«ANSA Alternatives to Neo-liberalism in Southern Africa The search for Sustainable human development in Southern Africa Editors: Godfrey Kanyenze, ...»
Contrary to the expectations of the reforms, the quality of healthcare has actually declined with the introduction of user fees and the commercialisation of healthcare. However, the improvement in health outcomes is not solely the responsibility of the health sector as other variables such as income, education, water and sanitation play significant roles. The figure below is an extract from the National Health Accounts report for 1998. It shows the health expenditures as a proportion of total GDP.
On average, this stands at 5.4% with South Africa being the highest spender at 7.5% and Mozambique being the lowest at 4%.
Women have been hit hard by these budget reductions. The United Nations reports that, in Zimbabwe, maternal and infant mortality rates are "unacceptably high" in rural areas and are increasing in Harare, the capital. Infant mortality rates reflect the economic, health and social status of the mother and thus serve as a proxy variable for measuring the impact of policies on women. With HIV/AIDS, the burden shouldered by women as the providers of basic healthcare in the African household, has been made significantly heavier.
Figure 5. Health expenditure as a percentage of GDP.
Statistical data reveals that Southern Africa is one of the regions with the highest recordings of HIV/AIDS infection and prevalence. Seven countries within the SADC region53 have more than a fifth of their total adult population infected with the HIV-virus. Women in SSA tend to have higher infection rates compared to men. It is estimated that for every ten men in the region there are 12 women living with HIV. Table 10 below shows the percentage of pregnant women within the Southern African region infected with the virus.
Table 10. Pregnant women in selected SADC countries infected with the HIV-virus
In 2003, Botswana was ranked as the country with the highest HIV/AIDS prevalence in the world (UNAIDS 2003). In 1998, 48% of pregnant women in Francistown were HIV-positive, and 60% of pregnant women in Beit-Bridge, a border town in Zimbabwe (Human Development Report
1998) were estimated to be infected with the virus. In Zambia, the prevalence is 25% in young female adults compared to 10% in males. By the end of 2005, Swaziland had become the worst affected country in the SADC region, with the national HIV/AIDS prevalence rate pegged at more than 40%.
There are many biological, cultural, traditional and economic reasons that make women more vulnerable to the pandemic. Culturally, many women are not in a position to negotiate for safe sex, while economically, many of them are deprived of information and do not have the resources to access healthcare services. Some international pharmaceutical companies consider anti-retroviral therapy a profit making business so this also remains out of reach for many women.
4.3.3 Women and the increased workload Macroeconomic frameworks continue to ignore the magnitude of women’s work. There have been revisions of Statistical National Accounts (SNA) such as the one conducted in 1993, which has been considered more gender oriented than previous SNAs in that it included subsistence production. However, the essence or rather the contribution of unpaid Botswana, Lesotho, Namibia, South Africa, Zimbabwe, Zambian and Swaziland.
This is decline from 45% in recorded in 2000.
care work (e.g. fetching fuel and water) is still not included in the estimation of productive activities in national accounts. The reasons cited for this exclusion have been that such data is difficult to measure or that many of the developing countries lack the adequate resources to undertake such an exercise. In this regard, the collection of national accounting statistics still excludes unpaid care work and thus underestimates the burden carried by women because of HIV/AIDS.
Boxes A and B below show the work load in the care economy and the increases to this load work resulting from the high prevalence of HIV/AIDS respectively.
This workload is ignored by policymakers and planners and thus is generally not supported by national socio-economic frameworks. As women are more disrupted by HIV/AIDS, they are bound to be more absent from work as they attend to ill partners, children and other members of the family and community. It traditionally remains the women’s responsibility to care for sick family and community members.
HIV/AIDS has led to an increased number of orphans and child headed families and it is mostly the women in the communities who take turns to look them.
The region reports a significant increase in home-based care as a measure to deal with the challenges brought on by the pandemic. Many households cannot afford to seek professional healthcare as the health delivery systems have collapsed. In response, women have had to shoulder the burden of HIV/AIDS, with little support from government and the private sector.
4.3.4 Regional responses to HIV/AIDS HIV/AIDS has been erroneously viewed as purely a health issue (Human Development Report 2003) and this has delayed some effective strategies from being implemented. However, it is now commonly agreed within the Southern African region that HIV/AIDS has many faces. It is a health issue, a human rights issue, a gender issue and a developmental issue, which requires a multifaceted and holistic approach for it to be prevented and mitigated.
An all stakeholder approach is required, as opposed to the uncoordinated efforts present in most countries in the region. While some countries such as Botswana, South Africa, Swaziland and Zimbabwe now have National AIDS Policies and Councils in place, these are not widely distributed neither are they translated into the vernacular languages. Laws that apply to various aspects of the epidemic should be developed and implemented.
5. Trade liberalisation, a gender perspective
Alternative development strategies on trade (the multilateral trading system) should also acknowledge that trade agreements and trade liberalisation has different implications on men and women. "New" advocacy recommends that gender analysis in the negotiation and implementation of liberalisation processes is the most effective way to attain the best possible outcomes from the multilateral trading system.
Gender inequality implications of globalisation and trade liberalisation arise because these phenomena do not eliminate existing inequalities in access to resources, power and decision making between men and women in society, (Mariama Williams 2003). Trade policy remains gender biased.
Often, policymakers assume that trade has direct effects on poverty reduction for both sexes, i.e. it is assumed that increased trade flows under trade liberalisation will lead to reduced poverty among male beneficiaries, which will result in reduced poverty for their female counterparts. It ignores the fact that women and men living in the same household have different utility functions and that total household income is not always equitably shared within the household unit between the male and female members.
Given that women and men have different productive roles, (women perform both productive and reproductive roles) trade will have different impacts on men and women. Before market liberalisation and globalisation, Southern African governmental institutions made significant efforts in supporting these roles through the provision of social services and economic development initiatives that were more people oriented. It is doubtful that trade liberalisation will provide long-term benefits for women in Southern Africa as there is no evidence that gender equity has been improved through trade liberalisation.
The comparative advantage theoretical model postulates that trade liberalisation will result in increased employment of unskilled labour in developing countries (which represents the female labour force in Southern Africa), however, empirical evidence has shown that women have failed to be absorbed in the formal sector, with many turning to the informal economy for survival. Any employment that has been generated in the formal economy is often characterised by women being exposed to labour rights violations and job and employment insecurities. For example, trade liberalisation has resulted in an increase in EPZs (infamous for their employed of cheap labour and deplorable working conditions), which tend to prefer women employees to men. In cases were men workers exceed female workers, such as in Zimbabwe, EPZs still tend to employ a greater percentage of female employees as compared to other sectors of the economy.
Each of the trade agreements under the multilateral trading system (WTO) has various implications on men and women. This research focused more on some of the implications of the WTO trade agreements on women and briefly summarises the possible impact of EPAs on women in Southern
5.1 Agreement on agriculture The fact that many women in Southern Africa are found in the agricultural sector implies that the Agreement on Agriculture (AOA) impacts directly on women within this region. Supporters of neo-liberalism and the liberalisation of trade advocate that through opening markets, women will
have the following benefits:
• Market access. It is assumed that members from the developing countries will benefit from increased market access of their agricultural commodities into the developed countries’ market and no or little tariffs. This "new" market access is assumed to be enjoyed equally between men and women producers of agricultural products. In addition, the agreement assumes that dumping of agricultural and textile commodities by developed countries into developing countries’ markets will be substantially reduced, before being eliminated. Unfortunately, experience has shown that these perceived benefits have not been achieved.
Instead, AOA has resulted in food insecurity in many of the Southern African countries.;
• Trade liberalisation. In Zimbabwe for example, trade liberalisation has promoted the production of cash crops that are considered to be tradable over food crops, which are considered to be non-tradable. There has been a substantial shift from the production of food crops (e.g. maize and wheat) to horticultural crops. This shift in crop production has worsened the country’s problem of food insecurity.
• Grappa. South Africa is one of the major producers and exporter of grappa. Women are the major producers of grappa in South Africa and stand to benefit (lose) the most in the exportation of this product. In 1989, the European Union granted Italy the exclusive rights to the production and exportation of grappa.
South is also expected to have phased out the term grappa by
2006. This means that South Africa will have to rename the product and engage in international advertisement to create a new wave of brand loyalty and competes against the "traditional producer" of grappa (Italy). This has the potential to close off markets that South Africa is currently accessing for its own grappa. In the long run, the South African women directly involved in the production of grappa and its other by-products, may lose employment as casual labour in wine plantations and wineries, through job reduction as South Africa struggles to reposition itself in the international market. South Africa "grappa case" not only provides an example of the current debates for market access, but the protectionism that still continues under the guise of trade related intellectual property rights (TRIPS).
5.2 Trade related intellectual property rights Trade Related Intellectual Property Rights (TRIPS) impact on women in two categories: on agricultural activities and on access to health care.
Transnational companies have become the "owners" of seeds and of vital medical drugs. With the increase in the infection rate of HIV/AIDS in Southern Africa, TRIPS has made it difficult for both women and men to counteract the impact of the deadly virus. For decades, women have been viewed as the custodians of seeds and herbal medical remedies. The incorporation of intellectual property rights in the multilateral trading system has threatened women’s rights to store and exchange seeds and herbal medicines.
Women form the majority in subsistence and small-scale agricultural farming. They are also responsible for the provision of food and other household income flows, especially in the rural areas. TRIPs may negatively impact on how women are able to fill in these responsibilities in that the monopolisation of seeds by transnational companies removes the ability of women to produce and market their agricultural products.
They often lose the right to export locally made products onto international market, without applying for authorisation form the patent holder should they use patented inputs. In this case, biodiversity should be considered an area of critical importance to women thus the vital need for gender sensitive farmers’ rights and plant breeders’ rights.
Source: Mariama Williams. 2003
Possible alternatives to TRIPS
• Explicit gender sensitive provisions and simple administrative processes for protecting traditional knowledge and ensuring benefit sharing between men and women communities must include
• Recognition of the role, contribution and specific- gender based constraints of women farmers in the identification, maintenance and refinement of germ plasm, and creating farmers’ and traditional varieties
• Provisions and mechanisms for the protection of unwritten knowledge
• A legal basis for government department to intervene on behalf of women and the disadvantaged
• Provision for improving and ensuring women’s access to seed, credit, technology and the results of research and development
• Provisions for expanding the scope of the public’s role in research and development, including programmes for women’s greater involvement
• Provisions for compulsory licensing for essential food inputs and food security
• Rejection of the patenting of plant varieties, animal breeds or essentially biological processes
• Rejection of International Union for Protection of New Varieties of Plants UPOV 1991 as the model for sui generis systems.