Opinion

The Great Debate

Combatting TB 2.0

Earlier this month, health officials in Los Angeles confirmed they are treating a patient for extensively drug resistant tuberculosis — a deadly form that does not respond to most of the antibiotics. The United States is one of 100 countries that have reported cases of “XDR-TB” since it was discovered in South Africa less than a decade ago.

Congress is holding public briefings Tuesday and Wednesday to look into the threat posed by tuberculosis, seeking expert recommendations to help develop a U.S. response. To be effective, public health efforts must adapt to the ways TB is evolving.

Tuberculosis is often described as an “ancient” malady, evident in Egyptian mummies. But today’s tuberculosis epidemic, which kills around 1.3 million people a year, is unlike its predecessors genetically, clinically and epidemiologically. Defeating TB 2.0 will require innovative approaches designed to fight this modern epidemic.

Many of the TB strains today come from “modern” genetic lineages rather than the “ancestral” strains common throughout human history. Modern TB strains now predominate in India, which has the world’s highest TB burden, according to recent research published in the International Journal of Tuberculosis and Lung Disease. Some modern strains are more virulent and progress more rapidly, studies suggest, making the disease far more dangerous.

Clinically, today’s TB is “partnering” with a number of modern diseases, creating complex illnesses that are more challenging to treat. While TB has historically been perceived as a lung disease, in people with HIV it often presents elsewhere — lymph nodes, spine, eyeballs, brain — with atypical symptoms. TB kills roughly 320,000 HIV-positive people every year, the leading cause of death for those HIV positive. Yet less than half of the people infected with HIV have been screened for TB, and vice versa.

Mandela and De Klerk: Essential partners

When Nelson Mandela and South African President F.W. De Klerk began their historic negotiations to end apartheid, each man professed respect for the other. Indeed their relationship appeared not only professional, but personal.

Yet as the negotiations dragged on through 1992 and 1993, tempers grew short, and South Africans grew increasingly frustrated with the slow progress toward the liberation that had seemed so promising just a few years ago. Most worrisome, violence was growing between the supporters of Mandela’s political party, the African National Congress, and Mangosuthu Buthelezi’s Inkhatha Freedom Party.

Much of the turmoil flamed in the province of KwaZulu-Natal, but it also spread dangerously into the outskirts of Johannesburg, which soon turned into a patchwork of no-go areas. On my effort to visit the area, for example, we were stopped by gunfire and forced to retreat. By the time of the elections in 1994, at least 3,000 people would be killed.

On meeting Mandela

Journalists are not easily impressed. We pride ourselves on our skepticism. (Most advisable of us, may I add.)

But I confess to having been in awe of Nelson Mandela, and not just in theory. I met him, spent about an hour with him — or, to put it more accurately, I spent about an hour in his presence.

It was in October, 1994, Mandela was the new president of South Africa and on a visit to the United States, seeking financial investments for his country. While in New York, he stopped in to speak to the editorial board of the New York Times, as people ranging from heads of state to political candidates did on a regular basis.

Mandela’s message of reconciliation

On the day that Nelson Mandela was elected as South Africa’s first black president, I drove across the fault lines of segregated suburbia to watch his fellow citizens vote him into office.

In the mixed-race “Malay Quarter” in central Cape Town — named for the residents descended from the Malaysian and Indonesian slaves brought to the city in the 17th and 18th centuries — joyous residents thronged the streets outside the polling stations.

In the affluent Atlantic seaboard suburb of Camps Bay, uniformed maids cheerfully made space so their white “madams” could wait with them in the long lines. And in a white blue-collar, mostly Afrikaner suburb on the edge of Table Bay, the queues moved quickest of all as the white group that implemented apartheid voted itself out of power with a grim — and ironic — efficiency.

Alicia Keys: Breaking the cultural logjam in Israel

Alicia Keys at the Grammy Awards in Los Angeles, California, Feb. 10, 2013. REUTERS/Mike Blake

JERUSALEM — The fireworks before the Alicia Keys concert in Tel Aviv on July 4 have been from activists demanding that the singer cancel her performance in Israel. But she was not swayed by these false comparisons between Israel and South Africa under apartheid.

Good for her. Israel is no Sun City, the race-restricted resort created by Pretoria in the 1980s to evade the international boycott against the apartheid regime.

from Africa News blog:

100 years and going strong; But has the ANC-led government done enough for its people?

By Isaac Esipisu

Although the role of political parties in Africa has changed dramatically since the sweeping reintroduction of multi-party politics in the early 1990s, Africa’s political parties remain deficient in many ways, particularly their organizational capacity, programmatic profiles and inner-party democracy.

The third wave of democratization that hit the shores of Africa 20 years ago has undoubtedly produced mixed results as regards to the democratic quality of the over 48 countries south of the Sahara. However, one finding can hardly be denied: the role of political parties has evidently changed dramatically.

Notwithstanding few exceptions such as Eritrea , Swaziland and Somalia , in almost all sub-Saharan countries, governments legally allow multi-party politics. This is in stark contrast to the single-party regimes and military oligarchies that prevailed before 1990.

from Africa News blog:

Was South Africa right to deny Dalai Lama a visa?

By Isaac Esipisu

Given that China is South Africa’s biggest trading partner and given the close relationship between Beijing and the ruling African National Congress, it didn’t come as a huge surprise that South Africa was in no hurry to issue a visa to the Dalai Lama.

Tibet’s spiritual leader will end up missing the 80th birthday party of Archbishop Desmond Tutu, a fellow Nobel peace prize winner. He said his application for a visa had not come through on time despite having been made to Pretoria several weeks earlier. (Although South Africa’s government said a visa hadn’t actually been denied, the Dalai Lama’s office said it appeared to find the prospect inconvenient).
Desmond Tutu said the government’s action was a national disgrace and warned the President and ruling party that one day he will start praying for the defeat of the ANC government.

It’s the second time the Dalai Lama has been unable to honour an invitation to South Africa by Tutu after failing to make it to a meeting in 2010.

from MacroScope:

Emerging markets: Soft patch or recession?

Could the dreaded R word come back to haunt the developing world? A study by Goldman Sachs shows how differently financial markets and surveys are assessing the possibility of a recession in emerging markets.
One part of the Goldman study comprising survey-based leading indicators saw the probability of recession as very low across central and eastern Europe, Middle East and Africa. These give a picture of where each economy currently stands in the cycle. This model found risks to be highest in Turkey and South Africa, with a 38-40 percent possibility of recession in these countries.
On the other hand, financial markets, which have sold off sharply over the past month, signalled a more pessimistic outcome. Goldman says these indicators forecast a 67 percent probability of recession in the Czech Republic and 58 percent in Israel, followed by Poland and Turkey. Unlike the survey, financial data were more positive on South Africa than the others, seeing a relatively low 32 percent recession risk.
Goldman analysts say the recession probabilities signalled by the survey-based indicator jell with its own forecasts of a soft patch followed by a broad sustained recovery for CEEMEA economies.
"The slowdown signalled by the financial indicators appears to go beyond the ‘soft patch’ that we are currently forecasting," Goldman says, adding: "The key question now is whether or not the market has gone too far in pricing in a more serious economic downturn."

Does America need a Truth and Reconciliation Commission for torture?

Paul van Zyl is the former executive secretary of South Africa’s Truth and Reconciliation Commission. In this presentation to the Poptech conference, he argues that America must confront its own legacy of torture:

A new America must confront this dark chapter openly and publicly. It must give victims a chance to testify and allow the American people to hear a firsthand, unvarnished account of the crimes committed in their name. It is only then that America will be able to say to itself in unambiguous terms: “We are not a nation that tortures its enemies. We regard torture as immoral and criminal. We will never justify or condone torture and we will punish those who commit these criminal acts.”

Watch the video below or click here to read van Zyl’s speech in full.

Click here for more Reuters coverage of Poptech.

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