South Africa: Will strict regulation of tobacco still suffice as global tobacco companies set sights on Africa

Tobacco usage continues to stake its claim atop of the global podium for causes of preventable deaths. According to the World Health Organisation (WHO) tobacco kills almost 6 million people a year and causes billions of dollars of economic damage worldwide. If the world continues along this current trajectory tobacco will kill more than 8 million people worldwide each year by 2030.  It is estimated that over the course of the 21^st century, tobacco could kill a billion or more people. Quite a sobering statistic when compared to the 20^th century where wars, conflict, famine and disease combined killed roughly the same number of people.

Most deaths due to tobacco-attributable illnesses occur in low and middle income countries. The costs to society due to smoking and tobacco abuse are many. Families are torn asunder, loved ones are lost and breadwinners perish due to smoking related illnesses every year. Not to mention the detrimental effect tobacco related illnesses and deaths have on the economy and levels of productivity. Against the backdrop of this incapacitated global tobacco epidemic, where does South Africa stand in terms of its management of tobacco and smoking and how do we compare to other nations?

South Africa has a rather capricious history with tobacco consumption. In 1994, the Medical Research Council estimated that for every R1 the government received from taxes on cigarettes, it spent R2 on treating tobacco related diseases. South Africa’s prevalence of smoking also ranks 20^th in the world and on average 8% of all deaths in South Africa, which equates to approximately 50, 000 deaths each year are a direct result of smoking related illnesses. Tobacco is a drain on our already ailing healthcare system and it comes as no revelation that South Africa is embroiled in a constant melee to find enough money to overhaul the overburdened health system and deal with the country’s quadruple burden of disease. It is estimated that the direct costs of smoking to South Africa can be quantified to approximately U$127-million which equates to about 1 billion 156 313 rands. This figure is representative of both private and public direct medical costs of treating tobacco related diseases. Indirect costs include environmental damage due to cigarette butt littering, suffering of victims and their families and losses in productivity. A recent review published in the journal Addiction found that smokers take on average three more sick days from work every year than non-smokers. Occupational Care South Africa (OCSA) estimated that productivity lost due to absenteeism cost our economy R12 billion in 2009. Therefore one must ask what steps South Africa has taken to curb this rather counter intuitive phenomenon and control the use of tobacco in order for the state to save money?

South Africa has indeed made significant strides in curbing the use of tobacco and preventing tobacco-attributable illnesses and deaths during the past decade. We have done this by implementing strong tobacco control legislation. The Tobacco Products Control Amendment Act ratified by President Nelson Mandela in 1999 provides South Africa with one of the most comprehensive tobacco control legislation packages in the world. This act bans tobacco advertising and promotions from tobacco companies. It also protects children and adolescents from multimillion-rand marketing schemes and ensures the rights of non-smokers to a smoke-free environment. More recently in 2009, President Jacob Zuma gazetted into law new anti-smoking regulations that strengthen limits on smoking in public places and put more regulations on the manufacturing and marketing of tobacco products. These include:

§  Larger fines for smoking in non-smoking areas

§  Prohibitions of smoking in partially enclosed public spaces, cars with passengers under the of 12 and areas used to commercial childcare, schooling or tutoring

§  Limited smoking areas to persons only over age the 18

§  Outlawed tobacco industry-sponsored ‘parties’

§  Prohibitions of the sale of tobacco products to and by persons under the age of 18.

South Africa has also stood firm in its relentless battle against tobacco companies. In 2012 British American Tobacco South Africa, the country’s largest cigarette manufacturer tried to lift the ban against the advertising of tobacco products. The Constitutional Court denied to the company leave to appeal. Yusuf Saloojee, executive director of the National Council against Smoking South Africa, said in a media report at the time of the ruling: “We welcome the Constitutional Court’s decision, which confirms our confidence that the country’s tobacco control laws are fair, reasonable and based on solid science.”

Thus despite our slightly tenuous history with tobacco, South Africa has actually made significant progress during the last decade in reducing tobacco usage. As a result of these tobacco control measures South Africa’s smoking rates have experienced a significant decline. Between 1995 and 2004 adult smoking rates fell by 20% and approximately 2.5% of smokers have stopped smoking resulting in a 40% decrease in annual cigarette consumption rates. South Africa was also one of the first signatories to the WHO Framework Convention on Tobacco Control’s (FCTC). The convention, which took effect in 2005, is ratified by nearly 170 countries. The recommendations state that smoke-free laws must cover all enclosed public places, workplaces, and public transport without exemption and avoid designated smoking rooms, ineffective ventilation, and air filtration schemes. However South Africa unfortunately falls somewhat short of the robust anti-smoking FCTC standard because we allow for designated smoking areas which negate the smoke free premise upon which the FCTC protocol is based.

In spite of this, South Africa, in comparison to many other middle to low income countries where the tobacco epidemic is still a burgeoning epidemic, has actually shown that the epidemic can be curtailed if evidence-based policies and initiatives such as those contained in the WHO’s Framework Convention on Tobacco Control are implemented properly. In addition a heartening study found that in contrast to the US, UK and Canada where tobacco causes 1 in every 5 or 6 deaths, in Africa it causes only 1in every 84 deaths. However, according to a 2009 smoke-free status report, Global Voices: Rebutting the Tobacco Industry, Winning Smoke free Air, Africans are set to experience the highest increase in the rate of tobacco use among developing countries. This is due to the illicit trade on black market cigarettes as well as African countries proving themselves lucrative target markets for predatory tobacco companies. In a report filed for the Los Angeles Times Online in December last year, Saloojee expressed concern over this growing interest in African countries saying, “The African population is very young. If they [tobacco companies] can hook customers now, they’ve got customers for the next 40 or 50 years. So the prospects of an increasing market share are very good.” The more countries move to fully meet their obligations under the FCTC the more aggressive tobacco companies are becoming to try and weaken public health efforts to ban tobacco advertising, promotion and sponsorship. And Africa is in their direct line of vision.  

Thus South Africa still has a great deal of ground to cover and hurdles to overcome before it reaches its goal of a truly smoke and tobacco free society. However one thing is for certain and that’s the fact that South  Africa  can consider itself a success story in terms of reducing tobacco usage and implementing progressive anti-smoking regulations. South Africa has also proven that cultural or regional factors need not prove insurmountable barriers to effective tobacco control, an example from which the rest of Africa should imbibe and attempt to emulate.

2013 Budget Analysis: Healthcare expenditure, NHI & Corruption. What's in store for South Africa this year...

The 2013 budget speech has allocated R133-billion over the medium term to health which accounts for 4.5% of the budget. Health financing and national health insurance will account for 44% of health spending over this period. Despite the tight fiscal climate, it does seem encouraging that the health sector is receiving extra funding. However South Africa already spends 8,5% of its gross domestic product on health and is still on the lower end of the health outcomes spectrum when compared with similar middle-income countries. Therefore is this increase to the health budget really necessary, or should Gordhan have paid more attention to spending money allocated to healthcare more efficiently?

Gordhan stated that alongside social assistance, access to health care is a vital element in the social wage. This is an encouraging statement given the manner in which social determinants play such a fundamental role in defining the status of a nation’s health. He also pointed out examples of progress in the healthcare sector, acknowledged the progress made in reducing mortality and improving the HIV and TB programmes and placed a renewed focus on the NHI initiative.
However Gordhan is too vague in supplying us with details regarding the National Health Insurance. It is all very well alluding to the fact that a tax increase ‘might’ be needed to fund the implementation of NHI without giving any concrete details about when, where and how this anticipated tax increase will manifest itself in the future.

New policy initiatives such as the NHI are only possible if South Africa succeeds in driving economic growth towards 5% year. According to Stats SA, our current GDP at market prices has only increased by 2,1% during the fourth quarter of 2012. This also means that government revenue needs to double within the next 20 years in order for NHI to become a reality. Therefore the affordability of the NHI is inextricably linked with the growth of the economy. Bearing this in mind and taking into consideration South Africa’s current economic growth trajectory at only 2,1%, implementation of the NHI is practically impossible to conceive unless government takes measures to reduce spending in certain areas and increase taxes in others. Gordhan however states that the initial phase of NHI will not place new revenue demands on the fiscus.
In my opinion this is rather short-sighted. South Africa unfortunately suffers from a quadruple burden of disease and the Gini Co-efficient for South Africa is one of the largest in the world. The gap between the rich and the poor is exponential and growing everyday. A NHI policy is going to need a large sum of capital to launch and implement never mind run effectively, to do this; taxes will have to be raised in order to procure this much needed capital. However Gordhan’s budget speech fails to address these glaring issues about how the NHI will be funded.

According to the Mail & Guardian, reductions have actually been made to the NHI grant due to slow spending. This seems completely counter-intuitive to me especially in terms of South Africa’s lack of sufficient economic growth and the fact that NHI will never come to fruition unless our GDP makes a distinct improvement in the global economy.
In addition, I also think that there should have been more clarity on how much money allocated to the health budget would be spent on combating corruption in the health sector. Not only is this a huge problem which directly affects South Africans at the moment but corruption in the health sector will undoubtedly also hinder the effective implementation of NHI.

(See http://www.news24.com/SouthAfrica/News/Corruption-costs-E-Cape-health-R45m-20110307
http://www.news24.com/SouthAfrica/Politics/Devastating-corruption-in-E-Cape-health-dept-20130203
http://www.aljazeera.com/indepth/opinion/2012/06/201265112355558115.html )

Gordhan should have been more lucid about how much money in the healthcare budget would be used to combat corruption, improve governance structures in health districts and hold public health officials accountable for their actions.

However despite these criticisms, the budget speech does show that health infrastructure, contracting with general practitioners and financial management reforms as well as medical and nurse training capacity must first be improved if NHI is to be effective and build public confidence in the reform.

Out with the old and in with the new: Ushering in a new Nomos

This morning I went to to such an insightful politics lecture that I just had to blog about because it was just that interesting! Today I learnt that the problem plaguing contemporary South African society is that most people are stuck within a redundant and anachronistic "NOMOS". The term Nomos was conceptualised by a theorist called Carl Schmidt (whose Nazi affiliations I am deliberately choosing to ignore). The idea of 'Nomos' was then capitlaised upon by Grant Farred who uses it in his writings. Nomos describes the way the world becomes structured according to certain ideas and trends that are preponderant in specific epochs in history. Usually these ideas are framed within an amnity/emnity binary. Apply this idea to South Africa and one can see the manifestation of this idea in all its shining glory.

South Africa unfortunately ascribes to an outdated Nomos whereby any opposition to the ANC or black organisations, initiatives and black people in general are always framed within this friend/enemy dichotomy, a dichotomy that particularly characterised the apartheid era. Anytime someone raises criticism against the ANC, its policies, etc etc they unfortunately fall victim to this outdated mode of reasoning and are labelled racist.. Helen Zille and the DA are a prime example. Read http://www.news24.com/MyNews24/I-am-a-racist-20120522 to provide you with more clarity.

But the purpose of this post is not to recount my politics lecture as riveting as it was. I think the ideas in Farred's writing are pertinent to the events happening right here and now within our very own university. In particular I think they are really relevant to the current debates regarding Brad Bense's campaign for SRC President and his use of the word "MLUNGU" in his campaign strategy. Once again, black people are up in arms at his choice of the word 'Mlungu" which loosely translated means 'white person'. Once again, Bense is unfortunately grouped into a category that immediately turns him into 'the enemy'. People are accusing him of alluding to the fact that "mlungu" has connotations of black servitude and oppression and therefore implying that he wants to be a stereotypical white authority figure that has charcterised race relations in the past. For example, one comment on the Rhodes SRC Facebook page said:
        
 "Let me remind or inform u that the name "mlungu" means boss for most black ppl who have worked for white ppl in our histry.This is so bcoz white ppl had high positions and owners of large properties while blck ppl were and still garden boys and domestic workers.Even to this day if a blck man is successful and has a blck man working for him he will call his boss"mlungu wam"which means "my boss".So the name "mlungu" does not only define race but also superiority of the other race over the other."

Instead of taking Brad's campaign at face value, people are accusing him of being racist and asking people to vote for him because he is white and wants to represent a stereotypical white authority figure. While I do not want to detract from the struggle or the plight of black people in the past, nor do I wish to relegate the significance of certain words to the periphery, I would like to show how the 'past' nomos is still a hauntingly pervasive feature in today's society and by constantly referring to this racial paradigm we are only contributing to the perpetuation of old-fashioned ideas which actually have no credence in contemporary society. And while I must question whether Bense is aware that the controversy he's sparked by the use of the word 'mlungu' may be of detriment to his campaign, I still wish to highlight the way people constantly try and group people into the friend versus enemy camps without looking at the bigger picture or even the smaller picture. 

Gtown h2O and alzheimers? Martin Davies Profile

Insightful, interesting and controversial. Take a look at what you are really drinking in Gtown's water and learn about the life of Martin Davies in celebration of Grahamstown's bicentennial birthday! 

http://www.youtube.com/watch?v=2saEkvGS9Eg&feature=plcp

The life a lowly waitress/waitressing 101 for dummies

 I have just finished my monthly dose of waitressing for the year and it dawned on me to compile a sort of “waitress's guide to the galaxy” for anyone who wishes to pursue this riveting job of clearing dirty plates, giving fake smiles to unpleasant customers and standing on your feet for 12 to 15 hours a day. Wow, I make it sound like torture and yes on certain days it can feel like the most arduous and awful job in the world but there’s no doubt in my mind that my years as a waitress have taught me some really valuable life lessons. I have made some incredible friends at the restaurant and had the privilege of meeting some really inspiring and interesting individuals. I have learnt the value of patience and the importance of tolerance. But most importantly I have learnt the skill of independence and budgeting my very hard earned money. And while I still rely on daddy for many things, having my own money in mu purse at the end of the day is such an awesome feeling. If you are willing to put in the hours, a waitress can earn a relatively sufficient sum of money. I will admit that sometimes the hours don’t translate into the moolah but that’s just part of the game honey. Anyway my 2 years at the very special Portuguese restaurant and sport bar called Cesco’s has inspired to me convey all my experiences in blog form. SO here it goes….I present you with Jilly’s guide to mastering the art of waitressing:

Rule Number 1: You’ll very quickly learn that pretty much everyone (especially men) who are patrons at a sports bar/ pub are fluent in the language of bullshit especially after a couple of drinks. NEVER argue with a bullshitter, you will just bring yourself down to their level and let’s face it, pissing off your customers by trying to prove your intellect might just cut your tip in half. So roll with it, laugh at their corny jokes, listen to their tall stories, show interest in their grand schemes and above all give them good service and you’ll be rewarded at the end of the day. Even if it means you having to listen to them boasting about the money their new business enterprise is pulling or hearing about their finesse on the racing track.

Rule number 2: Never ever date the manager, a co-worker or anyone else remotely involved in the restaurant, especially when you are about as compatible Stephen Hawkin and Paris Hilton. Avoid interwork relationships at all costs because when the things go pear shaped and you are forced to work with that person on a daily basis afterwards, it’s not very pleasant. Also if you are an intellectual university student studying subjects like politics, history and journalism, DO NOT get involved with a restaurant manager who doesn’t have a degree or craft behind his name, doesn’t watch the news, thinks newspapers are for checking the classifieds for new car or bike deals and can only speak two languages namely: bullshit and motorbike. It’s a dead end job for dead end people. It will NEVER work out between you so don’t go there no matter how hot he is.

Rule number 3: NEVER steal food off someone’s plate. Hepatitis is REAL people and trust me I’ve seen people do weird and nasty shiz to their food.

Rule number 4: ALWAYS wash your hands…there is no place more grimy or dirty than a restaurant.

Rule number 5: If a customer insists that you to have a shot or a drink with him/her, substitute it with something non-alcoholic but similar in consistency. That way you can pocket the money, have fun with your customers and avoid getting phuza faced like them. For example, substitute patron shot with a tot of Kola Tonic, trust me, it works. And if customers get suspicious, rub the rim of the shot glass with some of the booze so that when they smell the shot it still smells like alcohol.

Rule Number 6: Never piss off the bartenders especially if you are working in a pub. People come there to drink so make sure you have the bartenders on your side.

Rule number 7: Most of us earn an hourly rate of R5 so tips really are your bread and butter so avoid the serving the following people at all costs. (I am fully aware that these are generalisations and stereotypes but I’ve had too many bad experiences with these certain groups of people not to mention them in my blog, read this blog and you'll be convinced http://www.stuckserving.com/ )

• Young people in their teens and early twenties. They run you ragged to get as many happy hour specials they can possibly consume in that one hour and then they do not tip. I don’t blame them, seeing as I am one of them but try and avoid serving them if you can, its just not worth it at the end of the day when you could be serving well-established lawyers and businessmen who can afford to give the waitress 10%, if not more. 
• Indian people (especially Indian women), they also hardly ever tip but make you run your toosh off getting them extra peri peri sauce every ten minutes. 
• Avoid middle aged women who come into the restaurant with their husbands and give you the beady eyeball when their husband orders something from you. They often don’t tip you to prove a point. (Most of the time their husbands are podgy 45 year old men nearing the end of their prime and going soft around the edges, honestly I’ll stick to my fresh meat while I can still get it lady, there’s no need for you to prove that he's your man by under-tipping me, I assure you I am really not interested in the mature block of stinky cheddar sitting next to you thank you very much. And if he has eyes for young blonde waitresses then maybe you should be spending your money on a marriage counsellor and not on that dish of prawns, just saying). 
• If you are willing to sacrifice what could potentially be quite a large tip, try and avoid single men in their 40’s as well. Sometimes a blonde waitress seems like a perfect trophy girlfriend for a lonely, single man who has most probably come out of a recent and ugly divorce and is going through a mid-life crisis. Trust me, sometimes being tolerant of these men’s attempts at flirting may give them the impression that you are keen for a sugar daddy. Show no mercy to their attempts to impress you with their shiny convertible Mercedes SLK’s and Nissan 350 Z’s. They are predators and definitely only want one thing from you and that’s when the term “good service”takes on two very different meanings if you catch my drift.

Rule number 8: Try and serve big families, birthday parties, bachelor parties, etc. Try and serve young guys in their 30’s who come in with their girlfriends and friends, they are always keen to impress their peers by proving how rich and successful they are by giving their waiter/waitress a large tip.

Rule number 9: When serving large parties or functions with other waiters, try and suss out who are the wealthiest and then look after them like they gold. Nine times out of ten they will reward with your own separate tip on the side for ‘taking such good care of them”.

Rule number 10: Make sure you befriend your fellow waiters. Working in a restaurant often involves team work and having the other waiters and waitresses on your side can often make your life a helluva lot easier especially when things get busy and you start spinning like a headless chicken on whoonga.

Rule number 11: Lastly while it is really tough work and the hours are super long and it’s extremely physically taxing at the end of a long shift, try and enjoy yourself. Make friends with the regulars (except the creepy Indian pervert who tries to give you big wet kisses and pinch your bum every so often), smile even if it’s fake and always make the best of it.

The top seven signs that you ain’t gonna get your 10% after serving THESE people:

7. They have a “Meal for 2 voucher”

6. They want takeaways from the Friday special buffet and unfortunately restaurant policies dictates no “special takeaways”. They get pissed off when you very politely tell them this.

5. They order a plate of chips…to share.

4. They ask how much EVERYTHING on the menu is.

3. They eat everything but complain about everything AFTER they have finished their meal.

2. When you ask “cheque or savings” and they say savings.

1. They wait for ‘Happy Hour’ before they order drinks.

P.S. If you really aspire to pursue a part time job as a lowly waitress join this network especially designed for us suckers who enjoy clearing dirty plates from people's tables ;P http://waiterstoday.com/

Keryn, ex waitress at Cesco's and current part time manager. The most awesome, hard core, soft hearted, biker mad, intelligent person I know and one of my very special and dear friends. 

My Two Cents Worth

With a new year comes new beginnings and hopefully the prosperity and success of my new blog. I may not be the world expert on politics, science or sport but I hope to use this blog to put in my two cents worth for anyone who cares to read it. My running commentary on current affairs, news, politics as well as the daily events in my ordinarily average life sprinkled with a healthy dose of sarcasm, wit, humour and cynicism will hopefully provide for some insightful and entertaining reading. If not, well you’re obviously an uncultured twit so maybe you should find someone else’s blog to tickle your fancy. 

Anyway jokes and caustic sarcasm aside, what does 2012 have in store for us besides for the prophesied apocalypse of our planet? I anticipate that this year will bring forth many changes in the political climate of South Africa. We’ve already seen JULIAAAAS suspended from the ANCYL despite all our fears that he would remain resolutely seated in his jungle gym throne. The ANC centenary celebrations held yesterday just proved that in-fighting, factionalism and individual ambition are threatening to overwhelm the ANC’s true objectives. These fears ring true in many an educated South African’s repertoire, despite efforts by ANC secretary General, Gwede Mantashe to quash these fears. In an interview conducted with the Sunday Times to mark theruling party’s centenary celebrations, Mantashe maintained that the perception that the ANC had failed to change into a modern political party was a “deliberate distortion”. I beg to differ, the ANC is in itself a deliberate distortion of the true values and objectives it stood for at its inception in 1912. The ANC is not a modern political party; they are a repressive, self serving bunch of morons who use the country’s wealth and resources to fuel their own greed and opulence. To do this they are reverting to fascist and dictatorial methods of repression by attempting to muzzle the press with the implementation of the secrecy bill. 

Many opposition leaders including Helen Zille of the DA, Bantu Holomisa of the UDM and the Rev Kenneth Meshoe of the ACDP all assert that the moral ground upon which the ANC started governing has been tainted and poisoned by government corruption, tender fraud, poor service delivery and polipreneurship where politicians are increasingly viewing politics as a business enterprise and  they are using their public tenure to stockpile huge amounts of wealth for themselves, their friends and their families. In my opinion, if the ANC stay in power for much longer, they will be awarding South Africa a one way ticket to a typical failed African state. I apologise for the hefty dose of pessimism especially at he beginning of a new year but the facts speak for themselves. What type of government that claims to ‘serve in the interests o0f the people’ spends over a hundred grand on a centenary celebration while the majority of the country don’t even have running water, food on the tables or ARV’s to curb the scourge of AIDS?? Would you as a mother eat a 5 course meal while your child is scavenging in a dustbin? 

The lack of common sense leaves me totally gobsmacked but then again how can we expect the ANC to have much common sense when our very own president hasn’t even passed matric. We shall see what this year has in store for South African politics, hopefully the DA will present a more robust opposition front rather than focussing most of their time on criticising the ANC for their untied shoelaces .Hopefully COPE can sort itself out and become the official opposition like it always promised to be, and hopefully Juju will flush himself down the toilet.