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South Africa’s new TB regimen cures drug-resistant cases

The new treatment which cures highly drug-resistant strains of tuberculosis will drastically shorten the treatment period

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South Africa's new TB regimen cures drug-resistant cases
A caretaker inspects bandages in the activity room of Ward 16, where the drug-resistant tuberculosis patients are housed and treated at the Sizwe Tropical Diseases Hospital in Johannesburg, South Africa. - A new treatment was approved on August 14, 2019 by the US Food and Drug Administration which cures highly drug-resistant strains of tuberculosis and drastically shorten the treatment period. (Photo by Michele Spatari / AFP)

Four years ago, South African fashion designer Innocent Molefe, 38, was diagnosed with tuberculosis. A year ago, it developed into multi-drug resistant strain requiring painful injections and heaps of pills.

Three months after the first round of treatment, he relapsed and started a second round. At the end of it, he still wasn’t cured.

Thanks to a new treatment – approved Wednesday by the US Food and Drug Administration – he is now cleared of the disease, has bounced back to work and has even resumed night-clubbing, something he has stopped four years ago.

“I was willing to beat TB and I’m living proof. I can move around… I can still go clubbing till the early hours,” said the dreadlocked designer at his home in Soweto township.

READ: South Africa buries 46 unidentified and unclaimed corpses

The announcement was especially welcomed in South Africa, one of the countries with the highest number of TB cases. Of the more than 1.6 million TB deaths recorded every year, more than 75,000 are in South Africa alone. In 2017, South Africa recorded more than 322,000 active TB cases.

South Africa's new TB regimen cures drug-resistant cases
TB patients rest in the garden of Ward 16, where the drug-resistant tuberculosis patients are housed and treated at the Sizwe Tropical Diseases Hospital in Johannesburg, South Africa.(Photo by Michele Spatari / AFP)

The new treatment which cures highly drug-resistant strains of tuberculosis will drastically shorten the treatment period.

The three-drug regimen consists of bedaquiline, pretomanid and linezolid – collectively known as the BPaL regimen.

Pretomanid is the novel compound developed by the New York-based non-profit organisation TB Alliance and which received the FDA greenlight Wednesday.

The treatment regimen was trialled at three sites in South Africa involving 109 patients and achieved a 90 per cent success rate after six months of treatment and six months of post-treatment follow-ups.

‘Groundbreaking treatment’-

With the treatment involving five pills of the three drugs daily taken over just six months – it makes easier to administer.

READ: South Africa’s adoption crisis blown open by baby box

This compares to between 30 and 40 drugs that multiple-drug resistant TB patients take each day for up to two years.

“Usually and in many places in the world, the treatment for (multiple) … drug-resistant TB would take anything between 18 to 24 months,” said Pauline Howell, principal investigator of the clinical trial at Sizwe Tropical Disease Hospital in Johannesburg.

“This still includes daily injections for six months, which are extremely painful,” Howell said, adding that taking only five pills would make a huge difference.

The FDA approval represents a victory for those suffering from highly drug-resistant forms of the world’s deadliest infectious disease, said Mel Spigelman, president and CEO of TB Alliance. 

South Africa's new TB regimen cures drug-resistant cases
TB patients do painting activities with a caretaker in the garden of Ward 16, where the drug-resistant tuberculosis patients are housed and treated at the Sizwe Tropical Diseases Hospital in Johannesburg, South Africa. (Photo by Michele Spatari / AFP)

Last year, there were more than half a million drug-resistant TB cases in the world.

A chronic lung disease which is preventable and largely treatable if diagnosed in time, tuberculosis is the top infectious killer, causing over 1.6 million deaths each year.

More than 10 million cases are recorded every year. The disease has worsened as it has become increasingly resistant to available medicines.

TB Alliance started designing the trial in 2014.

“This is really groundbreaking result we have here,” said Folu Olugbosi, clinical director and head of the South African office of TB Alliance.

Patients are moving from a “truckload of pills” to cure the resistant strain with just three drugs and in just six months, Olugbosi said.

READ: Poo Power: How dung biodigester is supercharging farming in Kenya

At the Sizwe hospital northeast of Johannesburg, a patient named Nxumalo arrived from Katlehong township for his regular post-treatment check-up to make sure he is still in the clear.

“With the old regimen, I would vomit,” said the 23-year-old unemployed man. “But with the one for research, it’s easier to take than 24 tablets.”

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Southern Africa

South Africa’s apex court rules spanking children as unconstitutional

The court upheld a 2017 ruling that sentenced a father for assaulting his 13-year-old son for watching a pornographic film

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South Africa's apex court rules spanking children as unconstitutional
The Constitutional Court in Johannesburg, South Africa. (File photo)

South Africa’s highest court on Wednesday upheld a ruling that spanking or corporal punishment of children at home was unconstitutional, saying the practices violate child rights.

In a much-awaited decision, the South African Constitutional Court backed a 2017 court ruling that sentenced a father for assaulting his 13-year-old son for watching a pornographic film. 

A religious freedom group had challenged that case, saying while it does not promote abuse, parents should have the right to raise their children according to their religious beliefs.

However, the nine constitutional judges unanimously ruled that spanking should be banned.

“The vulnerability of children, their rights to dignity and to have the paramountcy of their best interests upheld, as well as the availability of less restrictive means to achieve discipline, render moderate and reasonable chastisement unconstitutional,” they ruled.

The court banned corporal punishment in prison in 1995 and in schools in 2000.

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Traditional rulers demand customary rituals for burial of Robert Mugabe

Once Mugabe’s remains were returned to Zvimba on Monday, traditional leaders demanded the burial remain in line with local rites

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Traditional rulers demand customary rituals for burial of Robert Mugabe

As public wakes for late Zimbabwean leader Robert Mugabe have drawn to a close, traditional chiefs are demanding the body be buried according to spiritual traditions.

Those requests have been part of a dispute over the final burial of Mugabe, who died September 6 almost two years after a coup ended his increasingly autocratic 37-year rule.

He died during a medical trip to Singapore aged 95, leaving Zimbabweans torn over the legacy of a man who some still laud for his role as a colonial-era liberation hero. 

Mugabe’s burial has already been caught up in a dispute between his family — who wanted to bury him at his rural homestead Zvimba — and the government, which pushed for the body to rest at a national monument in the capital. 

They finally agreed Mugabe would be buried at the National Heroes Acre monument, in about 30 days, once a mausoleum was built for him.

But Mugabe was a non-practising chief in his homestead, and the burial feud has highlighted the spiritual beliefs, superstitions and rituals surrounding deaths of traditional leaders in parts of Zimbabwe.

Once Mugabe’s remains were returned to Zvimba on Monday, traditional leaders demanded the burial remain in line with local rites.

One of the Zvimba chiefs, Raphael Zvikaramba, said they had “so far” accepted the government’s proposal, but refused to comment on the details.

“(Zvimba) chiefs are buried in caves and the burial is secretly conducted at night,” Mugabe’s nephew Dominic Matibiri told reporters, standing outside his late uncle’s rural house.

‘Not just a president’ –  

A prominent Zimbabwean traditional healer, Benjamin Burombo Jnr, detailed the cultural beliefs and superstition surrounding the deaths and funerals of chiefs.

Traditional rulers demand customary rituals for burial of Robert Mugabe
A Catholic priest consoles a family members as the coffin of late former Zimbabwe President Robert Mugabe lies in state at the Mugabe homestead in Kutama village, 80 km northwest of Harare, Zimbabwe, on September 16, 2019. (Photo by Zinyange Anthony / AFP)

“When a chief such as Mugabe dies, he is not a person that can be buried at Heroes Acre, that is forbidden. He should be buried in a cave,” Burombo told reporters.

“Mugabe was not just a president, but he was the embodiment of the spirit of Kaguvi,” he added, referring to one of Zimbabwe’s revered spirit mediums and pre-colonial nationalist leader.

When a chief died, often his body “would be dried”, his teeth “extracted” and his finger and toenails “ripped off”, Burombo said. 

He said the body would then be wrapped in skin hides before burial, and could even be swapped with a token such as a goat’s head to be buried instead.

“You can build that monument, but it doesn’t mean that is where the remains of Mugabe will be buried… it’s just for people to continue remembering him.”

Mugabe grew up Catholic and was educated by Jesuits. But according to Burombo, he still followed “traditional norms and practices” despite “going to church”.

Exaggerating the mystery –

Mugabe’s remains currently lie in his childhood village of Kutama, in Zvimba district, about 90 kilometres west of Harare.

During a mass held in his honour, Priest Emmanuel Ribeiro — a former acquaintance — said the former President “was secretive and private” about his beliefs.

Traditional rulers demand customary rituals for burial of Robert Mugabe
Zimbabwe’s former first lady Grace Mugabe (2L) follows proceedings during a body viewing ceremony of late former Zimbabwean president Robert Mugabe hosted at Murombedzi Growth Point, about 107 km northwest of Harare, Zimbabwe, on September 16, 2019, as people have been accorded the opportunity to view Mugabe’s body a week after his death. – (Photo by Jekesai NJIKIZANA / AFP)

Retired sociology professor Claude Mararike told reporters the secrecy surrounding the funerals of traditional chiefs had “long vanished”.

He said that in the past, a death would only be revealed days or even weeks after burial.

“Very few people knew where the chief was buried,” Mararike said. “There were caves where a particular clan normally buried their own chiefs.”

But Mararike said that long-standing political tensions between the family and government “might have precipitated” the discord and mystery surrounding the funeral.

Mugabe’s family are still bitter over the role current President Emmerson Mnangagwa played in his ouster.

A former guerrilla who fought alongside Mugabe against colonial forces, Mnangagwa was fired as first Vice President in 2017. Mugabe had branded him a “traitor”.

Soon after, protesters took to the streets and military officers pressured Mugabe to step down in what was widely seen as a struggle between Mnangagwa’s faction and loyalists to Mugabe’s wife Grace inside the ruling ZANU-PF party. 

“There obviously was quite a lot of anger among the Zvimba people on how their son was removed from office,” said Mararike.

“The late President Mugabe might have said something before he died,” he added referring to how he wanted to be buried, “but what he really said we don’t know”.

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South Africa apologises to Nigeria after xenophobic attacks

Buhari and Ramaphosa are expected to meet at a state visit in South Africa next month

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South Africa apologises to Nigeria after xenophobic attacks

A South African envoy expressed the country’s “sincerest apologies” to Nigeria on Monday, after a wave of anti-migrant attacks swept through Johannesburg and surrounding cities in recent weeks, fuelling diplomatic tensions. 

A meeting with Nigerian President Muhammadu Buhari in the capital Abuja was held to convey President Cyril Ramaphosa’s “sincere apologies about the incident that has recently transpired in South Africa,” the special envoy, Jeff Radebe, told reporters. 

READ: Police arrests several shop looters in South Africa

“The incident does not represent what we stand for,” he said, adding that South African police would “leave no stone unturned, that those involved must be brought to book.”

In a statement after the meeting, Nigeria’s presidency said “President Buhari responded to profuse apologies from the South African president, pledging that relationship between the two countries will be solidified.” 

Johannesburg and surrounding areas were rocked by a series of deadly attacks on foreigners in recent weeks, with many directed against Nigerian-owned businesses and properties.

South Africa apologises to Nigeria after xenophobic attacks

At least 12 people were killed in the violence that left hundreds of shops destroyed.

READ: Nigeria ramps up security to protect South African businesses

No Nigerians were killed according to South African authorities but the violence led to condemnation across Africa, particularly in Nigeria, fuelling diplomatic tensions between the continent’s two leading economies.

The violence also prompted reprisal attacks against South African firms in Nigeria and the temporary closing of South Africa’s diplomatic missions in Lagos and Abuja.

Last week, almost 200 Nigerian migrants were repatriated back to Lagos, Nigeria’s commercial capital, following the unrest. 

At least 400 more are expected to return out of some 100,000 Nigerians estimated by the government to reside in South Africa.   

Buhari and Ramaphosa are expected to meet at a state visit in South Africa next month.

READ: 189 Nigerians repatriated from South Africa after xenophobic attacks

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