A work in progress: the new South Africa's first fifteen years

Inroads: A Journal of Opinion, Summer-Fall, 2008 by Robert Cohen

These policies coincided with an affirmative action policy known as Black Economic Empowerment. ("Black" is defined as including Africans, Coloureds and Indians, i.e. all non-Whites). Targets were set in terms of ownership of companies, management positions and access to services, although the approach was a very gradual one. The result is visible in the form of a Black middle class, known as the Black Diamonds. They have jobs, drive nice cars (a third of all the cars sold in the country in 2007 were to Blacks), wear fine clothes and jewellery, carry the latest cell phones and iPods and fill the restaurants and nightclubs. As they move into middle-class suburbs, GDP grows--as does consumer debt.

But the Gini hasn't budged noticeably: there is still a huge gap between the haves and the have-nots. Only now there are starting to be Blacks on the have side. Unemployment remains stuck at 25 per cent, not including people who have given up looking for work. An underclass is trapped in the "second economy" of subsistence agriculture, hawking, begging and crime, though it has generated some striking examples of entrepreneurship: for less than a dollar, young men watch your car while you eat in a restaurant, or people with large garbage bags in intersections help you clean out your car. Every person with means thus expects to continually contribute to the informal economy, not to mention employing maids and gardeners who support whole families on what they are paid.

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It is one thing to talk of statistics and the second economy. There are also facts on the ground. It sometimes takes a visitor to bring it into focus, like a Canadian architect friend who couldn't find the words to describe the miserable conditions of men, women and children living in the squalor of a squatter settlement in Johannesburg.

Health and HIV-AIDS

In 1994 South Africa's health system had two parallel sectors: a public sector financed through general taxation for the majority and a. private sector funded mainly through user premiums for a minority able to pay. The system continues to this day, even though health care was enshrined as a right in the 1996 constitution and completely reorganized. Spending on health care has increased, but the patient pool has increased much faster and the supply of qualified doctors and nurses has gone down.

The HIV-AIDS pandemic completely overwhelmed the system and its response capacity. Initially, programming was limited to voluntary preventive programs--educational campaigns, condom distribution, control of sexually transmitted diseases and counselling and testing. However, in the face of growing international and national pressure and a Constitutional Court ruling provoked by a South African nongovernmental organization, the Treatment Action Committee, the government was compelled to implement antiretroviral (ARV) treatment in 2002 for the prevention of mother-to-child transmission. UNAIDS reports that ARV therapy is now accessible through a network of clinics, but in 2005 only 23 per cent of HIV-infected men and women received the therapy. Moreover, about 5.5 million South Africans are living with HIV (worldwide the number is 33.2 million). This includes 18.8 per cent of adults aged 15 to 49. With 1,000 deaths a day, South Africa is home to the largest number of infected people on the whole planet. Among 15- to 24-year-old pregnant women, figures from antenatal clinics show rates around 30 per cent. A whole generation of orphans is being raised by grandparents, their parents dead of AIDS.