AfricaFocus Bulletin
October 28, 2015 (151028)
(Reposted from sources cited below)

Editor’s Note

“Based on its inquiry, the Commission finds that there are
reasonable grounds to believe that acts of murder, rape and sexual
violence, torture and other inhumane acts of comparable gravity,
outrages upon personal dignity, targeting of civilian objects and
protected property, as well as other abuses, have been committed by
both sides to the conflict.”

For a version of this Bulletin in html format, more suitable for
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This AfricaFocus Bulletin contains excerpts from the introduction
and executive summary of the report, which was completed a year ago
but only released this month, after extensive internal consideration
by the African Union. The report is published in full, with the
exception of a confidential list of alleged perpetrators submitted
to the AU Peace and Security Council.

Although these excerpts focus on accountability for human rights
violations, the report also contains in-depth analysis and
recommendations on other fundamental issues of state-building, as
well as on continued engagement by the African Union, other
international institutions, and Sudanese civil society and
governmental institutions. In addition, there is a separate opinion
by one of the commissioners, Dr. Mahmood Mamdani, with very
substantive additional analysis. Your editor has not yet read the
full report (315 pages) and separate opinion (60 pages), but both
clearly warrant careful attention not just for their analysis of
South Sudan but also for their critical approach to international
peace-building initiatives more generally.

For other news on South Sudan, visit http://allafrica.com/southsudan
and http://sudantribune.com/

For previous AfricaFocus Bulletins on South Sudan, visit
http://www.africafocus.org/country/southsudan.php

For previous AfricaFocus Bulletins on peace and security, visit
http://www.africafocus.org/intro-peace.php

++++++++++++++++++++++end editor’s note+++++++++++++++++

Final Report of the African Union Commission of Inquiry on South
Sudan

AU Commission of Inquiry on South Sudan

Addis Ababa, Ethiopia P. O. Box 3243 Telephone: +251 11 551 7700 /
+251 11 518 25 58/ Ext 2558

Website: http://www.au.int/en/auciss

[excerpts from executive summary; full executive summary and
full report available at http://www.peaceau.org/en/article/abc]

A. Introduction

1. As part of its response to the crisis in South Sudan, the Peace
and Security Council of the African Union (AU), at its 411th meeting
held at the level of Heads of State and Government, in Banjul, The
Gambia, on 30 December 2013, mandated the establishment of the
Commission of Inquiry on South Sudan (AUCISS). In the said
communiqué, the PSC requested: […] the Chairperson of the
Commission, in consultation with the Chairperson of the African
Commission on Human and Peoples’ Rights (ACHPR) and other relevant
AU structures, to urgently establish a Commission to investigate the
human rights violations and other abuses committed during the armed
conflict in South Sudan and make recommendations on the best ways
and means to ensure accountability, reconciliation and healing among
all South Sudanese communities. Council requests that the above-
mentioned Commission submit its report to Council within a maximum
period of three months.

2. In specific terms, the AUPSC Communiqué mandates the AUCISS:

a) To investigate the human rights violations and other abuses
committed during the armed conflict in South Sudan;

b) To investigate the causes underlying the violations;

c) To make recommendations on the best ways and means to ensure
accountability, reconciliation and healing among all South Sudanese
communities with a view to deterring and preventing the occurrence
of the violations in future; and

d) To make recommendations on how to move the country forward in
terms of unity, cooperation and sustainable development;

e) To submit a report within a maximum period of three (3) months.

3. Pursuant to the AUPSC Communiqué, the Commission adopted the
Terms of Reference (ToR) detailed in the Concept Note Relating to
the Establishment of the AUCISS are to:

a) Establish the immediate and remote causes of the conflict;

b) Investigate human rights violations and other abuses during the
conflict by all parties from 15 December 2013;

c) Establish facts and circumstances that may have led to and that
amount to such violations and of any crimes that may have been
perpetrated;

d) Compile information based on these investigations and in so doing
assist in identifying perpetrators of such violations and abuses
with a view to ensuring accountability for those responsible;

e) Compile information on institutions and process or lack thereof
that may have aided or aggravated the conflict resulting in
violations of human rights and other abuses;

f) To examine ways on how to move the country forward in terms of
unity, cooperation and sustainable development;

g) Present a comprehensive written report on the overall situation
South Sudan to the African Union Peace and Security Council within a
period of three (3) months from the commencement of its activities.

h) Make recommendations based on the investigation on the following:

* appropriate mechanisms to prevent a recurrence of the conflict;

* mechanisms to promote national healing and cohesiveness,
particularly focusing on the need for all South Sudanese communities
to live together in peace;

* modalities for nation building, specifically focused on building
of a functional political order, democratic institutions and post-
conflict reconstruction;

* accountability mechanisms for gross violations of human rights and
other egregious abuses to ensure that those responsible for such
violations are held to account.

4. The Commission interpreted its mandate to consist of four focal
areas: healing, reconciliation, accountability and institutional
reforms. The Commission approached its mandate in a holistic manner,
emphasizing the interrelatedness of the mandate areas.

5. Following consultations, the Chairperson of the AU Commission
formally announced the creation of the AUCISS on 7 March 2014 at the
Headquarters of the African Union. The Commission is constituted as
follows:

The Chairperson:

i) H.E. Olusegun Obasanjo, Former President of the Republic of
Nigeria.

Other members of the Commission:

ii) Lady Justice Sophia A.B Akuffo, Judge of the Supreme Court of
Ghana, President of the African Court on Human and Peoples’ Rights.

iii) Professor Mahmood Mamdani, Professor and Executive Director,
Makerere Institute of Social Research, Makerere University, Kampala,
Uganda, Herbert Lehman Professor of Government, Columbia University.

iv) Ms. Bineta Diop, President, of Femmes Africa Solidarité (FAS),
AU Chairperson’s Special Envoy on Women, Peace and Security.

v) Professor Pacifique Manirakiza, Professor of Law, University of
Ottawa and Member, African Commission on Human and Peoples’ Rights

6. The Commission was sworn in on March 12, 2014 and thereafter
adopted a programme of work.

…

21. During the first three months following its constitution, the
Commission conducted several missions to South Sudan and
neighbouring countries during the following dates; April 16
(Khartoum), April 23-30 (Juba), May 10-15 (Kenya), May 15-18
(Uganda); May 26-June 4 (South Sudan: Juba, Bor, Bentiu and
Malakal), June 5-7 (Kenya: Kakuma Refugee Camp) and Khartoum; and 20
July – 11 August (Unity, Upper Nile, Jonglei, Central Equatoria
State, Western Equatoria State, Lakes State, Western Bahr el Ghazar
State, Northern Bahr el Ghazal State, Warrap State and Eastern
Equatoria State).

22. The Commission was granted an extension of time of 3 months by
the decision of the 23rd Ordinary Session of the Assembly of the AU
held in Malabo from 26 to 27 June 2014 following the presentation of
its Interim Report to the Assembly of Heads of States and
Government. The Commission’s request for extension of time was
justified by the need to conduct more extensive consultations with
different sectors of South Sudanese Society in all the 10 states as
well as the Diaspora (Kenya, Uganda, Switzerland, United Kingdom)
and to finalize investigations. During this second phase of the
Commission’s work, the Commission covered the entire country between
July and August in its efforts to ensure that all parts of the
society – particularly those parts of the country that were not the
specific theatres of violence but had been, inevitably, affected by
the conflict – were given the opportunity not only to offer their
perspectives on the background to the crisis but to also air their
views on the way forward for the country.

…

*******************************************************

II. Examination of Human Rights Violations and Other Abuses During
the Conflict: Accountability

125. The Commission’s inquiry and investigations focused not only on
the key areas in the four states that have been the main theatres of
violence but also extended to other places where violations could
have occurred or where relevant evidence may be found. The sites of
investigations included Juba and its environs, Bor (Jonglei), Bentiu
(Unity), Malakal (Upper Nile), rural areas surrounding these major
towns, and Kakuma refugee camp in Kenya. Time constraints precluded
visits to refugee camps in Ethiopia (Gambella), Sudan, and Uganda.
Site visits to alleged theatres of violence were undertaken where
permitted. In particular, the Commission visited Gudele joint
operation centre, Tiger Battalion barracks, Juba Teaching Hospital,
New Site burial site, Giyada Military Hospital, Bor Teaching
Hospital, St Andrews burial site, Bor burial site, Malakal Teaching
Hospital and Malakal burial site. Forensic reviews of the stated
sites were undertaken and documentation carried out. Witness or
survivor injuries were also examined by the forensic doctors and
forensic evidence was collected at crime scenes or incident sites.

Findings Relating to Violations of Human Rights and Other Abuses
(violations IHL)

126. The Commission found cases of sexual and gender based violence
committed by both parties against women. It also documented extreme
cruelty exercised through mutilation of bodies, burning of bodies,
draining human blood from people who had just been killed and
forcing others from one ethnic community to drink the blood or eat
burnt human flesh. Such claims were registered during interviews of
witnesses of crimes committed in Juba. Elsewhere, witnesses of
crimes committed in Bor Town, also provided evidence of brutal
killings and cruel mutilations of dead bodies. In Malakal town,
reports of abduction and disappearance of women from churches and
the hospital where communities had sought refuge during the
hostilities that began in December 2013 were rife. In Unity State,
Bentiu, the capital has been the focus of much of the fighting,
having changed hands several times between government and opposition
soldiers during the course of the conflict. Bentiu town is largely
destroyed. In Leer county, the Commission heard testimony of
civilians, including children and teenagers killed, houses, farms
and cattle burned, and of sexual violence.

127. Overall, the Commission found that while there was limited
active conflict in all states visited, tensions remain high in the
three most conflict affected states of Upper Nile, Unity and
Jonglei. Many respondents talked of fear and all stakeholders and
interlocutors noted a level of anxiety of an impending attack by one
side or the other. Life for civilians in all three state capitals of
Malakal, Bentiu and Bor has not fully returned to normal. The
majority of civilians remain either in UNMISS protection of civilian
sites (POCs) or in inaccessible locations in the surrounding
villages and rural areas. Guarantees of security remain a great
concern for civilians.

128. The Commission found that most of the atrocities were carried
out against civilian populations taking no active part in the
hostilities. Places of religion and hospitals were attacked,
humanitarian assistance was impeded, towns pillaged and destroyed,
places of protection were attacked and there was testimony of
possible conscription of children under 15 years old.

129. The Commission found that unlawful killings of civilians or
soldiers who were believed to be hors de combat (no longer taking
part in hostilities), were committed in and around Juba. The people
killed were either found during the house to house searches or
captured at roadblocks.

130. The Commission found that violations of human rights and other
abuses in relation to massive and indiscriminate attacks against
civilians and civilian property were carried out in Bor town.
Visible evidence of torched non- military objects like houses,
market place, administration houses, hospital and hospitals form the
basis of the Commission’s conclusion that these crimes were
committed. The Commission also found that civilians were targeted in
Malakal, which was under the control of both parties at different
times during the conflict. Serious violations were committed in
Malakal Teaching Hospital through the killings of civilians and
women were raped at the Malakal Catholic Church between 18th and
27th February 2014. In Bentiu the Commission heard testimony of the
extremely violent nature of the rape of women and girls – that in
some instances involved maiming and dismemberment of limbs.
Testimony from women in UNMISS PoC Site in Unity State detailed
killings, abductions, disappearances, rapes, beatings, stealing by
forces and being forced to eat dead human flesh.

131. Based on its inquiry, the Commission finds that there are
reasonable grounds to believe that acts of murder, rape and sexual
violence, torture and other inhumane acts of comparable gravity,
outrages upon personal dignity, targeting of civilian objects and
protected property, as well as other abuses, have been committed by
both sides to the conflict.

132. The Commission found that the context in which these violations
and crimes were committed is a non-international armed conflict
(NIAC) involving governmental (and allied) forces and SPLM/IO
fighters.

133. The Commission’s investigations as well as information received
from various sources, including its consultations, leads the
Commission to conclude that there are reasonable grounds to believe
that serious violations of human rights have occurred and that
serious violence of other abuses have also occurred, which, given
the context in which they have occurred – may amount to violations
of international humanitarian law.

Finding on the Crime of Genocide

134. The Commission finds that based on the information available to
it, there are no reasonable grounds to believe that the crime of
genocide has occurred.

135. Despite the seeming ethnic nature of the conflict in South
Sudan, the Commission, during its consultations with various groups
and individuals did not have any reasonable grounds to believe that
the crime of genocide was committed during the conflict that broke
out on December 15, 2013.

Recommendations Relating to Violations of Human Rights and Other
Abuses (Violations of IHL)

136. The Commission recommends the establishment of an ad hoc
African legal mechanism under the aegis of the African Union which
is Africa led, Africa owned, Africa resourced with the support of
the international community, particularly the United Nations to
bring those who bear the greatest responsibility at the highest
level to account. Such a mechanism should include South Sudanese
judges and lawyers. The Commission has identified possible alleged
perpetrators that might bear the greatest responsibility using the
standard of ‘reasonable grounds’ to believe that gross violations of
human rights and other abuses have occurred during the conflict (see
the highly confidential list not publicly available as part of this
report).

137. The Commission believes that with appropriate reforms, both
military and civilian justice can and should contribute to
establishing accountability. The Commission therefore recommends
that immediate reforms of civilian and military justice be
initiated. While it is believed that a long-term reform process of
the judiciary is necessary (see section recommendations related to
the judiciary above), a minimalist approach can be adopted with
respect to the criminal justice system.

138. Based on the central role played by customary justice in
facilitating access to justice in South Sudan, and the views
expressed by South Sudanese that this institution must play a role
in reconciliation at community level, the Commission recommends that
an appropriate role should be fashioned for traditional justice and
conflict resolution mechanisms, to be established in relationship
with formal accountability processes as well as the peace and the
national healing, peace and reconciliation. The Rwandan experience
with Gacaca could be instructive.

139. The Commission’s inquiry established that South Sudanese
traditional justice mechanisms combine retributive and restorative
remedies which include payment of compensation in modes acceptable
by litigants, often cattle. The notion of civil accountability i.e.
compensation to an individual for loss suffered, is indeed one of
the key features of South Sudan’s indigenous justice systems. More
importantly, the moral authority and legitimacy inherent in the
traditional systems, as understood and valued by the South Sudanese
people has a valuable role to play in healing and reconciliation and
appeasing the deeply felt grievance occasioned by violations
suffered by individuals and communities.

140. The Commission therefore recommends the creation of a national
reparations fund and programme linked appropriately to these
traditional justice mechanisms, to benefit victims of gross human
rights violations. Eligibility for reparative measures undertaken
(including rehabilitation and psychosocial assistance should not be
limited to the period to which the Commission’s mandate relates
(from December 15, 2013) but can include victims of past human
rights violations. While certain elements, particularly psychosocial
assistance and other appropriate forms of interim reparations should
be implemented immediately the broader reparations programme can be
linked to the work of a future Truth Commission.

Findings Relating to Healing and Reconciliation

141. The Commission found that the multiple conflicts and repeated
violations of human rights experienced in South Sudan have wrecked
relations between and among communities, and generated many victims.
It also established that the policy of amnesty adopted by the
government after the signing of the CPA left the past unexamined,
conflicts unresolved and their impacts, partly represented in
victims and survivors of human rights violations unaddressed.

142. The crisis has occasioned massive displacement of South
Sudanese (a reported 1.5m). Many of those displaced have live in
multiple protection sites and IDP camps around the country while
others have taken refuge in neighbouring countries.

143. The Commission’s consultations disclosed that many South
Sudanese take the view that reconciliation is dependent upon
justice, which is broader than criminal justice. The view was
expressed that those who have committed atrocities should be
prosecuted, and that victims and communities are unlikely to embrace
reconciliation otherwise, given the culture of impunity in South
Sudan. Recommendations Relating to Healing and Reconciliation

144. The Commission believes that the only sustainable solution to
facilitate the return of IDPs and refugees to their homes, is
dependent upon a political settlement in the ongoing mediation
process. The Commission urges all actors to work towards a speedy
resolution of the crisis.

145. The Commission recommends that warring parties should
facilitate the movement of IDPs in and out of the camps in their
respective areas of control.

146. It is the Commission’s view that it is necessary to establish a
structured process to provide an opportunity for South Sudanese to
engage with their history, to discover the truth about the conflicts
and human rights violations of the past, and to attend to the needs
of victims. This is the only way to foster healing, peace and
reconciliation in South Sudan, and to forge a common future. Such a
body should lead to truth, remorse, forgiveness and restitution
where necessary, justice and lasting reconciliation being achieved.

147. The Commission recommends that such a structured process must
involve and include women as key stakeholders, and that processes
and procedures operated by a future mechanism should be gender-
sensitive.

148. Overall, it is recommended that there is a need for a national
process, however organised, to provide a forum for dialogue, inquiry
and to record the multiple, often competing narratives about South
Sudan’s history and conflicts; to construct a common narrative
around which a new South Sudan can orient its future; to uncover and
document the history of victimization and to recommend appropriate
responses.

149. The Commission urges all sectors of South Sudanese society and
relevant regional and international actors to unite around the
process of national reconciliation, which is necessary for the
restoration of sustainable peace, social cohesion and stability.

150. The Commission recommends that the Truth and Reconciliation
should be established in relationship with ‘hybrid’ mechanisms such
as Wunlit with a mandate to investigate human rights violations and
to drive a national peace and reconciliation process. Unlike Wunlit,
such hybrid mechanism should be comprehensive, rather than
localized. Such mechanisms would operate under the national
mechanism, which should develop guidelines that seek to among
others, align the operations of grassroots mechanisms with human
rights and other identified ideals.

151. The Commission also recommends the establishment of a framework
for memorialization as part of the broader process of reparations.
This process should be inclusive and participatory.

On Sequencing Peace and Justice

152. The Commission’s discussion of the relationship between peace
and justice concluded that while they should be conceived as
complementary, comparative experience shows that the two notions are
often in tension, and that the context in which relevant processes
unfold is critical: while some contexts allow for reconciliation
processes and justice, particularly criminal justice measures to be
undertaken at the same time, multiple factors in other contexts
militate against such an approach. In these contexts, sequencing
offers an alternative approach that responds to the imperatives of
justice and the need to reconcile and establish stability in post
conflict societies.

153. Having considered the specific context of South Sudan, the
Commission recommends that consideration should be given to
sequencing of peace and justice, with the result that certain
aspects of justice allow for the establishment of basic conditions,
including restoring stability in South Sudan and strengthening of
relevant institutions. This should facilitate necessary reform of
the criminal justice system in order to implement some of the
Commission’s recommendations on accountability. These necessary
reforms to civilian and military justice should, in the context of
broader institutional reforms, facilitate the institution of
reconciliation measures.

*****************************************************

AfricaFocus Bulletin is an independent electronic publication
providing reposted commentary and analysis on African issues, with a
particular focus on U.S. and international policies. AfricaFocus
Bulletin is edited by William Minter.

AfricaFocus Bulletin can be reached at africafocus@igc.org. Please
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or to suggest material for inclusion. For more information about
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mentioned. For a full archive and other resources, see
http://www.africafocus.org

By James Thompson

Note: For many years many people have prayed to divine beings to deliver human beings from a variety of cataclysms to no avail. Their prayers have been met with wars, famine, homelessness, racism, sexism, xenophobia and poverty. Perhaps it is time that prayers are addressed to those who can change the course of history. Divine beings do not cause wars, famine, homelessness, racism, sexism, xenophobia and poverty. Human beings are responsible for these societal ills.

Let us pray!

Dear humanity:

Let us gather our collective strength to battle the ills that persecute us.

Let us find the wisdom to discern the difference between the wealthy who oppress us and our fellow workers who share in our oppression.

Let us demand that the wealth that we workers produce be shared equally among all people.

Let us demand an end to all imperialist wars of oppression and prepare ourselves for a class war in which workers can prevail over their oppressors.

Let us demand an end to fascism, terrorism and efforts to achieve world domination.

Let us demand an end to famine, homelessness, homophobia, racism, sexism, xenophobia and poverty.

Let us utilize our collective political strength to overcome oppression in all its forms.

Let us demand democracy for working people and an end to democracy for the wealthy to the exclusion of all other peoples.

Let us work for education for all people, healthcare for all people, housing for all people and food for all people.

Let us work for collective human respect for our environment as well as respect for all beings on this planet.

Let us fight against the negative forces of the wealthy who seek to enslave all humans, animals and the environment for their selfish desires.

Let us demand an end to nuclear weapons. We must remember that all beings can be cremated equally.

Let us respect all sovereign nations until we achieve a socioeconomic system in which nations are irrelevant.

Let us respect all religions equally. Let us respect those who choose no religion.

Let us work for the unity of working people to achieve the above goals.

May it be so.

AfricaFocus Bulletin
October 20, 2015 (151020)
(Reposted from sources cited below)

Editor’s Note

“Despite MTN having its headquarters located in South Africa, 55% of
the “management and technical fee payments” flow to “MTN
International” (MTNI)–a company which has no staff and is located
in Mauritius. The remaining 45% was paid to MTN Dubai–a subsidiary
which the company says it renders international financial services
and shared services to MTN Group.” – Quartz Africa, on new report by
amaBhungane and Finance Uncovered

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The “Africa Rising” narrative is dubious as a gross
oversimplification of African reality. But it does point to at least
one important reality: the growth of consumer markets that are
attracting much international attention. Particularly notable are
two ubiquitous consumer goods, one old (beer), one new (mobile
phones), which are producing enormous profits. The question is where
do those profits go?

This AfricaFocus Bulletin contains several background documents
related to (1) the South African mobile company MTN and exposure of
its profit-shifting strategies in a new report, and (2) the giant
formerly South African beer company SABMiller (just being
purchased by a rival global giant Anheueser-Busch InBev). SABMiller
was featured in an ActionAid report in 2010, which is summarized
below. So, to understand the complexity of “Africa Rising,” consider
these tax tricks the next time you are drinking beer and browsing on
your mobile phone.

For previous AfricaFocus Bulletins on tax evasion, illicit financial
flows, and related issues, visit
http://www.africafocus.org/intro-iff.php

For previous AfricaFocus Bulletins on information and communication
technologies, visit http://www.africafocus.org/ictexp.php

++++++++++++++++++++++end editor’s note+++++++++++++++++

Tax Tricks

South Africa’s ‘next president’ is entangled in another corporate
tax dodging allegation–this time it’s with MTN

Sibusiso Tshabalala

October 13, 2015 Quartz Africa

http://qz.com/522656/

For more detailed report, see http://amabhungane.co.za / direct URL:
http://tinyurl.com/od3s9fd

South Africa’s deputy president Cyril Ramaphosa–long seen as the
most likely next successor to president Jacob Zuma–has seen his
name caught up in another corporate tax dodging allegation, this
time with Africa’s largest mobile phone company MTN.

Last week Friday, amaBhungane, an investigative journalism
organization, and Finance Uncovered, a global network of
journalists, published a story alleging that Africa’s largest mobile
network, MTN, was involved in shifting millions of dollars from its
subsidiary companies in Nigeria, Uganda, Côte d’Ivoire and Ghana to
companies in Dubai and Mauritius in order to avoid its tax
obligations. This all happened under Ramaphosa’s watch, as he was
chairman of MTN’s board of directors, between 2001 and 2013.

In September last year, South Africa’s Mail and Guardian reported
that Lonmin–a mining company which Ramaphosa was a board member of
between 2010 and 2013–was involved in a scheme to move profits
generated from its platinum mining activities in South Africa to
Bermuda.

While Ramaphosa, one of South Africa’s richest men, has taken a
strong public stance against tax avoidance as deputy president it
doesn’t seem to be in tune with his former life as a captain of
industry. It is also causing a revision to the expectation that he
is next in line when Zuma’s term ends in 2019.

According to the report, MTN subsidiary companies in Nigeria,
Uganda, Cote d’Ivoire and Ghana paid “management fees”–which
according to MTN cover for elements like back office support,
technology transfer (to subsidiary companies) and use of the MTN
brand.

While it is common for telecom companies to charge their
subsidiaries management fees–as MTN itself argues in a response to
a set of questions asked by the investigative team–the bone of
contention is whether the large sums of money flowed to “real
offices staffed with people doing actual work to earn the money” as
the investigative report states.

MTN’s ‘management fees’

The investigative team reports that despite MTN having its
headquarters located in South Africa, 55% of the “management and
technical fee payments” flow to “MTN International” (MTNI)–a
company which has no staff and is located in Mauritius. The
remaining 45% was paid to MTN Dubai–a subsidiary which the company
says it renders international financial services and shared services
to MTN Group.

Territories like Dubai and Mauritius are better known as “tax
havens”–many multinational companies stash their profits here using
complicated payment systems to subsidiaries. The lure of a low tax
rate, or a sometimes a zero-rate tax regime, is hard to resist: it
means multinationals can cut the cost of doing business without
paying tax in the country they’re required to do so.

Chris Maroleng, MTN spokesman said the company has not been involved
in any tax avoidance scheme and that it had responded fully to the
investigative team’s claims.

“We have been able to prove that we’re tax compliant in all our
operational jurisdictions. We have not infringed any laws and we
have nothing to hide,” said Maroleng. He added that MTN had been in
contact with the amaBhungane and Finance Uncovered team for a
“protracted period” and that the company had satisfied itself with
all of its responses.

The deputy president’s office said it is referring all queries on
the matter to MTN.

Meanwhile, the Right 2 Know campaign, a South African organization
that advocates for freedom of expression and anti-corruption, has
played on a MTN ad-slogan from 2009 to signal their discontent. MTN
frequently used the South African slang word “ayoba” (loosely
translated as “cool”) in their ads. Now R2K–is calling for the
investigations against–has spun the slogan back to the company and
Ramaphosa. Their version: “Tax dodging is not ayoba.” (
http://www.r2k.org.za/2015/10/12/investigate-mtn-ramaphosa/)

*************************************************************

Finance Uncovered Investigation: MTN’s Mauritian Billions

Finance Uncovered, 09 Oct, 2015

http://www.financeuncovered.org/ – Direct URL:
http://tinyurl.com/qhklzpa

The Finance Uncovered global network of investigative reporters have
today published a cross-border investigation into South African
telecoms giant MTN exposing how billions of rand from its
subsidiaries in Ghana, Nigeria and Uganda have been shifted to a
shell company in the small island tax haven of Mauritius.

The two year investigation spanning five countries was published
today in South Africa’s Mail and Guardian, the Ugandan Observer and
Ghana Business News.

The reporting team

Finance Uncovered is a global network of journalists from over 55
countries across the globe. This investigation was undertaken by
Craig Mckune of amaBhungane in South Africa, George Turner and Nick
Mathiason from Finance Uncovered in London, Francis Koktuse in
Ghana, Emmanuel Mayah in Nigeria and Jeff Mbanga in Uganda.

A report in Nigeria will follow shortly.

MTN’s Offshore Payments

The reporting team discovered MTN revenue producing companies
operating in Ghana, Nigeria, Uganda and Cote d’Ivoire made
substantial payments to offshore companies in Dubai and Mauritius.
These payments were counted as a cost of business for the operating
companies, lowering their profits and potential tax bill.

The enormous sums were purportedly for management and technical
services performed on behalf of these companies, as well as royalty
payments for the use of the MTN brand. In Ghana, these payments
accounted for more than 9% of the turnover of the company.

African journalists in Ghana, Nigeria and Uganda working with
Finance Uncovered discovered that 55% of management and technical
fee payments are directed towards MTN International, a company based
in Mauritius. The Mauritius company has no staff and is little more
than a post box. The remaining 45% was routed to MTN Dubai, where
the company employs 115 staff who provide shared services to the
group.

MTN told reporters that MTN International remunerates companies in
South Africa for management services performed on behalf of the
company. They were unable to answer why the payments were made to
Mauritius first.

Company documents published by MTN said that money in MTN Mauritius
was used to repay external debts of the MTN group and dividends,
rather than pay for management services.

But after further questions were put to MTN, the company was forced
to admit that not all of the revenue was passed onto South Africa.
The company refused to disclose how much it kept in Mauritius.

The company said that MTNI is resident in South Africa for tax
purposes and the Mauritian entity gives no tax benefit to the
company.

MTN in Africa

Our revelations are particularly sensitive given the sheer size of
MTN. The South African listed firm is the largest cell phone company
in Africa with 227,503,000 subscribers worldwide. Almost one in four
mobile phones in Africa are part of the MTN network a total of 161m.

This means MTN is the largest company in many of the countries in
which it operates. It is also frequently one of the largest
taxpayers in African countries so they are particularly vulnerable
to profit shifting by the company.

Game over?

Our investigation has established that a number of African countries
have now challenged the offshore payments made by MTN. Authorities
in Nigeria and Ghana have frozen payments and the Ugandan
Authorities has placed a large tax bill on the company for
management fees paid over a 6 year period.

Ghana

Scancom, MTN’s subsidiary in Ghana, paid 758m Cedi (Rand 3.7bn,
$401m) in management and technical fees to MTN Dubai between 2008
and 2013 equivalent to 9.64% of the company’s revenue.

An agreement between the Ghanaian Investment Promotion Centre and
the company that allowed the management fees to be paid expired in
2013 and payments have been frozen. MTN is currently negotiating a
new agreement with GIPC.

Uganda

MTN Uganda paid 3% of turnover in management fees between 2003 and
2009 to MTNI in Mauritius. The Uganda Revenue Authority issued MTN
with a “notice of assessment” in 2011. This was for a number of tax
issues between 2003 and 2009, but a large portion was to do with a
dispute over management fees. The total tax bill from the URA was
R467m ($69m).

Nigeria

In 2013 the company disclosed that it had paid R2.5bn ($562m) in
fees to MTN Dubai between 2010 and 2013. The company made this
disclosure because the fee payments had been reversed following a
failure to come to a new agreement on management fees with Nigerian
regulators.

Despite these fees being paid to MTN Dubai, MTN confirmed to us that
these fees are then ‘on-paid’ to MTNI in Mauritius and that MTNI
Mauritius is the ‘ultimate beneficiary’ of the fees.

Cote d’Ivoire

MTN has confirmed to us that the company paid 12bn West African
Francs in 2012 and 14bn West African Francs (Rand 512.9m, $55.53m)
in 2013 in management fees to MTNI. The figure for 2013 is
equivalent to 5% of the revenue made by MTN in Cote d’Ivoire.

*****************************************************

Finance Uncovered, “Can We Beat Tax Avoiding Multinationals?,”
Finance Uncovered, Oct. 18, 2015
[Brief excerpt. For full article visit
https://www.byline.com/column/39/article/499]

How the MTN case shows that OECD “solutions” for such tax evasion
will not work.

“Unfortunately the OECD proposals are unlikely to bring these
practices to an end, and could even make the whole process even less
transparent.

The OECD has embraced the arm’s-length concept and many of the
solutions it proposes are simply aimed at giving tax authorities
more and better tools to use in their transfer pricing
investigations. There will be better access to comparable data to
determine prices, bigger books of guidance for tax authorities, but
in the end tax authorities will continue to need to rely on complex
investigations and highly subjective analysis of the complicated
internal structures of multi-national companies.”

******************************************************

“Calling Time: Why SABMiller should stop dodging taxes in Africa”

by ActionAid, November 2010, Updated 2012

Summary by Malik Stan Reaves written for AfricaFocus Bulletin and
US-Africa Network, Oct. 20, 2015

Full report available at
http://www.actionaid.org.uk/tax-justice/calling-time-the-research

London-based SABMiller plc is the world’s second largest beer
company making more than $3 billion a year in profits. The origins
of the company date back to the founding of South African Breweries
in 1895 and it owns several African breweries. Its many brands
include Coors Light, Miller Light, Keystone Light (#2, #4, and #12
in sales in the USA), Castle, Kilimanjaro, and Lion (in Africa), and
Grolsch (in Europe and global).

The company has some 65 tax havens, and this ActionAid report
estimated it has used them to reduce their tax bills by as much as
1/5 in Africa. For example, its Ghana operations generate about $45
million a year, yet SABMiller paid no taxes for the two years before
the report and only for one year in the prior four years.

ActionAid estimated loses to governments in Africa of as much as $30
million a year, “enough to put a quarter of a million children in
school.”

To avoid paying taxes, SABMiller uses transfer pricing payments made
by its subsidiaries to sister companies in the corporation. “These
payments can reduce or even eliminate profits in one place at
a stroke of an accountant’s pen; a kind of financial alchemy that
also shrinks the company’s tax bill.”

ActionAid examined the accounts of eight SABMiller subsidiary
companies in Ghana, Mozambique, Tanzania, South Africa, Zambia and
India, along with researching the tax systems in these countries.
ActionAid identified four “tax-dodging” techniques used in Africa.
Tax dodging or tax avoidance is seen by ActionAid as designed to
comply with the letter of the law though the practice is
irresponsible and unethical (whereas tax evasion breaks tax laws).
The report notes that there is no mention of tax in SABMiller’s code
of business conduct and ethics.

The first is a loophole in Dutch tax law which allows SABMiller’s
Dutch holding company for its African operations, Rotterdam-based
SABMiller International BV, to pay next to no tax on the royalties
they earn. “Six SABMiller companies in Africa paid this Dutch
company $37.5 million in royalties last year, according to their
most recent accounts. If the company’s African operations that do
not publish accounts also make payments at the same rate, the total
can be expected to be $65 million. This corresponds to an estimated
tax loss to African countries of $15 million.”

The second dodge involves millions in management fees paid yearly by
African subsidiaries to SABMiller companies in European tax havens,
mostly in Switzerland. Some fees are high enough to wipe out all
taxable profits.

In the third dodge, SABMiller subsidiary Mubex in Mauritius is used
by SABMiller breweries in other African countries as a purchasing
agent, even though the goods may not be produced in or even transit
through Mauritius. Mubex makes a profit, the amount of which is
unknown due to tax haven secrecy, and is taxed at 3% as against what
would be much higher rates in the countries where the beer is
actually produced.

In the fourth tax dodge, African breweries are able to borrow money
from Mubex, in Ghana’s case seven times what’s allowed in that
country, leading to interest costs that erase sizable amounts of tax
liability.

ActionAid calls on SABMiller to do three things:

1. Take a responsible approach to tax. Stop using tax havens to
siphon profits out of Africa, for example by ending the huge
payments for lucrative brand rights and management services to
Switzerland and the Netherlands.

2. Understand and disclose the impact of its tax planning. SABMiller
needs a tax code of conduct to explain how it applies its
sustainable development principles to its tax affairs. It should be
open and transparent about its use of tax havens and tax avoidance
techniques.

3. Be more transparent about financial information. Make public the
accounts of each of its subsidiaries – especially for companies in
countries where accounts are kept secret – and provide a country-by-
country snapshot of tax payments and other financial information.

It further lays out several recommendations for governments to shore
up their tax operations and policies.

Outcomes:

In June 2011, a meeting of tax authorities from several African
countries, supported by the African Tax Administration Forum (ATAF),
considered the findings of the report. A multilateral tax treaty was
presented to ATAF’s council meeting the following year which would
“allow African countries to work together to investigate the tax
affairs of multinational companies operating across the continent”
(page 3, para 3).

Other Actions:

“Over 10,000 people across the world have taken action, asking
SABMiller to adopt a more responsible approach to its tax affairs in
the developing world. The company has been questioned in media
interviews, by ActionAid at its Annual General Meeting, and by
students at Edinburgh University, who voted to ban the company’s
beers from their student union.”

“Schtop tax dodging” beer mats found their way to Australia, Sweden,
the Netherlands, Ghana, South
Africa, Senegal and the United States.”

ActionAid charcterized SABMiller’s response to the outcry over its
practices as “a combination of denial and obfuscation,” including
ownership moves resulting in reduced transparency and shifting
exposure in Mauritius, but “increased royalty payments and
management service fees paid into tax havens across the continent.”

Given the “protests and occupations” in the 18 months since the
original publication of Calling Time, they noted that “corporate
attitudes towards tax have changed…increasingly aware of the
reputational issues… involved in governance around tax.”

Note:  The corporate malfeasance in this ActionAid report is
identified as tax avoidance rather than tax evasion. ActionAid is
thus not accusing SABMiller of breaking any laws but of being
unethical and irresponsible “in failing to acknowledge the impact of
its tax dodging on public revenues.” The term “illicit financial
flows,” not yet in wide use at the time of the ActionAid report, is
not a concept used in this report. To what extent some forms of
abusive transfer pricing may be illegal as well as illegitimate is a
still unresolved issue in the literature on the subject.

*****************************************************

Beer & Mobile as Rising Retail Markets

“Anheuser-Busch InBev and SABMiller to Join,” New York Times, Oct.
13, 2015 http://tinyurl.com/otmzfxt

“The research firm Euromonitor International estimated on Tuesday
that the combined Anheuser-Busch InBev-SABMiller would account for
29 percent of global beer sales, after selling assets to win
regulatory approval. It also would be more than three times as large
in terms of sales as its next closest competitor, the Dutch brewer
Heineken, according to Euromonitor.”

“Bud-SAB tie-up hinges on a scramble for Africa,” Reuters, Sept. 24,
2015
http://tinyurl.com/ngsavbz

“Africa is Budweiser’s lost continent. For SABMiller, it is the
jewel in the crown. Where Anheuser-Busch InBev is basically absent,
Africa generated 28 percent of SAB’s revenue and 30 percent of its
EBITDA [Earnings Before Interest, Taxes, Depreciation and
Amortization]
last year. That’s the key to a potential offer by the Budweiser
brewer for its $89 billion rival.”

“SAB and Castel, one of its partners, share around 55 percent of
Africa’s ‘formal’ beer market.”

“The Beerhemoth,” The Economist, Oct. 17, 2015
http://tinyurl.com/pwwjula

“The battle lasted one tumultuous month. In September SABMiller, the
world’s second-largest brewer, said it was the target of a takeover
by its bigger rival, AB InBev. There followed a volley of bids,
skirmishes in the press and tense private talks: between them, the
firms’ main shareholders include a big tobacco company, the dashing
scion of Colombia’s richest family and three Brazilian billionaires,
not to mention South Africa’s public-investment fund. On October
13th, one day before a deadline mandated by British takeover rules
(SABMiller is listed in London), the companies announced a tentative
deal.”

“The Mobile Economy: Sub-Saharan Africa 2015”
http://gsmamobileeconomy.com/ssafrica/

“The mobile industry in Sub-Saharan Africa continues to scale
rapidly, reaching 367 million subscribers in mid-2015. Migration to
higher speed networks and smartphones continues apace, with
mobile broadband connections set to increase from just over
20% of the connection base today to almost 60% by the end
of the decade. Falling device prices are encouraging the rapid
adoption of smartphones, with the region set to add more than
400 million new smartphone connections by 2020, by which
time the smartphone installed base will total over half a billion.”

********************************************************

AfricaFocus Bulletin is an independent electronic publication
providing reposted commentary and analysis on African issues, with a
particular focus on U.S. and international policies. AfricaFocus
Bulletin is edited by William Minter.

AfricaFocus Bulletin can be reached at africafocus@igc.org. Please
write to this address to subscribe or unsubscribe to the bulletin,
or to suggest material for inclusion. For more information about
reposted material, please contact directly the original source
mentioned. For a full archive and other resources, see
http://www.africafocus.org

Africa/Global: Health Challenges & Threats

AfricaFocus Bulletin
October 13, 2015 (151013)
(Reposted from sources cited below)

Editor’s Note

Last week was the first week since March 2014 that no new cases of
Ebola were reported in the affected West African countries. And late
last month the World Health Organization announced official
guidelines for beginning antiretroviral therapy for all persons
infected with HIV even before they show symptoms of AIDS. Fully
eradicating either disease and building sustainable health system
remain  formidable challenges, however. At the same time, U.S.
policy to promote greater protection for large pharmaceutical
companies in trade negotiations poses a still rising threat to
global efforts to guarantee the universal right to health.

For a version of this Bulletin in html format, more suitable for
printing, go to http://www.africafocus.org/docs15/rth1510.php, and
click on “format for print or mobile.”

To share this on Facebook, click on
https://www.facebook.com/sharer/sharer.php?u=http://www.africafocus.org/docs15/rth1510.php

This AfricaFocus Bulletin contains one short article on the threat
to health in the least developed countries from hard-line U.S.
policy on protection for pharmaceutical companies, followed by links
with short excerpts from other recent articles on Ebola, the cost of
medicine and the current dysfunctional pharmaceutical system,
HIV/AIDS, and a promising advance in  medical technology providing
cost-effective blood auto-transfusion in developing countries.

While progress has been made both on the long-term pandemic HIV/AIDS
and the West African Ebola epidemic more recently, neither battle is
completely won. Neither have the economic, personal, and societal
damages been repaired, nor the world’s health systems prepared for
new epidemics, nor the necessary resources invested to guarantee the
universal right to health.

For previous AfricaFocus Bulletins on health and related issues,
visit http://www.africafocus.org/intro-health.php

The WHO Ebola Situation Report is available at
http://apps.who.int/ebola/ebola-situation-reports

Updates on AIDS are available at http://www.unaids.org

Frequent updates on the status of access to medicines are available
on the MSF / Doctors Without Borders website on this issue at
http://www.msfaccess.org/

++++++++++++++++++++++end editor’s note+++++++++++++++++

LDCs be damned:  USTR and Big Pharma seeks to eviscerate Least
Developed Countries’ insulation from pharmaceutical monopolies

Professor Brook K. Baker, Health GAP and Northeastern U. School of
Law

HealthGap blog, October 12, 2015

http://www.healthgap.org/blog – Direct URL:
http://tinyurl.com/pbhd94q

Professor Brook K. Baker, Health GAP (Global Access Project) &
Northeastern U. School of Law, Program on Human Rights and the
Global Economy
Honorary Research Fellow, Faculty of Law, Univ. of KwaZulu Natal, SA

In November of 2001, at the height of the global AIDS pandemic,
every WTO member country in the world, including the United States,
voted unanimously in the Doha Declaration on the TRIPS Agreement and
Public Health that WTO Least Developed Countries members should be
granted an unconditional extension of any obligation to grant or
enforce patents, data protections, or exclusive marketing rights on
pharmaceutical products.  These countries desperately needed access
to affordable generic medicines and freedom from the pillage of Big
Pharma’s monopoly pricing.  This sensible and humane transition
policy was confirmed by votes of the WTO TRIPS Council and General
Council in 2002.

Fast forward to 2015, and LDCs are again seeking an extension of
that same no-pharmaceutical-monopolies policy, which expires on
January 1, 2016.  Their request has reportedly received approval in
nearly every capital of the world – except Washington D.C. (with
some weakening opposition from Australia, Canada, and Switzerland).
Nothing in the plight of least developed countries has changed –
they remain desperately poor, they continue to lead the world in
negative health statistics and early death, and they continue to
struggle with development challenges and inadequate capacity in
their industrial, technological, and administrative sectors.  More
to the point, they continue to need access to affordable medicines,
and, if possible, new manufacturing capacity and expertise to
produce at least some medicines on their own.

What the LDCs seek is simple: rather than another time limited
extension (even a relatively long 15 year one like the one they
first got), is an extension that lasts as long as they remain an
LDC.  Once an LDC member transitions to lower-middle income status,
its obligation to begin to process, grant, and enforce patents and
data protections on medicines would change.  But in the meantime,
countries that were still LDCs could import cheaper generics legally
from abroad or manufacture them locally with no intellectual
property restrictions whatsoever.

What does the United States Trade Representative want – what pound
of flesh is it seeking from LDCs for an further extension that is
guaranteed to them by paragraph 7 of the Doha Declaration and by
Article 66.1 of the TRIPS Agreement?  After all those documents
state that initial TRIPS transition periods, like LDCs had for
pharmaceuticals, were granted without prejudice to further
extensions and that WTO member “shall, upon duly motivated request
by a least-developed country Member, accord extensions [of LDC
TRIPS-compliance transition periods].”  In this context, “shall”
means “must,” no “ifs,” “ands,” or “buts.”

Instead of acceding to these clear TRIPS mandates, the USTR is
unwilling to discuss an extension for as long as an LDC remains an
LDC and instead is demanding a more miserly, time-limited extension.
The US has been unwilling to state its position publicly.  Instead,
it has selectively listened to corporate “stakeholders” at home,
namely PhRMA and BIO, who oppose an unlimited extension because …
well, because of what they say to back up every IP monopoly demand:
“We need more profits, even from the poorest countries in the world,
in order to research the next generation of life saving medicines.”

Unfortunately, the USTR has not listened to access-to-medicines
advocates who wrote a letter urging US support for the LDC extension
over a month ago with no response to date.  Nor is the USTR
listening to other “key” US stakeholders including Senator Sanders,
and Representatives Jan Schakowsky (D-Ill.), Rosa DeLauro (D-Conn.),
Jim McDermott (D-Wash.), Raúl M. Grijalva (D-Ariz.), Keith Ellison
(D-Minn.), Barbara Lee (D-Calif.), and Sam Farr (D-Calif.), elected
officials who have all have expressed unequivocal support for the
LDC request.  Even the European Commission has voted unanimously in
favor of the unlimited extension.

At a meeting in Geneva with 15 Ambassadors from the LDC Group on
Friday October 9, Ambassador Michael Punke, Deputy United States
Trade Representative and U.S. Ambassador and Permanent
Representative to the World Trade Organization, and gave a
startling, unbelievably craven and subservient justification for the
US demand for a short-duration extension.  He said that Big Pharma
was disappointed with the additional intellectual property and
pharmaceutical protections the US secured for it in Trans Pacific
Partnership negotiations and thus that the US could not give ground
on the LDC extension.

Right, the poorest countries in world should get shortchanged on
their desperately needed access to more affordable generic medicines
because Big Bio did not get 12 years of data exclusivity monopoly
protections on their $100,000-plus per-patient-per-year biologics.

The USTR’s policy positions on the LDC extension request are deadly.
They cynically safeguard Big Pharma’s global monopoly empire with
potential catastrophic effects on LDCs ability to strengthen their
human and technological well-being.  At a time when we see migrants’
bodies washing onto European beaches, the USTR wants to make sure
that pharmaceutical capacity is stillborn in many of the countries
those migrants come from.  This dour and ethically demented policy
position cannot stand.

Is President Obama’s administration so out of touch with
humanitarian values and common decency that it wants the US to be
the sole country at the WTO to oppose a mandatory, unconditional
pharmaceutical extension for LDCs that is their legal right?

*************************************************************

Links on Ebola (with very short excerpts)

(1)http://www.npr.org/sections/goatsandsoda – Direct URL:
http://tinyurl.com/q7trnqv

Amy Maxmen, “To Prevent The Next Plague, Listen To Boie Jalloh,” NPR
Goats & Soda, Oct. 8, 2015

“This is a landmark week in West Africa. For the first time since
the Ebola outbreak, there were no new cases reported in Guinea,
Liberia and Sierra Leone.

There are many unsung heroes who deserve credit for this milestone.
One of them is Dr. Boie Jalloh, age 30. Ten days after he showed up
for his medical residency at 34th Military Hospital in Freetown,
Sierra Leone, he received a letter requesting his presence at the
hospital’s newly constructed Ebola unit.”

“To me, first and foremost, I wish the government and our
international partners would invest in medical education. We really
need more doctors and nurses here — we needed them before Ebola. You
can supply all the drugs you want, but people won’t be able to get
those drugs if there is only one health care provider for 10,000
people. [Note: According to the World Bank, the number is 1.8 —
compared to 100 in the U.S.]”

(2) http://www.eboladeeply.org / Direct URL:
http://tinyurl.com/obf26pm

Brooks Marmon, “In Liberia, Paying Tribute to Those Who Sang Against
Ebola,” Ebola Deeply, Sept. 22, 2015

Last week, the conference room of Monrovia’s Young Men’s Christian
Association (YMCA) was decked out in red, white and blue balloons:
the colors of Liberia’s Lonestar flag. The event? A tribute by the
Musicians’ Union of Liberia (MULIB) to the artists – singers, hip-co
stars, songwriters and other musicians – who joined the Ebola fight.

Bernard Benson, better known as D.J. Blue, the manager of Hott FM,
one of Liberia’s most popular radio stations, was the M.C. for the
event. He set the tone by noting, ‘We took Ebola from 100 percent to
0.0 … no one must underestimate what Liberian music did. It
resonated to every Liberian, to the people that matter.’ G. Bennie
Johnson, MULIB’s vice president, echoed his words, adding that
‘musicians have the power, real power, to do something good for this
country.’

Nearly a dozen videos accompanying Ebola awareness songs were
screened as part of the festivities.”

[see full article at link above for embedded videos.]

*************************************************************

Links on Cost of Medicines (with very short excerpts)

(1) http://www.doctorswithoutborders.org – Direct URL:
http://tinyurl.com/qchbgz5

MSF / Doctors without Borders, “The Cost of Medicine,” Alert, Fall
2015, pages 10-12 on “Fundamental Changes Needed in the Biotechnical
Innovation System.”

“A primary driver of biomedical innovation is public funding coupled
with the granting of patents and other intellectual property rights
that give pharmaceutical companies exclusive domain to make and sell
a new medicine or vaccine for a stipulated period of time. This in
turn gives companies monopoly control over the market for that
product, allowing them to charge high prices and inhibiting
competition that would drive down costs.

Companies therefore decide where to allocate resources based on the
revenues they believe a particular product could generate, not the
public health burden they could address. What this means in
practical terms is that public health priorities and needs rarely
determine how corporate efforts are directed. In the current
ecosystem, companies watching their profit margins and stock prices
are effectively dis-incentivized from focusing resources and
attention on diseases and conditions that primarily affect people in
the developing world, people who don’t represent a lucrative market.

From our vantage point, it’s a broken system that is both
inefficient and ineffective at responding to the most pressing
global public health needs. And our field teams witness these costs
on a daily basis.”

“In addition, there is a lack of transparency from the
pharmaceutical industry, so we don’t really know what the R&D costs
are for specific products, what proportion of a given product was
publicly financed, or how much it costs to manufacture. The accuracy
of industry-funded estimates on the cost of developing a drug is
questionable at best.

(2) http://www.msfaccess.org/ / Direct URL:
http://tinyurl.com/o7yj4ms

MSF Access, “TPP trade pact will deepen global crisis of exorbitant
drug prices unless dangerous terms are removed.” Press release,
Sept. 25, 2015

“As public outrage about exorbitant drug prices features in new
headlines in the US and around the world, negotiators and trade
ministers from the 12 Trans-Pacific Partnership (TPP) countries are
converging in Atlanta to potentially finalize the trade pact, which
has been negotiated in secret over a period of more than five years.
Recent leaked copies of the TPP’s intellectual property chapter
confirm the inclusion of harmful rules that will lock in high prices
and block affordable generic medicines for years.  MSF urges all TPP
countries to firmly reject provisions that will deepen the global
crisis of unaffordable medicines and health products.”

Also includes link to 4-page briefing paper on the TPP: “Trading
Away Health”

*******************************************************

Links on HIV/AIDS (with very short excerpts)

(1)http://www.healthgap.org/blog – Direct URL:
http://tinyurl.com/qdbyf52

Health GAP,  “Celebration and Call to Action – New WHO Guidelines on
HIV Treatment and PrEP

“(September 30, 2015) Health GAP welcomes the World Health
Organization’s release of new global guidelines on HIV treatment,
recommending that all people living with HIV be started on HIV
treatment regardless of disease stage and encouraging expanded
availability of pre-exposure prophylaxis (PrEP) to groups at
particularly high risk of contracting HIV.

Earlier guidelines recommended that health care providers wait until
people with HIV reached a certain level of disease progression
before starting treatment, despite the fact that years ago many
wealthy countries including the United States had already begun
providing treatment immediately upon diagnosis  to all people living
with HIV regardless of how advanced their disease. The shift in
guidelines comes after new results from the NIH-funded START trial,
which provided conclusive evidence of the benefits of immediate
initiation in May of this year.”

“Only 15 million people are currently on treatment and 37 million
are infected, meaning that an additional 22 million people are now
eligible for immediate treatment. HIV testing has to be
significantly increased, people need to be enrolled in treatment
when they test positive, and they will need durable connection to
quality care.”

“Unfortunately donors and major funders are acting as if additional
resources are not needed. Just a few days ago the US announced a
major initiative to expand treatment and to reduce infections among
young women, but it identified no additional resources. ‘Preliminary
estimates show that the US must add at least $300 million new
dollars each year over the next few years to existing global AIDS
funding to help meet the new treatment and prevention goals,’ said
Professor Brook Baker, Health GAP’s Senior Policy Analyst.”

(2) http://www.thelancet.com/ – Direct URL:
http://tinyurl.com/nq5btzp

“Vancouver Consensus: antiretroviral medicines, medical evidence,
and political will,” The Lancet, August 8, 2015

“In 1996, the global HIV community gathered in Vancouver, Canada,
for the XI International AIDS Conference and shared the clear
evidence that triple-combination antiretroviral treatment held the
power to stem the tide of deaths from AIDS. The HIV treatment era
had begun. As we gathered again in Vancouver in July, 2015, it was
clear that a new transformative moment is upon us. The Vancouver
Consensus statement,1 which emerged at the recently concluded 8th
International AIDS Society Conference on HIV Pathogenesis, Treatment
and Prevention (IAS 2015), signals the scientific affirmation that,
rather than limiting access to those who are immune compromised,
immediate access to antiretroviral medicines holds the power to
rapidly advance the fight to end AIDS.

The consensus—signed by more than 500 researchers, clinicians, and
civil society experts—is clear: ‘All people living with HIV must
have access to antiretroviral treatment upon diagnosis. Barriers to
access in law, policy, stigma and bias must be confronted and
dismantled. And as part of a combination prevention effort, PrEP
(Pre-Exposure Prophylaxis) must be made available to protect those
at high risk of acquiring HIV. The strategic use of ARVs—through
treatment and other preventive uses—can save countless millions of
lives, reduce new infections, and move us vastly closer to our goal
of ending the epidemic. A new era of opportunity against this
epidemic has dawned, and we must seize it.’

…

Medical evidence is unambiguous. At this point, further delays
threaten not only millions of lives but also threaten a resurgence
of this pandemic. But if we act rapidly, we can drive down HIV
incidence, death, and long-term costs. Political will is needed to
complete the work of what can be one of the most effective public
health interventions in history.”

*****************************************************

Links on technical advances for developing countries

Sisu Global Health (http://www.sisuglobalhealth.com/)

A recent start-up led by three women from Michigan, Sisu Global
Health was initially based in Grand Rapids, Michigan, and has
recently moved to Baltimore, near the Inner Harbor.

“The Hemafuse [now being tested by doctors in Zimbabwe and Ghana] is
a manual autotransfusion device is that used to retransfuse a
patient’s own blood during an internal hemorrhage, specifically
ruptured ectopic pregnancies or road traffic accidents. The current
procedure commonly used in Sub-Saharan Africa consists of salvaging
blood with a kitchen soup ladle and filtering it with gauze.
Compared to this soup ladle autotransfusion, Hemafuse takes 1/3 of
the time, 1/9 of the staff, and is significantly safer. The Hemafuse
functions much like a giant syringe to suction blood through a
filter when a handle is pulled up. When the handle is pushed down
the blood is transferred directly to a blood bag in a closed
system.”

“This device is surgical – meaning that it can intervene during a
pivotal moment in an individual’s care. Compared to most moments
when autologous blood transfusion occurs, the Hemafuse, as an
intervention, will be both more urgent and more evident in terms of
results. Its handheld, sleek design reduces both blood flow issues
and failure modes from a slippery, gloved hand mid-surgery. In many
of the surgical suites that we’ve been in, space is at a premium.
Improvements on hospitals and buildings are not keeping up with the
increase in patient admittance and population growth, meaning
smaller rooms for more people.

This device, as one Tanzanian doctor put it, will eliminate a
‘messy’ and sometimes futile process.

All opinions from these doctors point to the success of this device,
however, the glaring fact that autotransfusion, the recycling of a
person’s own blood, has been debated solely in Western countries. Of
all the published material concerning African healthcare, only 1-2%
have contributions from the continent’s own physicians.
Additionally, these articles and the repository services that
attempt to collect thousands of articles are often not
internationally indexed to include African medical papers. They come
from a continent that has been performing autotransfusion for years,
but whose voices have not been given the mechanism to be heard in
the medical community.”

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