OpenUCT :: Browsing by Author "Nattrass, Nicoli"

Browsing by Author "Nattrass, Nicoli"

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AIDS and human security in Southern Africa
(Taylor & Francis, 2002) Nattrass, Nicoli
The rapid spread of HIV/AIDS in Southern Africa is both a cause and a consequence of poverty. But while there is a clear link between AIDS and economic insecurity, there is no evidence of a connection between AIDS and security understood in the policing/state security sense of the term. Orphans are a human tragedy but not a direct security threat. AIDS does not appear to be high on the list of political priorities for most Southern Africans. Governments are thus likely to continue to respond to the epidemic unevenly and with limited resources.
Open Access
AIDS and human security in Southern Africa
(2002) Nattrass, Nicoli
HIV/AIDS is the greatest health threat facing humankind - particularly for those people living in Southern Africa. Of the estimated 40 million people infected with HIV worldwide, over two thirds live in Sub-Saharan Africa. Southern African countries top the HIV prevalence tables. According to the World Bank, if AIDS had not affected Southern Africa, 'life expectancy would have reached 64 by 2010-15. Instead, it will have regressed to 47, reversing the gains of the past 30 years' (2001: 139). Figure 1 shows how life expectancy rose in the 10 Southern African countries during the 1970s and early 1980s, but then fell sharply in the 1990s as the AIDS epidemic and economic crisis took their toll.
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AIDS and the scientific governance of medicine in post-apartheid South Africa
(Oxford University Press (OUP), 2008) Nattrass, Nicoli
AIDS policy in post-apartheid South Africa has been shaped by persistent antipathy towards antiretroviral drugs (ARVs). This hostility was framed initially by President Mbeki's questioning of AIDS science and subsequently by direct resistance to implementing prevention and treatment programmes using ARVs. Once that battle was lost in the courts and in the political arena, the Health Minister, Tshabalala-Msimang, continued to portray ARVs as 'poison' and to support alternative untested therapies. Demographic modelling suggests that if the national government had used ARVs for prevention and treatment at the same rate as the Western Cape (which defied national policy on ARVs), then about 171,000 HIV infections and 343,000 deaths could have been prevented between 1999 and 2007. Two key scientific bodies, the Medicines Control Council (MCC) and the Medical Research Council (MRC) fall under the ambit of the national Department of Health. Although notionally independent, both have experienced political interference as a consequence of their scientific approach towards AIDS. AIDS policy improved after the Deputy President was given responsibility for coordinating AIDS policy in 2006. However, the undermining of the scientific governance of medicine is a legacy that still needs to be addressed.
Open Access
AIDS and the scientific governance of medicine in South Africa
(2006) Nattrass, Nicoli
South Africa's approach to AIDS has been shaped by persistent antipathy on the part of President Mbeki and his Health Minister towards antiretroviral therapy. This was framed initially by Mbeki's questioning of AIDS science and subsequently by direct resistance to implementing prevention and treatment programmes using antiretrovirals. Once that battle was lost in the courts and in the political arena, the Health Minister continued a war of attrition by portraying antiretrovirals as 'poison', supporting alternative untested therapies and undermining the scientific regulation of medicines. Two key scientific bodies, the Medicines Control Council (MCC) and the Medical Research Council (MRC) fall under the ambit of the national Department of Health. Although notionally independent, both have experienced political interference as a consequence of their scientific approach to AIDS. The MCC appears no longer able to respond to complaints if these are lodged against alternative therapists supported by the Health Minister, and its law enforcement personnel have been over-ruled by the Director General of Health.?
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AIDS Conspiracy Beliefs and Unsafe Sex in Cape Town
(Springer Verlag (Germany), 2011) Grebe, Eduard; Nattrass, Nicoli
This paper uses multivariate logistic regressions to explore: (1) potential socio-economic, cultural, psychological and political determinants of AIDS conspiracy beliefs among young adults in Cape Town; and (2) whether these beliefs matter for unsafe sex. Membership of a religious organisation reduced the odds of believing AIDS origin conspiracy theories by more than a third, whereas serious psychological distress more than doubled it and belief in witchcraft tripled the odds among Africans. Political factors mattered, but in ways that differed by gender. Tertiary education and relatively high household income reduced the odds of believing AIDS conspiracies for African women (but not men) and trust in President Mbeki's health minister (relative to her successor) increased the odds sevenfold for African men (but not women). Never having heard of the Treatment Action Campaign (TAC), the pro-science activist group that opposed Mbeki on AIDS, tripled the odds of believing AIDS conspiracies for African women (but not men). Controlling for demographic, attitudinal and relationship variables, the odds of using a condom were halved amongst female African AIDS conspiracy believers, whereas for African men, never having heard of TAC and holding AIDS denialist beliefs were the key determinants of unsafe sex.
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AIDS denialism versus science
(Prometheus Books, 2009) Nattrass, Nicoli
Open Access
AIDS Growth and Distribution in South Africa
(2002) Nattrass, Nicoli
This paper discusses recent research into the economic impact of AIDS in South Africa. It focuses on demographic and macroeconomic modelling and on firm-level impact studies. While the overall picture is murky, certain trends and findings are indicative of a likely increase in inequality. Relatively skilled workers could benefit from greater employment, higher wages, a larger supply of products produced for their niche markets, and may also live longer as it becomes economically viable for firms to provide anti-retroviral medication. The relatively unskilled and unemployed will probably experience declining income, falling consumer welfare, and suffer greater morbidity and mortality from AIDS. The size of the pie may shrink as a result of AIDS, but employed people - and especially the skilled amongst them - will enjoy a growing share.
Open Access
AIDS growth and distribution in South Africa
(2002) Nattrass, Nicoli
This paper discusses recent research into the economic impact of AIDS in South Africa. It focuses on demographic and macroeconomic modelling and on firm-level impact studies. While the overall picture is murky, certain trends and findings are indicative of a likely increase in inequality. Relatively skilled workers could benefit from greater employment, higher wages, a larger supply of products produced for their niche markets, and may also live longer as it becomes economically viable for firms to provide anti-retroviral medication. The relatively unskilled and unemployed will probably experience declining income, falling consumer welfare, and suffer greater morbidity and mortality from AIDS. The size of the pie may shrink as a result of AIDS, but employed people - and especially the skilled amongst them - will enjoy a growing share.
Open Access
AIDS, economic growth and income distribution in South Africa
(Wiley, 2003) Nattrass, Nicoli
South Africa is home to more HIV-positive people than any other country in the world. This is a developmental disaster, yet our understanding of the economic impact of the AIDS pandemic is sketchy at best. Macroeconomic modellers are divided over whether the overall impact of the epidemic will be to raise or lower per capita GDP, and there are no studies of the impact of AIDS on income distribution. This paper provides a critical overview of recent macro-economic research on the impact of AIDS in South Africa. It is not a comprehensive bibliographic review (as in CADRE 2000a and 2000b), but rather a selective analysis of recent and important pieces of economic research. The key objective is to explain, in an accessible manner, how different macroeconomic models arrive at different results and to point to the limitations of these models - in particular, their failure to take into account the dynamic adjustments suggested by firm-level studies. It is argued that the recent sharp decline in the cost of antiretroviral medication will probably result in more firms providing such medication to their workers (particularly skilled workers). If so, then the economic impact of AIDS will be less substantial than that projected by the main macroeconomic models. However, the distributional implications are unsettling.
Open Access
AIDS, gender and access to Antiretroviral treatment in South Africa
(2006) Nattrass, Nicoli
In South Africa, the AIDS epidemic has highly gendered dimensions. Typically, women's social oppression is implicated in understanding gender and AIDS issues. In the context of treatment, this paper shows that HAART coverage is better for women than for men. It argues that social constructs of masculinity are exposing men to risk, resulting in the undermining of men's access to HAART. Men's tendency to access health services less readily than women is a key factor explaining why men tend to access HAART relatively less. The paper draws on a range of data sources, including the ASSA2003 demographic model and the Demographic and Health Survey.
Open Access
AIDS, unemployment and disability in South Africa: The case for welfare reform
(2005) Nattrass, Nicoli
South Africa is facing a dual crisis of AIDS and unemployment. According to the ASSA2002 demographic model, by 2005 19% of adults (and 11% of all South Africans) were HIV-positive. This amounts to a socioeconomic crisis of significant proportions. AIDS undermines the economic security of households by reducing the productivity of (and eventually killing) mainly prime-age adults while simultaneously diverting scarce household resources towards health care. Poor households are especially vulnerable to these shocks. In most of sub-Saharan Africa, where agriculture accounts for a significant portion of employment and output, AIDS has affected the poor mainly through its negative impact on productivity in peasant agriculture. By contrast, South Africa’s history of de-agrarianisation and the destruction of peasant farming under apartheid have left the vast majority of households dependent on wage labour. Under these conditions, the negative impact of AIDS is experienced directly through illness-induced retirement from wage-labour, and indirectly through the contraction of employment opportunities (especially unskilled jobs) by firms trying to avoid AIDS-related costs.
Open Access
AIDS, unemployment and disability in South Africa: the case for welfare reform
(Health and Medical Publishing Group (HMPG), 2005) Nattrass, Nicoli
South Africa is facing a dual crisis of AIDS and unemployment.1 According to the ASSA2002 demographic model, by 2005 19% of adults (and 11% of all South Africans) were HIV-positive. This amounts to a socioeconomic crisis of significant proportions. AIDS undermines the economic security of households by reducing the productivity of (and eventually killing) mainly prime-age adults while simultaneously diverting scarce household resources towards health care. Poor households are especially vulnerable to these shocks.2,3 In most of sub-Saharan Africa, where agriculture accounts for a significant portion of employment and output, AIDS has affected the poor mainly through its negative impact on productivity in peasant agriculture.4 By contrast, South Africa’s history of de-agrarianisation and the destruction of peasant farming under apartheid have left the vast majority of households dependent on wage labour.5 Under these conditions, the negative impact of AIDS is experienced directly through illness-induced retirement from wage-labour, and indirectly through the contraction of employment opportunities (especially unskilled jobs) by firms trying to avoid AIDS-related costs (see Rosen and Simon6).
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Ambiguities of 'culture' and the Antiretroviral rollout in South Africa
(Taylor & Francis, 2005) Ashforth, Adam; Nattrass, Nicoli
This paper reflects on two contrasting cultural strategies for supporting the rollout of highly active antiretroviral therapy (HAART): The Treatment Action Campaign's Treatment Literacy Programme which seeks to educate people into a conventional scientific understanding of HIV disease and treatment; and a Department of Health Voluntary Counselling and Testing (VCT) video which harnesses putative 'indigenous knowledge' relating to illness and healing. It points out that the latter strategy risks connecting with fears regarding the 'African science' of witchcraft. This can serve to confuse, rather than clarify, ambiguities concerning the notion of 'cure'. Science education is challenging, but has the potential to empower patients to manage their illness effectively.
Open Access
Ambiguities of 'culture' and the antiretroviral rollout in South Africa
(2006) Ashforth, Adam; Nattrass, Nicoli
This paper reflects on two contrasting cultural strategies for supporting the rollout of highly active antiretroviral therapy (HAART): The Treatment Action Campaign's Treatment Literacy Programme which seeks to educate people into a conventional scientific understanding of HIV disease and treatment; and a Department of Health Voluntary Counselling and Testing (VCT) video which harnesses putative 'indigenous knowledge' relating to illness and healing.? It points out that the latter strategy risks connecting with fears regarding the 'African science' of witchcraft. This can serve to confuse, rather than clarify, ambiguities concerning the notion of 'cure'. Science education is challenging, but has the potential to empower patients to manage their illness effectively.?
Open Access
Antiretroviral treatment and the problem of political will in South Africa
(Health and Medical Publishing Group, 2006) Nattrass, Nicoli
South African AIDS policy has long been characterised by suspicion on the part of President Mbeki and his Health Ministers towards antiretroviral therapy.1,2 The Minister of Health, Manto Tshabalala-Msimang, resisted the introduction of antiretrovirals for mother-to-child transmission prevention (MTCTP) until forced to do by a Constitutional Court ruling – and she resisted the introduction of highly active antiretroviral therapy (HAART) for AIDS-sick people until a cabinet revolt in late 2003 forced her to back down on this too. Since then, the public sector rollout of HAART has gained momentum, but it has been uneven across the provinces and continues to be constrained by a marked absence of political will at high levels.
Open Access
Are country reputations for good and bad leadership on AIDS deserved: an exploratory quantitative analysis
(2008) Nattrass, Nicoli
Some countries, like Brazil, have good reputations on AIDS policy, whereas others, notably South Africa, have been criticized for inadequate leadership. Cross-country regression analysis suggests that most of the 'poster children' for AIDS leadership have indeed performed better or worse than expected given their economic and institutional constraints and the demographic and health challenges facing them. Regressions are run on HAART coverage (number on highly active antiretroviral therapy as % of total need) and MTCTP coverage (pregnant HIV+ women accessing mother-to-child-transmission prevention services as % of total need). Brazil, Burkina-Faso, Cambodia, Costa Rica, Mali, Namibia, Suriname, Thailand, Paraguay, and Uganda performed consistently better than expected. South Africa, Uruguay, and Trinidad and Tobago performed consistently and significantly worse than expected.
Open Access
Are country reputations for good and bad leadership on AIDS deserved?: an exploratory quantitative analysis
(Oxford University Press, 2008) Nattrass, Nicoli
Some countries (e.g. Brazil) have good reputations on AIDS policy, whereas others, (notably South Africa) have been criticized for inadequate leadership. Cross-country regression analysis reveals that these 'poster children' for AIDS leadership have indeed performed better or worse than expected given their economic and institutional constraints and the demographic and health challenges facing them. Regressions were run on HAART coverage (number on highly active antiretroviral therapy as percentage of total need) and MTCTP coverage (pregnant HIV-positive women accessing mother-to-child-transmission prevention services as percentage of total need). Brazil, Cambodia, Thailand and Uganda (all of whom have established reputations for good leadership on AIDS performed consistently better than expected - as did Burkina-Faso, Suriname, Paraguay Costa Rica, Mali and Namibia. South Africa, which has the worst reputation for AIDS leadership, performed significantly below expectations - as did Uruguay and Trinidad and Tobago. The paper thus confirms much of the conventional wisdom on AIDS leadership at country level and suggests new areas for research.
Open Access
Assessing the sustainability of seal tourism at Duiker Island, Hout Bay
(2020) Heide, Trygve; O'riain, Mannus; Nattrass, Nicoli
Pinniped focused tourism has grown rapidly both globally and in South Africa. In a 2002 survey South Africa was identified as having earned the most revenue from seal ecotourism of all the countries that engage in this activity. Seal tourism includes approaching colonies on foot, by kayak, on large and small motorised boats and more recently in the water through snorkelling and scuba diving activities. Like most wildlife tourism seal snorkelling operators can use their tours to educate clients about seal biology and threats, while providing them with a memorable physical experience with minimal impact on the seals. The goal of this research was to explore aspects of the demography, attitudes and values of tourists participating in two different seal viewing activities at the same island. Additionally, I investigated levels of satisfaction with each tour type, differences in the style of education provided by operators and which tour provided tourists and what facts tourists found most interesting. In the second part of the study I quantified the behavioural response of seals to tourists who entered the water to snorkel with seals in an attempt to assess potential impacts of immersive trips on seal behaviour. The study was conducted at Duiker Island, near Hout Bay in the city of Cape Town between November 2019 and January 2020. This period coincides with the breeding season of Cape fur seals (Arctocephalus pusillus pusillus) and the peak tourist season. Questionnaires were distributed to both seal viewing tourists (n = 53) who had viewed seals from a large boat and seal snorkelling participants who had swum with seals at the island (n = 90). More women than men undertook both types of tour, though the proportion of men increased on snorkelling compared to viewing tours. Probit models revealed key behavioural and attitudinal differences between seal viewing and seal snorkelling participants with the latter being more pro-environmental. Seal snorkelling guides used a more interpretive style when educating tourists including the use of visual aids while seal viewing tours announced facts through a loudspeaker on the vessel. Seal snorkelling guides would also include information to awareness about plastic pollution and seal entanglement, with a donation box for a seal disentanglement program run by the Two Oceans Aquarium. Seal snorkelling participants listed an average of two facts they had learnt on the tour compared to a mean of 1.24 facts for seal viewing tours. Both tours were rated very highly for overall levels of satisfaction (seal snorkelling mean score = 9.17/10; seal viewing = 8.58/100). Surface observations of seal behaviour in response to seal snorkelers in the water close to the boat suggested a minimal impact with most seals (88%) behaving neutrally and only 0.2 % engaged in avoidance behaviour. Below water observations revealed that seal numbers declined with increasing number of people in the water and seals adjusted both their position in the water column (more diving) and their activity (more active) in response to snorkeler presence. These findings suggest that both the number of snorkelers and the area over which they spread should be controlled so that seals can choose to avoid snorkelers and behavioural changes are localised to select demarcated areas. The presence of the guides in the water together with the tourists ensured there were no inappropriate interactions between seals and snorkelers (e.g. touching and biting by seals in response). This is the first study on the thriving seal ecotourism industry at Duiker Island and reveals high levels of satisfaction by both seal viewing and seal snorkelling tourists. While there were measurable impacts of seal snorkelers on seals these were highly localised and unlikely to present an adverse impact on seals at the Island more generally. Controlling the number of operators and ensuring snorkelers are always accompanied by guides should ensure that this valuable business continues, potential impacts are minimised and negative interactions (e,g. bites from seals or people touching or feeding seals) are prevented.
Open Access
Attrition in the Khayelitsha panel study (2000-2004)
(2005) Magruder, Jeremy; Nattrass, Nicoli
Despite the fact that the original study had not been designed as a panel study (and despite the fact that no attempt to track the respondents had been made in the intervening four years), the response rate was (as we argue below) reasonably good.? This paper describes the two waves of this Khayelitsha panel study, and provides an analysis of attrition.? The first wave of the data (KMP 2000) is publicly available in the Data First Resource Centre of the CSSR.?
Open Access
A brief history of predators, sheep farmers and government in the Western Cape, South Africa
(2017-03) Nattrass, Nicoli; Conradie, Beatrice; Drouilly, Marine; O'Riain, M. Justin
This paper provides a brief history of the conflict between South African sheep farmers and predators (and we touch also on the debate between diverse stakeholders over how best to respond to that conflict). We focus in particular on black-backed jackals and commercial sheep farmers in the Western Cape Karoo, drawing on historical sources, colonial records, early ecological thinking and observations by farmers to paint a picture of this dynamic conflict. The paper forms part of an inter-disciplinary project about sheep farming and predators in the Karoo