africa’s problems.

“We could see the weakening of the rand in the long-term and South Africa could find itself in a situation where it is unable to meet its obligations and we could have a crisis like a Brazil or Argentina,” he says.

South Africa is already in technical recession following two consecutive quarters of negative growth.

“The government doesn’t have a lot of flexibility to be spending money on anything other than the necessities. Things like the National Health Insurance (NHI) and other noble policies that the government is trying to implement; the question is where will the money come from? If they expropriate land, they will need to assist the farmers and maybe give some sort of guarantees to banks…We don’t know the depths of what kind of money could be required to do that but the government probably won’t afford it. We are struggling to manage our public wage bill, so it would be difficult,” says Nathanson.

Ian Matthews, Head of Business Development at Bravura, an independent investment banking firm specializing in corporate finance and structured solutions, has similar views to Nathanson. He says an uncertain regulatory landscape cannot hope to instil confidence in foreign investors. The main concern, he says, has been whether foreign investment assets could be expropriated without compensation.

According to Matthews, in this climate, there is every possibility that direct foreign investment could contract significantly.

Prior to 2018, South African Reserve Bank (SARB) statistics had shown that FDI into South Africa declined from R76 billion in 2008 to just R17.6 billion in 2017 and a UN report, Global Investment Trends Monitor indicates that in 2015, FDI into South Africa fell by 74% to $1.5 billion.

According to Matthews, banks are the biggest source of credit for farmers at 61% and about R148 billion outstanding in loans for agricultural land and R1.6 trillion in property.

“Initially playing down the risk of expropriation of property without compensation, South Africa’s banks have since proposed a fund to help accelerate land transformation. Although no amount has been suggested for the fund, the proposal signifies the banks’ intention of seeking practical solutions to protect the billions of rands in assets that are tied up in farm loans,” he says.

South African banks are worried.

Taking the same view as Hall, according to Nedbank Group, one of South Africa’s commercial banks, the government has not used its existing powers to expropriate land for land reform purposes effectively, nor has it used the provisions in the Constitution that allow compensation to be below market value in particular circumstances.

“Changing [the Constitution] would send a very strange and damaging signal to our people and potential investors. It is our view that the acquisition of land and the current Constitutional provisions have not been a key obstacle to land reform so far and that an amendment to Section 25 of the Constitution would offer little in the way of sustainable solutions in the future,” says the bank in its written submission at the Public Hearings on the review of Section 25 of the Constitution.

It says the key challenges are lack of effective implementation of current powers, lack of capacity, lack of resource allocation and lack of proper and structured support for new land owners.

“As a commercial bank, we are a key role player in funding the economy and any material impact to property prices would adversely affect confidence in the banking system and could trigger a classic banking crisis with significant negative knock-on effects on the economy,” said Nedbank CEO Mike Brown, speaking to the Constitutional Review Committee, which is investigating proposed changes to the Constitution.

Cas Coovadia, Managing Director of the Banking Association of South Africa, says there are better ways of expropriating land for blacks.

“To expropriate land with compensation without ensuring that we have the funds to support those who get the land in the way that fulfils the commitment of the president that it will not threaten food security and agricultural production is going to be a challenge,” he says.

Coovadia says the banks made it clear that the critical thing for the country right now is to get investments and create growth.

“We have been engaging government through the department of land and rural development for the past five years. We have presented projects and initiatives, we think, through a public-private partnership between the banking sector, agricultural sector, and government, can ensure people get land in a sustainable way and get commercial farmers involved to offer support,” he says.

The trick is, according to Coovadia, releasing land owned by the state first and giving it to the people.

“This is a problem that needs to be dealt with but it should be handled carefully… We don’t even know how much land is owned by who and where. We need a land audit to understand these issues. We don’t have enough issues or data on land to understand how exactly to deal with it. We need to stop pretending that having an amendment of Section 25 is going to fix our land reform issues,” he says.

On the other hand, the EFF has welcomed the government’s plans to expropriate land.

“The ANC president Cyril Ramaphosa has finally capitulated and submitted to the basic logic of amending Section 25 of South Africa’s Constitution to allow for expropriation of land without compensation,” said spokesperson Mbuyiseni Ndlozi in a statement after Ramaphosa’s announcement.

“The resolute submissions of the people on the ground and in all the public hearings exposed the ANC to the fact that an absolute majority of black people agree with the EFF’s steadfast and consistent position that the Constitution should be amended to allow for expropriation of land without compensation. This illustrates that when given an opportunity, the people of South Africa are always ready to provide resolute guidance on key economic and redress questions,” he says.

Until the motion is brought to a vote in parliament, the land expropriation debate lives on.

Risks of amending the Constitution, according to Nedbank

Any changes to the Constitution, however well-intentioned, would send a negative signal to potential investors and be seen as a risk to future property rights. Should this happen, according to Nedbank at the Public Hearings on the review of Section 25 of the Constitution:
• Fixed investment spending and job creation would suffer
• Borrowing costs could rise at a time that the country – and government – could ill-afford
• Growth would remain below potential

In the unlikely event of a poorly-implemented land reform program, carried out exclusively or largely through Expropriation Without Compensation, the effects would be more structural and significant:
• Property prices would plummet along with other asset prices
• There would be large-scale defaults, with little or no collateral for the banks to offset losses
• Government may have to step in to protect depositors’ funds in the event of a banking crisis
• Borrowing costs generally would soar
• The economy would be severely depressed and unemployment would rise even further
• Food security would be impaired and food prices would increase

Focus

What does it mean to be HIV-undetectable or to have a suppressed viral load?

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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.


Saidy Brown’s t-shirt is unapologetic and as loud as her activism. “HIV POSITIVE #TEST & TREAT,” it reads. Picture: Karen Mwendera

“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).

READ MORE |The Fight for Rights: Five Gains and Five Losses for Women in 2018

“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.

HIV-Undetectable

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.

Dr Sindisiwe van Zyl. Picture: Supplied

“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.

Dr June Fabian. Picture: Supplied

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.

Professor Francois Venter. Picture:Supplied

“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?

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Software Pirates Use Apple Tech To Put Hacked Apps On iPhones

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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.

Electronic Arts’ new game challenges Fortnite

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

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Earth’s Earliest Mobile Organisms Lived 2.1 Billion Years Ago

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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

-Will Dunham

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