Improving the efficiency of monitoring adherence to antiretroviral therapy at primary health care level: a case study of the introduction of electronic technologies in Guguletu,South Africa

This paper presents a case study of the efficiency gains resulting from the introduction of electronic technologies to monitor and support adherence to highly active antiretroviral therapy (HAART) in Guguletu, South Africa. It suggests that the rollout of HAART to such resource-poor communities can be assisted significantly by the introduction of modified cellphones (to provide home based support to people on HAART and improve the management of adherence data) and simple bar-coding and scanning equipment (to manage drug supplies). The cellphones have improved the management of information, and simplified the working lives of therapeutic counsellors, thereby enabling them to spend less time on administration and to devote a constant amount of time per patient even though their case loads have risen threefold. It has helped integrate the local-level primary health service provision of HAART with the kind of centralised data capture and analysis that could potentially support a national HAART rollout.     

'Don't owe,won't pay!': A critical analysis of the Jubilee SA position on South African government debt

Jubilee 2000 (SA) supports the cancellation of South African national government (and other) debt on the grounds that it is odious debt from the apartheid years. The organisation has called for foreign creditors to cancel the debt voluntarily and has threatened to call for debt repudiation if such cancellation is not forthcoming. However, unlike voluntary debt cancellation, debt repudiation would probably have serious consequences for investment and growth. Furthermore, as most government debt has accumulated after the end of apartheid, and as most is domestic and marketable, the moral argument for repudiation is problematic. Jubilee 2000 (SA) is also calling for the government pension scheme (which owns a large proportion of the domestic government debt) to be restructured. Contributions to the pension fund may be excessive (as argued by Jubilee 2000), but the case is not clear. South Africa should publish a dual set of accounts in line with how other countries report their liabilities so as not to overstate the deficit in the eyes of investors.     

Differentiation in Economic Costs and Returns from Living with Wildlife in Namibian Community Conservancies

There is substantial differentiation across Namibian community conservancies in the costs and returns from living with wildlife. Real returns rose between 1998 and 2017, albeit unevenly. Those bordering national parks, and with higher game counts, earned more. Large livestock predators (lion, leopard, hyaena, cheetah, wild dog) had the greatest impact on human–wildlife conflict costs across all regions. As of 2017, more than a fifth of conservancies had higher estimated costs than economic returns from hunting and tourism. More resources are required to support Namibian conservancies if this is to be a sustainable model, especially as coronavirus limits international travel.     

Pro-poor birth coverage and child health in Africa

This paper explores which African countries had relatively low rates of underweight children and relatively high birth coverage (percentage of births with a skilled attendant) in the poorest quintile. Swaziland and Rwanda emerged as relatively ‘pro-poor’ in that both measures were more than one standard deviation better than predicted by GDP per capita. Unlike Swaziland, Rwanda’s status as an outlier was eliminated in regressions controlling also for urbanisation, medical professionals per 1000 people and health spending, suggesting that its pro-poor outcomes were related to these factors. AIDS funding may have helped Swaziland provide primary health care to the poor, but its high birth coverage preceded the HIV epidemic. Although relatively pro-poor in international terms, Swaziland and Rwanda emerged as relatively unequal by the CIX measure of health inequality with regard to percentage of underweight children across quintiles. It is important not to conflate relatively equal with relatively pro-poor health outcomes.     

A South African Variety of Capitalism?

This paper explores the South African political economy through the lens of a variety of capitalism (VoC) approach. It argues that attempts were made in the early post-apartheid period to forge a more social-democratic and co-ordinated variety of capitalism, but that this floundered as the government adopted neoliberal macroeconomic policies against the wishes of organised labour, and as black economic empowerment policies further undermined an already racially-fraught business sector. Organised labour was able to push for, and maintain, protective labour market policies – but this came at the cost of growing policy inconsistency notably with regard to trade liberalisation which, in the presence of growing labour-market protection, has exacerbated South Africa's unemployment crisis. Unemployment remains intractable (and with it inequality) and corruption/patrimonialism appears to be a growing problem.     

Unemployment and aids: the social‐democratic challenge for South Africa

Addressing Aids and unemployment is one of the greatest challenges facing South Africa at present. Health and welfare interventions will be costly and are likely to meet with resistance from taxpayers. Expanding employment (which will help alleviate poverty and expand the pool of taxpayers) is thus necessary. An inclusive social accord could help, but only if organised labour is prepared to make concessions, as was the case in the new social accords in Australia, Ireland and the Netherlands.     

Wage Strategies and Minimum Wages in Decentralized Regions: the Case of the Clothing Industry in Phuthaditjhaba,South Africa

During the apartheid era, many South Africans were forcibly relocated to ‘bantustans’ and other decentralized regions with little economic basis. The only manufacturing employment was provided by industries attracted to the areas by selective incentives and low wages. After the transition to democracy, the remaining incentives were removed and minimum wages were extended to these (previously exempt) areas. This study of workers and managers in the clothing industry in Phuthaditjhaba, the old capital of the QwaQwa homeland, indicates that such developments may exacerbate unemployment and poverty in the region. Taiwanese export‐oriented firms (the largest employers) are most threatened by the changes as they prefer to pay new employees low wages, and then increase them in line with experience and productivity. Falling employment will translate directly into rising poverty as very little welfare support is available for the unemployed in South Africa. Given that people (whether employed or unemployed) consistently rank increases in employment over wage increases, this suggests that minimum wage determination should be particularly sensitive to local conditions and potential employment losses. Pendant le règne de l'apartheid, de nombreux Sud‐Africains ont été réimplantés de force dans les ‘bantoustans’ ou autres régions décentralisées à faible base économique. Le seul emploi industriel provenait des secteurs attirés dans ces zones par des mesures d'incitation et des salaires avantageux. Après la transition vers la démocratie, les dernières primes ont été supprimées et les salaires minimum étendus à ces régions (jusque lá dispensées). Cette étude des ouvriers et cadres du secteur de l'habillement à Phuthaditjhaba, ancienne capitale du QwaQwa, indique que ces changements sont susceptibles d'aggraver chômage et pauvreté au plan local. Les exportateurs taïwanais (les plus gros employeurs) sont les plus menacés puisqu'ils préfèrent payer peu les nouveaux embauchés, puis les augmenter en fonction de l'expérience et de la productivité. Une chute de l'emploi se traduirait directement par une accentuation de la pauvreté, les chômeurs bénéficiant d'une aide tès limitée en Afrique du Sud. Étant donné que les gens (qu'ils aient un travail ou non) classent systématiquement la progression de l'emploi avant celle des salaires, on peut en déduire que le minimum salarial devrait varier très sensiblement selon le contexte local et les pertes d'emploi potentielles.