# South Africa - United States Department of State

- South African Freedom Day Antony J. Blinken, Secretary of StateOn behalf of the people of the United States, congratulations to all South Africans on the historic 30th anniversary of their country’s first democratic elections.Freedom Day provides us with an opportunity to underscore the strong U.S.-South Africa relationship built upon our two countries’ mutual commitment to democracy and human rights.The United States reaffirms its dedication to collaborate with South Africa to improve the health of our peoples, foster deeper economic and commercial relations, and strengthen cooperation to ensure the safety and security of our citizens and people everywhere. I am hopeful that we may also expand our collaboration to confront the threat and mitigate the impacts of climate change.I offer my best wishes on this historic 30th anniversary and a year of prosperity ahead.						Tags																					Bureau of African Affairs																								Office of the Spokesperson																								The Secretary of State																								South Africa
- South Africa HomeReportsBureau of Democracy, Human Rights, and Labor2023 Country Reports on Human Rights Practices&#8230;South Africa				hide	document.addEventListener("DOMContentLoaded", function(event) {	if(window.jQuery) {		jQuery( document ).ready(function() {			if (jQuery(".bc_middle").hasClass("collapse")) {				jQuery(".bc_ellipse").click(function(){					jQuery(".bc_hide").toggleClass("visible");					jQuery(".bc_middle").toggle();					jQuery(".bc_ellipse").toggle();					jQuery(".bc_content").toggleClass("noflex");					jQuery(".block_breadcrumbs_content").toggleClass("noflex");				});				jQuery(".bc_hide").click(function(){					jQuery(".bc_hide").toggleClass("visible");					jQuery(".bc_middle").toggle();					jQuery(".bc_ellipse").toggle();					jQuery(".bc_content").toggleClass("noflex");					jQuery(".block_breadcrumbs_content").toggleClass("noflex");				});			} else {				jQuery(".bc_ellipse").hide();			}		});	}});																							2023 Country Reports on Human Rights Practices: South Africa																																					Bureau of Democracy, Human Rights, and Labor																																																																																							Download Report																																																							Translations																																																																 In this section										/																							EXECUTIVE SUMMARY																																													EXECUTIVE SUMMARY																															Section 1. Respect for the Integrity of the Person																																																									a. Arbitrary Deprivation of Life and Other Unlawful or Politically Motivated Killings																																																																											b. Disappearance																																																																											c. Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment, and Other Related Abuses																																																																			Prison and Detention Center Conditions																																																																																																																		d. Arbitrary Arrest or Detention																																																																			Arrest Procedures and Treatment of Detainees																																																																																																																		e. Denial of Fair Public Trial																																																																			Trial Procedures																																																								Political Prisoners and Detainees																																																																																																																		f. Transnational Repression																																																																											g. Property Seizure and Restitution																																																																											h. Arbitrary or Unlawful Interference with Privacy, Family, Home, or Correspondence																																																																																	Section 2. Respect for Civil Liberties																																																									a. Freedom of Expression, Including for Members of the Press and Other Media																																																																			Internet Freedom																																																																																																																		b. Freedoms of Peaceful Assembly and Association																																																																			Freedom of Peaceful Assembly																																																								Freedom of Association																																																																																																																		c. Freedom of Religion																																																																											d. Freedom of Movement and the Right to Leave the Country																																																																											e. Protection of Refugees																																																																											f. Status and Treatment of Internally Displaced Persons																																																																											g. Stateless Persons																																																																																	Section 3. Freedom to Participate in the Political Process																																																									Elections and Political Participation																																																																																	Section 4. Corruption in Government																															Section 5. Governmental Posture Towards International and Nongovernmental Monitoring and Investigation of Alleged Abuses of Human Rights																															Section 6. Discrimination and Societal Abuses																																																									Women																																																																											Systemic Racial or Ethnic Violence and Discrimination																																																																											Indigenous Peoples																																																																											Children																																																																											Antisemitism																																																																											Trafficking in Persons																																																																											Forced Organ Harvesting																																																																											Acts of Violence, Criminalization, and Other Abuses Based on Sexual Orientation, Gender Identity or Expression, or Sex Characteristics																																																																											Persons with Disabilities																																																																											Other Societal Violence or Discrimination																																																																																	Section 7. Worker Rights																																																									a. Freedom of Association and the Right to Collective Bargaining																																																																											b. Prohibition of Forced or Compulsory Labor																																																																											c. Prohibition of Child Labor and Minimum Age for Employment																																																																											d. Discrimination (see section 6)																																																																											e. Acceptable Conditions of Work																																																																																																							EXECUTIVE SUMMARY				There were no significant changes in the human rights situation in South Africa during the year.Significant human rights issues included credible reports of: unlawful or arbitrary killings; torture or cruel, inhuman, or degrading treatment or punishment by the government; harsh and life-threatening prison conditions; arbitrary arrest or detention; serious government corruption; extensive gender-based violence, including domestic or intimate partner abuse, sexual violence, child, early, and forced marriage, and femicide; crimes involving violence or threats of violence targeting members of national groups, specifically foreigners; trafficking in persons, including forced labor; and crimes involving violence or threats of violence targeting lesbian, gay, bisexual, transgender, queer, or intersex persons.The government did not take credible steps to investigate, prosecute, and punish officials who may have committed human rights abuses. There were numerous reports of impunity.																														Section 1.													 Respect for the Integrity of the Person												    																																																a. Arbitrary Deprivation of Life and Other Unlawful or Politically Motivated Killings										There were several reports that the government or its agents committed arbitrary or unlawful killings.The Independent Police Investigative Directorate (IPID) told media it was overwhelmed by the large number of deaths resulting from police shoot-outs in KwaZulu-Natal. Between October and November, KwaZulu-Natal police reported 19 persons were killed in seven shoot-outs with police.Authorities claimed to be investigating a shoot-out between police and an alleged criminal syndicate, which left 19 suspects dead in September at a villa in Limpopo. It was not clear whether IPID was examining the use of force during the police raid (see also section 2.b., Freedom of Assembly).Watchdog groups noted deaths in custody often resulted from physical abuse combined with a lack of subsequent medical treatment or neglect (see section 1.c., Prison and Detention Center Conditions, Abusive Physical Conditions).There were attacks and ongoing harassment against whistleblowers. In August, six suspects were convicted and sentenced in the 2021 killing of Babita Deokaran, an accountant in the Gauteng Department of Health. She was killed after she discovered and exposed personal protective equipment tender corruption in the Gauteng premier’s office. Activists demanded the investigation and prosecution of the alleged masterminds.																																				b. Disappearance										There were no reports of disappearances by or on behalf of government authorities.																																				c. Torture and Other Cruel, Inhuman, or Degrading Treatment or Punishment, and Other Related Abuses										Although the constitution and law prohibited such practices, there were reports of police use of torture and physical abuse, some of which resulted in deaths.Eight members of the police’s VIP protection unit were suspended and then reinstated after they were filmed attacking civilians on the N1 highway.Civil society expressed concern regarding the Gauteng premier risking abuse of police powers by appointing and deploying 6,000 crime prevention wardens as part of his anticrime strategy. Media reported several complaints of brutality by the wardens including unauthorized searches and assaults of citizens.Impunity was a significant problem in the security forces. The South African Police Service was often identified as acting with impunity. The police watchdog organization IPID documented the lack of police accountability for thousands of annually registered police brutality complaints.																Prison and Detention Center Conditions						Prison conditions were harsh and life-threatening due to overcrowding, poor sanitation, inadequate medical care, disease (particularly tuberculosis), as well as inmate-on-inmate rape and physical abuse.Abusive Physical Conditions: According to the Judicial Inspectorate for Correctional Services’ (JICS) quarterly report from April to June, there were 40 unnatural deaths between April and June; another 30 were classified as unknown cases. During the same quarter, JICS received 166 complaints: 59 related to inmate-on-inmate assaults, 19 concerning official-on-inmate assaults, and 13 related to transfers. JICS also received 10 complaints of sexual assault, along with one reported corruption matter, two cases involving torture, one incident of self-harm, and three instances of inhuman treatment.Civil society groups reported gross overcrowding of prisons was a problem. According to the 2021/2022 Department of Correctional Services Annual Report, in March the country held 143,223 prisoners in facilities with a capacity of 110,836 persons.The newspaper Mail &amp; Guardian reported on shortages of prison doctors, inadequate investigation and documentation of prisoner deaths, inadequate monitoring of the prison population, and high prisoner suicide rates. Food, sanitation, and health care in prisons and detention centers were inadequate. Prisons provided inmates with potable water, but supplies and food were occasionally inadequate, and sanitation was poor. Government and civil society accused the Department of Public Works of failing to make infrastructure repairs at prisons nationwide. Most cells had toilets and basins but often lacked chairs, adequate light, and ventilation. The Department of Correctional Services required doctors to complete and sign reports of inmate deaths due to natural causes to lessen the incidence of deaths caused by neglect.Administration: Authorities did not always conduct proper investigations of credible allegations of mistreatment.Independent Monitoring: The government usually permitted monitoring by independent nongovernmental observers of prison conditions, including visits by the International Committee of the Red Cross. The independent JICS during the year adopted a strategic approach to inspect all 243 correctional service facilities at least once during a two-year cycle.																										d. Arbitrary Arrest or Detention										The constitution and law prohibited arbitrary arrest and detention and provided for the right of any person to challenge the lawfulness of arrest or detention in court. The government generally observed these requirements; however, there were numerous cases of arbitrary arrests of foreign workers, asylum seekers, and refugees.																Arrest Procedures and Treatment of Detainees						The law required that a judge or magistrate issue arrest warrants based on sufficient evidence. The law also required police to promptly inform detainees of the reasons for their detention, their right to remain silent, and the consequences of waiving that right. Police had to charge detainees within 48 hours of arrest; hold them in conditions respecting human dignity; allow them to consult with legal counsel of their choice at every stage of their detention (or provide them with state-funded legal counsel); and permit them to communicate with relatives, medical practitioners, and religious counselors. The government did not always respect these rights. The law required police to release detainees (with or without bail) unless the interests of justice required otherwise, although bail for pretrial detainees often exceeded what suspects could pay.Arbitrary Arrest: During the year there were numerous cases of arbitrary arrest, particularly of foreign workers, asylum seekers, and refugees. Nongovernmental organizations (NGOs) and media outlets reported security forces arbitrarily arrested migrants and asylum seekers, including those with proper documentation, often because police were unfamiliar with migrant and asylum documentation. In some cases, police threatened documented migrants and asylum seekers with indefinite detention and bureaucratic hurdles unless they paid bribes. The law prohibited the detention of unaccompanied migrant children for immigration law violations, but NGOs reported the Department of Home Affairs and the South African Police Service (SAPS) detained them.Pretrial Detention: Lengthy pretrial detention was common. According to the Department of Correctional Services, detainees waited an average of 176 days before trial. Observers attributed the high rate of pretrial detention to arrests based on insufficient evidence for prosecution, overburdened courts, poor case preparation, irregular access to public defenders, and prohibitive bail amounts. Police often held detainees while prosecutors developed cases and waited for court dates. Legal scholars estimated less than 60 percent of those arrested were convicted. The law required a review in cases of pretrial detention of more than two years’ duration. The pretrial detention frequently exceeded the maximum sentence for the alleged crime.																										e. Denial of Fair Public Trial										The law provided for an independent judiciary, and the government generally respected judicial independence and impartiality. There were numerous reports of lost trial documents, often when the accused was a government official. NGOs stated judicial corruption was a problem.																Trial Procedures						The law provided for the right to a fair and public trial, and an independent judiciary generally enforced this right. Police did not always inform detainees promptly and in detail of the charges against them. Provision of free interpreter assistance depended on availability and cost. Limited access to interpreters sometimes delayed trials. Judges sometimes transferred cases from rural to urban areas to access interpreters more easily. Prosecutors described obtaining interpretation for interviews of suspects and victims as a challenge.Although detainees and defendants had the right to legal counsel provided and funded by the state when “substantial injustice would otherwise result,” this right was limited due to a general lack of information regarding rights to legal representation and inadequate government funding of such legal services. There was no automatic right to appeal unless a convicted individual was younger than age 16, but courts could give defendants permission to do so. Civil society provided pro bono legal services for the country’s most underserved communities.						Political Prisoners and Detainees						There were no reports of political prisoners or detainees.																										f. Transnational Repression										Not applicable.																																				g. Property Seizure and Restitution										Not applicable.																																				h. Arbitrary or Unlawful Interference with Privacy, Family, Home, or Correspondence										The constitution and law prohibited such actions, and there were no reports that the government failed to respect these prohibitions.																																					Section 2.													 Respect for Civil Liberties												    																																																a. Freedom of Expression, Including for Members of the Press and Other Media										The constitution and law provided for freedom of expression, including for members of the press and other media, and the government generally respected this right. An independent press, a generally effective judiciary, and a functioning democratic political system combined to promote freedom of expression, including for media members. Nevertheless, the law permitted authorities to restrict reporting on security forces, prisons, and mental institutions.Freedom of Expression: Civil society groups complained regarding a steady shrinking of free expression space with particular concern for backlash received on social media for expressing opinions or publishing articles. According to Amnesty International, in August 2022 the Department of Justice and Constitutional Development condemned attacks and online death threats against a human rights law firm, the Socio-Economic Rights Institute, which had to close its offices after defending the rights of informal traders, and similar harassment continued during the year.Violence and Harassment: There were instances of journalists, in particular women journalists, who were subjected to violence, harassment, or intimidation by authorities or political party representatives due to their reporting.Several NGOs contacted through Amnesty International expressed concern regarding threats to freedom of expression across these fronts, “a) in person attacks on journalists by police, political parties, and the public; b) online hate speech, harassment, and doxing among online threats targeting journalists; c) surveillance of journalists by state intelligence; d) punitive legislation that targets journalists or limits their ability to report; e) ongoing vulnerability of senior journalists at the public broadcaster.”The South African News Editors’ Forum continued to express concern regarding the prevalence of online harassment of journalists, especially threats to women and foreign national journalists.Censorship or Content Restrictions for Members of the Press and Other Media, Including Online Media: Government and political officials often criticized media for lack of professionalism and reacted sharply to media criticism. Claims of political interference emerged after the South African Broadcasting Corporation dismissed its Head of News, Phathiswa Magopeni, in January 2022. Magopeni stated she was dismissed because former Minister of Transport Fikile Mbalula blamed the corporation’s coverage for the ruling African National Congress’ (ANC) poor performance in the November 2021 municipal elections. Some journalists believed the government’s sensitivity to criticism resulted in a higher degree of self-censorship.Libel/Slander Laws: Defamation was a criminal offense, although there were no prosecutions for defamation during the year. The law also prohibited blasphemy, although reports indicated the last known prosecution for blasphemy was in 1968.Nongovernmental Impact: The South African News Editors’ Forum described the September 2022 serving of a criminal summons by former President Jacob Zuma’s legal representatives against News24 journalist Karyn Maughan as a case of intimidation. The law allowed a person directly affected by a crime to bring a private criminal prosecution against an individual if prosecutors declined to bring a case, as happened in Maughan’s case. In June the Pietermaritzburg High Court ruled in favor of Maughn. Zuma’s representatives charged Maughan improperly published documents that were held by prosecutors on Zuma’s medical condition, but the court found the information was in fact already public. The court labeled Zuma’s attempt to privately prosecute the journalist as “abuse of process” and defended media’s right to freedom of expression.																Internet Freedom						The government did not restrict or disrupt access to the internet or censor online content. The law authorized state monitoring of telecommunication systems, however, including the internet and email, for national security reasons. The law required all service providers to register on secure databases the identities, physical addresses, and telephone numbers of customers.																										b. Freedoms of Peaceful Assembly and Association										The constitution and law provided for freedom of assembly and association, and the government generally respected these rights. Nevertheless, NGOs reported many municipalities required protest organizers to provide advance written notice before staging gatherings or demonstrations.																Freedom of Peaceful Assembly						Despite a 2018 court ruling eliminating prenotification requirements for gatherings or demonstrations, NGOs reported many municipalities required protest organizers to provide advance written notice, especially in small rural communities where organizers were often unaware of their rights.Police on occasion used excessive force in response to demonstrations but were almost never held accountable or disciplined for their actions (see sections 1.a. and 1.c.). In August, SAPS shot and killed a boy, age 16, during service delivery protests in Slovo Park related to electricity, water, sewage, and waste hauling services. IPID stated it was investigating the youth’s death.						Freedom of Association						Some government officials questioned the funding for NGOs operating in the country across a range of topics including environmental justice and legal rights advocacy. NGOs also widely criticized the draft General Intelligence Laws Amendment Bill as an attempt to vet persons who might want to establish an NGO.																										c. Freedom of Religion										See the Department of State’s International Religious Freedom Report at  https://www.state.gov/religiousfreedomreport/.																																				d. Freedom of Movement and the Right to Leave the Country										The law provided for freedom of internal movement, foreign travel, emigration, and repatriation, and the government generally respected these rights.																																				e. Protection of Refugees										The government generally cooperated with the Office of the UN High Commissioner for Refugees and other humanitarian organizations in providing protection and assistance to refugees, returning refugees, or asylum seekers, as well as other persons of concern.Access to Asylum: The law provided for the granting of asylum and refugee status, and the government had an established system for providing protection to refugees. Refugee advocacy groups criticized the government’s processes for determining refugee status, citing long waits for appointments, low approval rates, large case and appeal backlogs, a lack of timely information provided to asylum seekers on their asylum requests and status of their cases, inadequate use of country-of-origin information, an inadequate number of processing locations, and official corruption. Despite Department of Home Affairs anti-corruption programs that punished officials found to be accepting bribes, NGOs and asylum applicants reported immigration officials solicited bribes. According to civil society groups, the system lacked procedural safeguards for seeking protection and review for unaccompanied children, trafficked victims, and survivors of domestic violence. During the year, government services strained to keep up with the caseload, and NGOs criticized the government’s implementation of the system as inadequate, putting asylum seekers at risk of detention and forced return. The Refugee Appeals Authority of South Africa made little progress in eliminating 130,000 cases from its backlog, experiencing staff shortages, technological inefficiencies, and the absence of appropriate project management. The lack of timely documentation had far-ranging impacts including limiting refugee travel, accessing civil registry services (including registering births), loss of employment, enrolling in education, and freezing of bank accounts. The government required children who achieved the age of majority to present independent cases demonstrating persecution in their country of origin, regardless of the age they entered the country with their parents. The government reopened the Cape Town Refugee Reception Center in March after 11 years of court battles.Abuse of Refugees and Asylum Seekers: Refugee advocacy organizations stated police and immigration officials physically abused refugees and asylum seekers (see also section 1.d., Arbitrary Arrest). Xenophobic violence was a continuing problem across the country, especially in Gauteng Province. Those targeted often owned or managed small, informal grocery stores in economically marginalized areas that lacked government services (see section 6, Systemic Racial or Ethnic Violence and Discrimination).Employment: The law permitted refugees to work lawfully. Asylum seekers had to obtain Department of Home Affairs approval to work, which was generally granted. Refugee advocates reported delays in status document renewals leading to refugees losing employment. According to NGOs specialized in the protection of refugee rights, refugees were regularly denied employment due to their immigration status.Access to Basic Services: Although the law provided for asylum seekers and refugees to have access to basic services, including education, health, social support, police, and judicial services, NGOs reported health-care facilities and authorities, particularly in Gauteng, discriminated against them. Some refugees reported they could not access education for their children because schools refused to accept asylum documents as proof of residency. NGOs reported banks regularly denied services to refugees and asylum seekers who lacked government-issued identification documents.Durable Solutions: The law allowed for some refugees to obtain permanent residency and a pathway to citizenship, but this was rarely achieved. The government generally collaborated with humanitarian organizations facilitating voluntary repatriation of refugees to their countries of origin or resettlement to third countries.Temporary Protection: The government offered temporary protection to approximately 180,000 individuals who might not qualify as refugees.																																				f. Status and Treatment of Internally Displaced Persons										Not applicable.																																				g. Stateless Persons										The country contributed to statelessness primarily through the administrative practices affecting birth registration, legal pathways to citizenship, and issuance and validity of identification documents (IDs). Women and children were particularly affected by statelessness and as a result routinely denied access to education, health care, and employment. In a September 2022 submission to parliament, Lawyers for Human Rights (LHR) estimated there were more than 10,000 stateless persons in the country because of a lack of access to birth registration, lack of an administrative process for citizenship application, inaccessible pathways to documentation for unaccompanied or separated migrant children, the government’s invalidation (or blocking) of IDs, and a host of other administrative barriers for foreign and local nationals alike. In May the LHR took the Department of Home Affairs to court for its practice of arbitrarily blocking IDs. The LHR claimed that the practice of blocking IDs harmed a majority of marginalized, Black South Africans, requiring them to produce extensive documentary evidence of their citizenship, information that often was lacking due to inadequate civil registration records for Black residents pre-1994. The government agreed to remove blocks from 1.4 million IDs shortly after the lodging of the lawsuit, although approximately 700,000 IDs remained blocked.The law allowed children with no other nationality born to foreign national parents who arrived in the country on or after January 1, 1995, always lived in the country, and were in possession of a birth certificate, to apply for citizenship.Foreign nationals had a separate two-step process to register a child’s birth. In addition, the foreign national had to have legal status in the country to engage in this process. The government required registration to happen within 30 days of the birth, or the applicant had to engage in a late registration process that advocates stated could take up to four years. Advocates stated that this process left many foreign nationals at risk of statelessness as well as South Africans without valid identity documents. Following birth registration, foreign nationals had to obtain official birth certificates from their country of origin.In 2021, the Constitutional Court ruled that unmarried fathers could register their children under their surname without the mother’s consent. The landmark ruling was to avoid placing children at risk of statelessness if the mother was undocumented, missing, or deceased.																																					Section 3.													 Freedom to Participate in the Political Process												    																						The law provided citizens the ability to choose their government in free and fair periodic elections held by secret ballot and based on universal and equal suffrage.																										Elections and Political Participation										Abuses or Irregularities in Recent Elections: In 2019 the country held National Assembly, National Council of Provinces, and provincial legislature elections. According to the Electoral Institute for Sustainable Democracy in Africa, the elections were transparent, fair, credible, and in line with the constitutional and legal framework for elections. Election observers, including the African Union and the Southern African Development Community, characterized the elections as largely credible. The government, however, restricted diplomatic missions from assigning more than two election observers each, effectively excluding diplomatic missions from broad observation of the elections.Political Parties and Political Participation: Opposition parties claimed the ruling ANC used state resources for political purposes in the provinces under its control. ANC membership conferred advantages. Through a cadre deployment system, the ruling party controlled and appointed party members to thousands of civil service positions in government ministries and in provincial and municipal governments (see section 4, Corruption). In October 2022, the government adopted the “National Framework towards Professionalization of the Public Sector” in an effort to ensure only qualified and competent individuals were appointed to positions of authority. In July, however, a skills audit report released by the Department of Cooperative Governance and Traditional Affairs revealed that 300 councilors in KwaZulu-Natal were illiterate.Participation of Women and Members of Marginalized or Vulnerable Groups: Civil society groups reported that fewer women participated as candidates and as voters in the 2021 municipal elections compared to national elections. Concerns regarding violence around municipal voting stations affected women’s voter turnout more than men’s voter turnout.																																					Section 4.													 Corruption in Government												    																						The law provided for criminal penalties for conviction of corruption by officials, but the government generally did not implement the law effectively, and officials sometimes engaged in corrupt practices with impunity. There were numerous reports of government corruption during the year.Corruption: Official corruption remained a problem. At least 10 agencies, including the SAPS Special Investigation Unit, Public Service Commission, Office of the Public Prosecutor, and Office of the Auditor General, were involved in anti-corruption activities. During the year the Office of the Public Protector, which was constitutionally mandated to investigate government abuse and mismanagement, investigated thousands of cases, some of which involved high-level officials.By year’s end, the government had not implemented the recommendations of the Commission on State Capture chaired by Chief Justice Zondo. The Zondo Report identified rampant corruption at Transnet, the Passenger Rail Agency of South Africa, and South African Airways. NGOs like Corruption Watch documented extensive corruption in government procurement and the award of tenders at all levels of government. Public procurement across levels of governance and state-owned enterprises continued to present opportunities for corruption directly contributing to declining and dysfunctional public services.For additional information about corruption in the country, please see the Department of State’s Investment Climate Statement for the country, and the Department of State’s International Narcotics Control Strategy Report, which includes information on financial crimes.																											Section 5.													 Governmental Posture Towards International and Nongovernmental Monitoring and Investigation of Alleged Abuses of Human Rights												    																						Domestic and international human rights groups generally operated without government restriction, investigating, and publishing their findings on human rights cases. Government officials were somewhat cooperative and responsive to their views.Retribution against Human Rights Defenders: Whistleblowers at all levels were at risk of retaliation, often carried out by organized crime syndicates on behalf of political or governmental persons or institutions (see section 1.a.). In January the former CEO of the state-owned electricity company, Eskom, Andre de Ruyter, reported to media that he survived an alleged poisoning by cyanide weeks prior. De Ruyter claimed he received several death threats for his efforts to clean up corruption at the power utility. In February Martha Ngoye was found not guilty on charges brought against her by the state-owned rail agency, Passenger Rail Agency of South Africa. Since testifying against state capture during the Zondo commission, Ngoye faced multiple costly lawsuits.Government Human Rights Bodies: The constitution established several state institutions tasked with supporting constitutional democracy. The task of these institutions was to promote and protect those rights within the Bill of Rights and operate independently. Among these was the South African Human Rights Commission, which was responsible for promoting the observance of fundamental human rights at all levels of government and throughout the general population. The commission had the authority to conduct investigations, issue subpoenas, and take sworn testimony. Civil society groups considered the commission only moderately effective due to a large backlog of cases and the failure of government agencies to adhere to its recommendations. Between November 2021 and June, the commission held a National Investigative Hearing into the 2021 unrest in KwaZulu-Natal and Gauteng Provinces. In November, 65 alleged instigators charged in connection with the unrest and public violence in KwaZulu-Natal appeared in court. As of December, courts convicted and sentenced nine looters for crimes of looting and theft.																											Section 6.													 Discrimination and Societal Abuses												    																																																Women										Rape and Domestic Violence: The law criminalized domestic violence and rape of women or men, including spousal rape, but the government did not effectively enforce the law. The minimum sentence for conviction of rape was 10 years’ imprisonment. Under certain circumstances, such as second or third offenses, multiple rapes, gang rapes, or the rape of a child or a person with disabilities, conviction required a minimum sentence of life imprisonment, unless substantial and compelling circumstances existed to justify a lesser sentence. Perpetrators with previous rape convictions or aware of being HIV positive at the time of the rape also faced a minimum sentence of life imprisonment, unless substantial and compelling circumstances existed to justify a lesser sentence.In most cases of rape and domestic violence, attackers were acquaintances or family members of the survivor, which contributed to a reluctance to press charges. NGOs stated that cases were underreported, especially in rural communities, due to stigma, unfair treatment, fear, intimidation, and lack of trust in the criminal justice system. There were numerous reports of rapes by police officers of: individuals in commercial sex; lesbian, gay, bisexual, transgender, queer, and intersex (LGBTQI+) persons; and incarcerated persons among others (see also section 1.c.).The Department of Justice and Constitutional Development operated 96 dedicated sexual offenses courts throughout the country. Although judges in rape cases generally followed statutory sentencing guidelines, women’s advocacy groups criticized judges for using criteria, such as the survivor’s behavior or relationship to the rapist, as a basis for imposing lighter sentences.The government provided funding for, and the National Prosecuting Authority operated, 63 rape management centers, addressing the rights and needs of survivors and vulnerable persons, including legal assistance. A key objective of the centers was prosecution of sexual, domestic violence, and child-abuse offenders. Approximately 75 percent of the cases they took to trial resulted in convictions.Domestic violence was pervasive and included physical, sexual, emotional, and verbal abuse, as well as harassment and stalking. For example, in February 2022, police officer Lucky Mudau while in uniform shot and killed his girlfriend while she was at work as a nurse at Tembisa Hospital in Ekurhuleni. Mudau then turned the gun on himself. Mudau was sentenced in June to 25 years for murder; however, his sentence was suspended for five years, and the Department of Correctional Services testified that it could not provide services to him as a quadriplegic inmate.The government prosecuted domestic violence cases under laws governing rape, indecent assault, damage to property, and violating a protection order. The law required police to protect survivors from domestic violence, but police commanders did not always hold officers accountable. Conviction of violating a protection order was punishable by up to five years’ imprisonment and up to 20 years’ imprisonment if convicted of additional criminal charges. Penalties for conviction of domestic violence included fines and sentences of between two and five years’ imprisonment.The government financed shelters for abused women, but NGOs reported a shortage of such facilities, particularly in rural areas, and that women were sometimes turned away from shelters. According to civil society, shelters operated with inconsistent funding, with staff having to forgo salaries for long periods at a time. While the government stated creating more shelters was a presidential priority, provincial/local departments were diminishing services and reducing funding for nonprofit organizations in the NGO shelter sector. During the year, gender-based violence shelters received only 39 percent of their annual operational budgets from government, forcing them to engage in extensive fundraising efforts.Female Genital Mutilation/Cutting (FGM/C): The law prohibited FGM/C of girls and women, but girls in isolated zones in ethnic Venda communities in Limpopo Province were subjected to the practice. The government continued initiatives to eradicate the practice, including national research and sensitization workshops in areas where FGM/C was prevalent.Other Forms of Gender-based Violence or Harassment: Although the practice of virginity testing for children younger than 16 (or those older than 16 without consent or proper counseling) was banned by law, reports by media and academia indicated it was still being carried out as a cultural practice.Although prohibited by law, sexual harassment remained a widespread problem.Discrimination: Discrimination against women remained a serious problem despite legal equality in family, labor, property, inheritance, nationality, divorce, pregnancy, and child custody matters. Women experienced economic discrimination in wages, extension of credit, and ownership of land.Traditional patrilineal authorities, such as a chief or a council of elders, administered many rural areas. Some traditional authorities refused to grant land tenure to women, a precondition for access to housing subsidies. Women could challenge traditional land tenure discrimination in courts, but access to legal counsel was costly.By law any difference in the terms or conditions of employment among employees of the same employer performing the same, substantially similar, or equal value work constituted discrimination. The law expressly prohibited unequal pay for work of equal value and discriminatory practices, including separate pension funds for different groups in a company. Although the government had courts in place to hear pay discrimination cases, a 2022 study found most employees lacked assistance in filing cases, so the courts dismissed many pay equity cases. The United Association of South Africa, a labor union, reported in March 2022 that the median gender pay gap was between 23 and 35 percent.Reproductive Rights: There were no reports of forced abortion on the part of government authorities. In December 2022, the NGO Her Rights Initiative and 85 victims wrote an open letter to the president requesting compensation to HIV-positive women who were victims of forced sterilizations in the country. In June Her Rights Initiative filed a complaint regarding forced sterilizations of HIV-positive women through the Special Procedures of the UN Human Rights Council.The full range of contraception methods, including emergency contraception, were available at all primary health-care clinics for free. Emergency health care was available for the treatment of complications arising from unsafe abortion.The government provided access to comprehensive sexual and reproductive health services for survivors of sexual violence. The law provided for survivors of gender-based violence to receive shelter and comprehensive care, including treatment of injuries, a forensic examination, pregnancy and HIV testing, provision of emergency contraception, and counseling rehabilitation services.According to the Saving Mothers Report 2021, the Maternal Mortality Ratio increased 47 percent from 2019 to 148.1 maternal deaths per 100,000 live births. In 2021, there were 1,504 maternal deaths. The report further identified that a significant systemic driver contributing to mortality was the length of time it took for emergency service personnel to arrive at a facility where a skilled birth attendant could deal with an emergency. In 2021, the National Department of Health officially launched the Maternal, Perinatal and Neonatal Health Policy, working towards the Sustainable Development Goal of reducing maternal mortality to below 70 per 100,000 live births and neonatal mortality to 12 deaths per 1,000 live births. The country had a policy to reduce institutional maternal mortality, neonatal mortality, and stillbirths by 50 percent by 2030. The policy provided a framework to improve the delivery of quality, comprehensive, and integrated maternal and neonatal health services. Maternal HIV testing and access to antiretroviral therapy significantly reduced deaths from nonpregnancy related infections and new HIV infections in children, with a reported reduction in infant polymerase chain reaction positivity at 10 weeks of age from 4.3 percent in 2015-16 to 0.68 percent in 2019-20. According to a June 2022 article in the Journal of Acquired Immune Deficiency Syndromes, antiretroviral therapy and condom promotion contributed significantly to the decline in HIV incidence in the country.Menstruation and access to menstruation hygiene affected girls’ attendance at school. One NGO estimated 30 percent of girls did not attend school while they menstruated, due to lack of access to sanitary products. During the year observers noted substantial increases in teenage pregnancies, which also affected girls’ attendance at school.In February 2022 the National Department of Basic Education officially launched the National Policy on the Prevention and Management of Learner Pregnancy as part of the Comprehensive Sexuality Education programs in schools. The policy aimed to support an environment to enable girls to stay in school and prevent discrimination and the stigmatization of pregnant students.Specifically, the policy required administrators to allow a pregnant girl to remain in school during her pregnancy and to return as soon after giving birth as was appropriate for both the learner and her child. The student’s school management was required to make reasonable accommodation of the learner, meaning allowance, as necessary, of short- to medium-term absences from school and an undertaking to retain the learner’s place in the school.																																				Systemic Racial or Ethnic Violence and Discrimination										There were numerous reports of racial discrimination, despite the prohibition under the constitution of unfair discrimination against anyone on one or more grounds, including on the ground of race. The South African Human Rights Commission stated in June 2022 that gross inequality was fueling racism and racial polarization. The Department of Human Settlements acknowledged inequality along racial lines had and continued to affect the country’s segregated spatial development as well as poor communities’ access to reliable infrastructure. Approximately 300 Equality Courts resolved only 600 matters a year. Authorities enforced antidiscrimination provisions in some cases. In November a woman from Gauteng Province was arrested and charged with crimen injuria, an act that injures the dignity of another person, after her racist rants were widely viewed online. The court sentenced her in March to three years imprisonment (one suspended), making her the first person in the country to be jailed for this offense.Some advocacy groups asserted white farmers were racially targeted for burglaries, home invasions, and killings, while many observers attributed the incidents to the country’s high and growing crime rate. According to a civil society organization, in 2022 there were 333 attacks and 50 killings compared to 415 attacks and 55 killings in 2021.Local community or political leaders who sought to gain prominence in their communities allegedly instigated some attacks on African migrants and ethnic minorities. The country experienced more than 1,500 incidents of vigilantism and mob violence, including xenophobic and anticrime vigilantism, often targeting Zimbabwean migrants. These attacks led to more than 200 fatalities and hundreds of injuries between January and September. Police were sometimes involved in the violence; more frequently, police were accused of condoning violence, particularly xenophobic, vigilantism, or political violence. The antimigrant group Operation Dudula, created during the riots in 2021, was able to organize and mobilize quickly and escalated the pace of its demonstrations and attacks, particularly in Soweto and Johannesburg. In September Operation Dudula registered as a political party and stated it planned to compete in future elections. Several of its members were accused of hate speech and physical violence.In April an antimigrant mob killed a Zimbabwean in Diepsloot, and throughout the year, there were examples of mobs setting fire to the homes and shops of migrants.In August, 77 persons died when a condemned building in downtown Johannesburg caught fire and residents were unable to escape because of padlocked emergency exists. The “Albert Street fire” brought into the spotlight the city’s serious housing shortage coupled with the estimated 600 buildings in Johannesburg that were “hijacked” by slumlords. Many of the Albert Street fire victims were foreign nationals. Many senior officials issued statements critical of “illegal immigrants” and immigrant legal advocacy NGOs. According to civil society, foreign national survivors of the August fire in Johannesburg needed to be accompanied to hospitals for burn treatment because they were afraid of being maltreated or harmed by hospital staff. Throughout the year there were examples of the vigilante group, Operation Dudula, intimidating foreign nationals from visiting public health clinics.																																				Indigenous Peoples										The NGO Working Group of Indigenous Minorities in Southern Africa estimated there were 7,500 indigenous San and Khoi in the country, some of whom worked as farmers or farm laborers. By law the San and Khoi had the same political and economic rights as other citizens, although the government did not always effectively protect those rights or deliver basic services to Indigenous communities. Indigenous groups complained of exclusion from land restitution, housing, and affirmative action programs. They also demanded formal recognition as “first peoples” in the constitution. The lack of recognition as first peoples excluded them from inclusion in government-recognized structures for traditional leaders. Their participation in government and the economy was limited due to fewer opportunities, lack of land and other resources, minimal access to education, and relative isolation.																																				Children										Birth Registration: Registration of births was inconsistent, especially in remote rural areas and by parents who were unregistered foreign nationals (see section 2.g., Stateless Persons). Children without birth registration had no access to government services such as education or health care, and their parents had no access to financial grants for their children.Education: In violation of the law, noncitizen children were sometimes denied access to education based on their inability to produce identification documents, such as birth certificates and immunization documents (see also section 6, Women, Reproductive Rights).Child Abuse: The law criminalized child abuse. Violence against children remained widespread. Civil society and academics documented evidence that experiencing child maltreatment and witnessing partner abuse in the home as a child increased the risk of becoming both a perpetrator and victim of sexual and intimate partner violence as an adult, contributing to intergenerational abuse and violence. The government struggled to uphold the law. Civil society attributed the shortcomings to underfunding of social services for children, capacity building for social workers, corruption, and mismanagement. Investigators and prosecutors were generally overwhelmed by case volume.There were reports of abuse of students by teachers and other school staff, including reports of assault and rape. The law required schools to disclose sexual abuse to authorities, but administrators sometimes concealed sexual violence or delayed taking disciplinary action.Child, Early, and Forced Marriage: By law parental or judicial consent to marry was required for individuals younger than 18. Nevertheless, ukuthwala, the practice of abducting girls as young as 14 and forcing them into marriage, occurred in remote villages in Western Cape, Eastern Cape, and KwaZulu-Natal Provinces. The law prohibited nonconsensual ukuthwala and classified it as a human trafficking offense. The National Prosecuting Authority prosecuted multiple cases of forced marriage.Sexual Exploitation of Children: The law prohibited commercial sexual exploitation, sale, and offering or procurement of children for commercial sex and child pornography. The government enforced the law. The Film and Publications Board maintained a website and a toll-free hotline for the public to report incidents of child pornography. Online sexual exploitation of children continued in the country. Government authorities from the Department of Social Development and SAPS conducted educational outreach programs on the dangers of online recruitment and grooming. Media, government, and civil society reported that children, particularly girls, were most vulnerable to human trafficking, sexual exploitation, and sex trafficking. The minimum age for consensual sex was 16. In August Gerard Ackerman was sentenced to 12 life sentences for crimes related to human trafficking and the sexual exploitation of teenagers. His codefendant, an acting judge, Paul Kennedy, committed suicide before the trial began.																																				Antisemitism										According to a 2020 study published by the Isaac and Jessie Kaplan Center for Jewish Studies at the University of Cape Town and the United Kingdom-based Institute for Jewish Policy Research, the country’s Jewish population stood at 52,300, with the majority living in Cape Town and Johannesburg. The South African Jewish Board of Deputies recorded 207 antisemitic incidents during the year, the highest since the early 1990s. After the October 7 terror attack in Israel, the number of antisemitic incidents increased by 70 percent. Reports included six incidents of assault, damage to property, abusive behavior, insults, threats, offensive gestures, hate mail, and boycotting Jewish-owned businesses. On October 11, a Johannesburg rabbi’s car was allegedly rammed by another car and chased to a gas station, where the rabbi was then verbally assaulted and threatened by the other driver. During a protest in Sandton on November 4, one organization threatened to “to target ‘them’ the way they have killed our people...we must fight them however we find them, we must boycott them, we must go to their homes.” Additionally, following the Israeli government’s response to the October 7 Hamas terrorist attack, numerous anti-Israel protests were held that were full of antisemitic rhetoric, imagery, and slogans. On November 11, ANC Secretary General Mbalula joined protesters in chanting “from the river to the sea,” implying the destruction of Israel.																																				Trafficking in Persons										See the Department of State’s Trafficking in Persons Report at:  https://www.state.gov/trafficking-in-persons-report/.																																				Forced Organ Harvesting										In March a boy, age six, was found left to die in a field in Boksburg, after some of his organs were removed.																																				Acts of Violence, Criminalization, and Other Abuses Based on Sexual Orientation, Gender Identity or Expression, or Sex Characteristics										Criminalization: No laws criminalized consensual same-sex sexual conduct between adults or so-called cross dressing. No facially neutral laws were disproportionately enforced against LGBTQI+ persons.Violence and Harassment: Despite government policies prohibiting discrimination, there were reports of official mistreatment or discrimination based on sexual orientation or gender identity or expression. Black lesbians and trans persons, particularly in rural areas, were vulnerable to assault and to “corrective” rape (a belief that sexual orientation or gender identity or expression could be changed through violence). LGBTQI+ individuals were particularly vulnerable to violent crime due to anti-LGBTQI+ attitudes within traditional and rural communities, in townships, and among police. Anti-LGBTQI+ attitudes of junior members of SAPS affected how they handled complaints by LGBTQI+ individuals.According to Mamba Online, a gay news website, as of October 2022, nine LGBTQI+ persons were killed. The number of victims was reportedly lower in 2023, although observers stated this could be due to underreporting. One NGO in Durban claimed most hate crime victims did not report their cases to police due to fears of secondary victimization; several activists accused religious leaders of not condemning hate crimes and killings against members of the LGBTQI+ community. In September SAPS arrested a group of men linked to 85 cases where LGBTQI+ persons were targeted on the Grindr social app and subsequently kidnapped for ransom. In December the “Grindr Gang” syndicate in Durban robbed and assaulted 13 men, leading to the death of one victim. Civil society alleged that many Grindr cases remained unreported and undercounted because victims feared being outed. In March the body of Nomvula Chenene was found buried under the shack of her accused killer near Orange Farm; family and civil society members believed Chenene was targeted because she was lesbian. Murder suspect Sizwe Buthelezi’s court case remained pending at year’s end.In August the cabinet passed the revised “National Intervention Strategy (NIS) Countering Discrimination, Hate Crimes, GBVF That Are Perpetrated Against People on the Basis of Their Sexual Orientation, Gender Identity, Gender Expression and Sex Characteristics.” The revised NIS widened its scope beyond violence against LGBTQI+ persons to motivating for an expansion of access to all human rights of LGBTQI+ persons. In September the minister of justice and constitutional development stated the National Prosecuting Authority secured eight convictions during the 2022-2023 financial years for hate crimes targeting individuals for their sexual orientation. A government official attributed the prosecutorial result to a “fully functioning Rapid Response Team” established by the NIS.Civil society expressed concern regarding increased hate speech and queerphobic bullying that in several instances led to LGBTQI+ youth committing suicide, including a student, age 12, who committed suicide after being bullied by his teacher in Ekurhuleni.Discrimination: The constitution explicitly prohibited discrimination based on sexual orientation but was silent to gender identity or expression or sex characteristics. The law prohibited discrimination on the basis of sexual orientation, gender identity or expression, or sex characteristics in housing, employment, nationality laws, and access to government services such as health care. Civil society expressed complaints concerning the mistreatment that LGBTQI+ foreign nationals faced at the Department of Home Affairs and Department of Health clinics. A 2021 study by several domestic organizations found evidence of discrimination against LGBTQI+ asylum seekers and called on the Department of Home Affairs to implement sensitization training for its employees; civil society complaints indicated the problem continued.There were no shelters dedicated to LGBTQI+ youth or adults. Transgender and intersex persons were refused entry into general population shelters because they did not fit the male or female categories. Transgender activists complained of discrimination and humiliation by officials and nurses at public hospitals and government offices. One individual reported sleeping on the sidewalk for two nights prior to their gender-affirming surgery because the hospital had no beds for them. The same individual, whose identity document had not been updated, was forced by police to reveal their breast reduction surgery scars.A religious leader, Oscar Bougardt, was called before the Equality Court in May to address anti-LGBTQI+ comments he had made on social media. The court found Bougardt guilty and fined him.Availability of Legal Gender Recognition: The law allowed transgender individuals to change their legal gender markers; however, the law imposed rigid barriers that left many transgender persons without accurate identity documents. The law required a medical diagnosis and for gender-affirming surgery to have been performed. Because of this, many transgender persons could not obtain legal gender recognition. Several organizations filed submissions to the Department of Home Affairs on the Draft Official Identity Management Policy in 2021, affirming that the existing system was discriminatory because it did not allow gender self-determination, removal of gender on identity documents, or offer gender-neutral option beyond male or female. Civil society reported a backlog at the Department of Home Affairs regarding name changes and changing gender markers for transgender persons, which negatively affects their ability to obtain a driver’s license, get married, obtain qualifications in their chosen name, open bank accounts, and more.Involuntary or Coercive Medical or Psychological Practices: Some traditional leaders, religious institutions, and parents continued to conduct so-called conversion therapy. “Corrective” rape was a well-known threat to LGBTQI+ persons. In November, a girl, age 15, fell victim to a “corrective rape” hate crime; although no suspect was arrested, the suspect was identified as a man in his 20s who wanted “to stop her from being lesbian.” Civil society reported that sexual, physical, and emotional abuse of LGBTQI+ children often began with family members in the home. One activist from West Rand described the practice of parents referring LGBTQI+ children to sangomas or traditional healers, who attempted to identify the source of the “curse” on the child. The activist said practices like these caused great harm to a child’s self-esteem and resulted in in higher suicide rates among LGBTQI+ youth.A 2022 report by Access-Chapter 2, an NGO, found that 50 percent of respondents “reported to have been forced to convert by their families, while 43 percent (of respondents) had a session with a religious representative or institution as intervention by parents, families, or communities.” Traditional healers reportedly immersed subjects in rivers to be cleansed while other were fed potions. Some respondents were subjected to beatings and slaps from the traditional healer.Civil society reported intersex babies continued to be subjected to genital mutilation.Restrictions of Freedom of Expression, Association, or Peaceful Assembly: There were no reports of restrictions on those speaking out on LGBTQI+ topics. LGBTQI+ organizations were able to register and convene events.																																				Persons with Disabilities										Persons with disabilities could access education, health services, public buildings, and transportation on an equal basis with others. The government provided government information and communication in accessible formats. President Cyril Ramaphosa enacted Sign Language as the country’s 12th official language in July. The law mandated access to buildings for persons with disabilities, but such regulations were rarely enforced, and public awareness of them remained minimal.The law prohibited discrimination based on physical, sensory, intellectual, and mental disability in employment or access to health care, the judicial system, and education. The law, however, prohibited persons identified by the courts as having a mental disability from voting. Department of Transportation policies on providing services to persons with disabilities were consistent with the constitution’s prohibition on discrimination. The Department of Labor ran vocational centers at which persons with disabilities learned income-generating skills. Nevertheless, government and private-sector employment discrimination existed. The law prohibited harassment of persons with disabilities and, in conjunction with the Employment Equity Act, provided guidelines on the recruitment and selection of persons with disabilities, reasonable accommodation for persons with disabilities, and guidelines on proper handling of employees’ medical information. Enforcement of this law was limited.The 2020-2021 Annual Report of the Department of Basic Education stated there were numerous barriers to education for students with disabilities, primarily a policy of channeling students into specialized schools at the expense of inclusive education. The department’s report noted progress toward a more inclusive basic education and cited expansion of “special schools” and increased enrollment of students with disabilities in both separate and public schools. Separate schools frequently charged additional fees (making them financially inaccessible), were far from students’ homes, and lacked the capacity to accommodate demand. Human Rights Watch reported in 2021 that children with disabilities were often denied tuition waivers or tuition reductions provided to other children. Children often were held in dormitories with few adult supervisors, many of whom had little or no training in caring for children with disabilities. When parents attempted to force mainstream schools to accept their children with disabilities – an option provided for by law – schools sometimes rejected the students outright because of their disabilities or claimed there was no room for them. Many blind and deaf children in mainstream schools received only basic care rather than education. Youth with disabilities in school faced problems of access (for example assistive equipment and technology; availability of learning materials in braille) and discriminatory attitudes that prevented their full and effective participation.In October reports emerged concerning psychiatric patients being kept in untenable conditions at the Charlotte Maxeke Johannesburg Academic Hospital.																																				Other Societal Violence or Discrimination										There were reports persons accused of witchcraft were attacked, driven from their villages, and in some cases killed, particularly in Limpopo, Mpumalanga, KwaZulu-Natal, and Eastern Cape Provinces. Victims were often elderly women. Traditional leaders generally cooperated with authorities and reported threats against persons suspected of witchcraft.Persons with albinism faced discrimination and were sometimes attacked for their body parts. Traditional healers believed albino parts from children when mixed with herbs could bring good luck. Ritual (muthi) killings persisted to obtain body parts believed by some to enhance traditional medicine. Civil society expressed concern regarding the kidnapping and trafficking of children for the purpose of organ removal. Police estimated organ harvesting for traditional medicine resulted in more than 50 killings per year. In April two boys, ages five and six, were found dead and mutilated in Soweto. On April 28, one of the boy’s grandmothers and her boyfriend were charged for their killing and kidnapping.The government sometimes responded quickly and decisively to xenophobic incidents, sending police and soldiers into affected communities to quell violence and restore order, but responses were sporadic and often slow and inadequate. Civil society organizations criticized the government for failing to address the causes of violence, for not facilitating opportunities for conflict resolution in affected communities, for failing to protect the property or livelihoods of foreign nationals, and for failing to deter such attacks by vigorous investigation and prosecution of perpetrators.There were continued political contract killings. According to a report by the Global Initiative Against Transnational Organized Crime, there were 141 political killings in 2022. In the first ten months of the year, 20 councilors were killed in KwaZulu-Natal.In September Police Minister Bheki Cele addressed media regarding political killings in KwaZulu-Natal. He said that since 2018, a task team had investigated 321 cases of political violence. He stated that 348 suspects had been charged and 60 convicted. Cele told media he planned to set up a similar task team to investigate political killings in Mpumalanga, where an ANC councilor Sbonelo Mthembu was ambushed in his home with two other victims in January. Five suspects including the former local mayor, Vusi Motha, were arrested and charged with murder. The case remained pending.HIV and HIV-related social stigma and discrimination in employment, housing, and access to education and health care remained a problem, especially in rural communities. Many individuals did not seek access to health services due to the fear of the stigma and discrimination. A community outreach study was conducted in 2021 among a commuter population in Johannesburg to identify the factors related to HIV stigma in the city. The study found that 51 percent of respondents reported a high level of stigma and discrimination.																																					Section 7.													 Worker Rights												    																																																a. Freedom of Association and the Right to Collective Bargaining										The law allowed all workers, except for members of the National Intelligence Agency and the Secret Service, to form and join independent unions of their choice without previous authorization or excessive requirements. The law allowed unions to conduct their activities without interference and provided for the right to strike, but it prohibited workers in essential services from striking, and employers were prohibited from locking out essential service providers. The government characterized essential services as “a service, the interruption of which endangers the life, personal safety, or health of the whole or part of the population; the Parliamentary service; and South African Police Services.”The law allowed workers to strike due to matters of mutual interest, such as wages, benefits, organizational rights disputes, socioeconomic interests of workers, and similar measures. Workers could not strike in disputes where other legal recourse existed, such as through arbitration. Labor rights NGOs operated freely.The law protected collective bargaining and prohibited employers from discriminating against employees or applicants based on past, present, or potential union membership or participation in lawful union activities. The law provided for automatic reinstatement of workers dismissed unfairly for conducting union activities. The law provided a code of good practices for dismissals that included procedures for determining the “substantive fairness” and “procedural fairness” of dismissal. The law included all groups of workers, including illegal and legally resident foreign workers.The government respected freedom of association and the right to collective bargaining. Labor courts and labor appeals courts effectively enforced the right to freedom of association and the right to collective bargaining, and penalties were commensurate with penalties for comparable violations of the law. The country’s National Economic Development and Labor Council served as a vehicle for social dialogue between organized business, organized labor, community, and the government. The council met to cooperate and negotiate on legislation and activities related to the economy, trade, labor, and development. During the year council members agreed that a “poly-crisis” afflicted the economy but did not reach consensus on a systemic long-term program to turn the economy around.Worker organizations were independent of the government and political parties, although the Congress of South African Trade Unions, the country’s largest labor federation, was a member of a tripartite alliance with the governing ANC party and the South African Communist Party. The minister of labor had the authority to extend agreements by majority employers (one or more registered employers’ organizations that represented 50 percent plus one of workers in a sector) and labor representatives in sector-specific bargaining councils to the entire sector, even if companies or employees in the sector were not represented at negotiations. Companies not party to bargaining disputed this provision in court. Employers often filed for and received Department of Labor exemptions from collective bargaining agreements.If not resolved through collective bargaining, independent mediation, or conciliation, disputes between workers in essential services and their employers were referred to arbitration or the labor courts.Workers frequently exercised their right to strike. Trade unions generally followed the legal process of declaring a dispute (notifying employers) before initiating a strike.																																				b. Prohibition of Forced or Compulsory Labor										See the Department of State’s Trafficking in Persons Report at:  https://www.state.gov/trafficking-in-persons-report/.																																				c. Prohibition of Child Labor and Minimum Age for Employment										See the Department of Labor’s Findings on the Worst Forms of Child Labor at:  https://www.dol.gov/agencies/ilab/resources/reports/child-labor/findings/ .																																				d. Discrimination (see section 6)																																														e. Acceptable Conditions of Work										Wage and Hour Laws: The minimum wage was above the official poverty line. The labor minister announced an increase in the minimum wage to 25.42 rand ($1.36) per hour for the year that went into effect in March. The law protected migrant workers, who were entitled to all benefits and equal pay. The minimum wage law also established a commission to make annual recommendations to parliament for increases in the minimum wage.The law established a 45-hour workweek, standardized time-and-a-half pay for overtime, and authorized four months of maternity leave for women. No employer could require or permit an employee to work overtime except by agreement, and employees could not work more than 10 overtime hours a week. The law stipulated rest periods of 12 consecutive hours daily and 36 hours weekly, which had to include Sunday. The law allowed adjustments to rest periods by mutual agreement. A ministerial determination exempted businesses employing fewer than 10 persons from certain provisions of the law concerning overtime and leave. Farmers and other employers could apply for variances from the law by showing good cause. The law applied to all workers, including workers in informal sectors, foreign nationals, and migrant workers, but the government did not prioritize labor protections for workers in the informal economy.Occupational Safety and Health: The government set appropriate occupational safety and health (OSH) standards through the Department of Mineral Resources and Energy for the mining industry and through the Department of Labor for all other industries.There were harsh penalties for violations of OSH laws in the mining sector. Employers were subject to heavy fines or imprisonment if convicted of responsibility for serious injury, illness, or the death of employees due to unsafe mine conditions. The law allowed mine inspectors to enter any mine at any time to interview employees and audit records. The law provided for the right of mine employees to remove themselves from work deemed dangerous to health or safety. The law prohibited discrimination against a mining employee who asserted a right granted by law and required mine owners to file annual reports providing OSH statistics for each mine, including safety incidents. Conviction of violating the mining health and safety law was punishable by two years’ imprisonment, and the law empowered the courts to determine a fine or other penalty for perjury. Outside the mining industry, no law or regulation permitted workers to remove themselves from work situations deemed dangerous to their health or safety without risking loss of employment, although the law provided that employers could not retaliate against employees who disclosed dangerous workplace conditions. Employees were also able to report unsafe conditions to the Department of Labor that used employee complaints as a basis for prioritizing labor inspections. Penalties were commensurate with those for comparable offenses.Wage, Hour, and OSH Enforcement: The Department of Labor was responsible for enforcing wage, hour, and safety laws outside the mining sector. The Department of Mineral Resources and Energy was responsible for enforcing OSH law in the mining sector through a tripartite Mine Health and Safety Council and an Inspectorate of Mine Health and Safety. Penalties for violations of wages and workhour laws outside the mining sector were commensurate with those for comparable offenses. Penalties were rarely applied against violators.The Department of Labor employed an insufficient number of labor inspectors to enforce compliance. Labor inspectors conducted routine and unannounced inspections at various workplaces that employed vulnerable workers. Labor inspectors investigated workplaces in both the formal and informal sectors. Labor inspectors and unions reported difficulty visiting workers on private farms.The government did not effectively enforce the law in all sectors. OSH regulations were frequently violated in the mining sector, and compensation for injuries was erratic and slow. Penalties were commensurate with those for comparable offenses, but not sufficient to deter violations. Unions in the agriculture sector noted their repeated attempts to have the Department of Labor fine farm owners who failed to shield workers from hazardous chemicals sprayed on crops. Although labor conditions improved on large commercial farms, the Congress of South African Trade Unions and leading agricultural NGOs reported labor conditions on small farms remained harsh. Underpayment of wages and poor living conditions for workers, most of whom were Black noncitizens, were common. Many owners of small farms did not measure working hours accurately, 12-hour workdays were common during harvest time, and few farmers provided overtime benefits. Amendments to the Basic Conditions of Employment Act attempted to address some labor abuses at farms. For example, changes prohibited farms from selling goods from farm-operated stores to farm employees on credit at inflated prices. During the COVID-19 pandemic, many employers cut salaries, without following the law restricting an employer’s ability to change an employee’s pay; this was especially evident with domestic workers. Most domestic workers had to stay with their employers or risked losing their employment.Farm workers also reported health and sanitation concerns.Mining accidents were common. On November 27, 11 mine workers died and 75 were injured when their conveyance system at Impala Platinum Mine started a rapid descent. In 2019 the Constitutional Court ruled employees assigned to workplaces via a labor broker (“temporary employment service”) were employees of the client and entitled to wages and benefits equal to those of regular employees of the client.Economic researchers reported that approximately 30 percent of total employment was informal, with higher rates in rural areas. Some labor laws, including workers compensation and minimum wage, applied to informal workers, but the laws were not evenly enforced. The Government Gazette confirmed that domestic workers were covered for injury or death under workers’ compensation laws and minimum wage laws. The government provided social assistance including disability, healthcare, child benefits, old-age pension benefits, and unemployment that could benefit a portion of lower income workers in the informal economy who met low- income thresholds.																																				    							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- DSS has logisticians around the world–Meet two who are going above and beyond in Africa By Jason Haskins, Security Engineering Officer in Pretoria, South AfricaDiplomatic Security Service (DSS) personnel can attest to the fact that hundreds, if not thousands, of pieces of security equipment accumulate in embassies and consulates overseas. Any item valued at over $500 is considered an asset and needs to be inventoried. As DSS and the office of security technology continues to complete security upgrades, the number of assets continues to increase and become more difficult to track.At the onset of each fiscal year, DSS begins the task of accounting for its technical security assets during the annual inventory. The heroes of inventory season are the 45 DSS logisticians in engineering security centers and offices around the world. Armed with barcode scanners, they scan cameras, security equipment installed at the embassy, screening equipment at guard booths, and spare parts in storerooms.Who are DSS logisticians? At engineering security centers and offices, they are typically family members of foreign service personnel and are knowledgeable about supply chain management, operations, and logistics. They provide year-round support with ordering, shipping, and receiving materials for technical security repairs, maintenance, or disposal. They assist with routing work orders and manage the storage and inventories of spare parts and systems. Whenever systems are repaired or replaced, they contribute to the record keeping and property management. There are countless logisticians working across the organization both domestically and overseas.With embassies and consulates in over 270 locations, DSS logisticians often utilize strategic planning and proactive thinking to ensure the correct parts are available even in the most remote places. Parts can take months to arrive and, if logisticians have not done their jobs properly, this could mean that a system, tool, or device is out of commission for just as long.Both seasoned and new logisticians alike find the work challenging but rewarding, especially due to the complexity and scale of the work. DSS Logistician Abdoulaye has been in this position for seven years. His wife works for the United States Agency for International Development and being a logistician for DSS allows him the flexibility to follow her wherever she is assigned. Together, they have worked in Manila, Dakar, and Pretoria.“I like discovering new places and helping to make the embassies safer,” Abdoulaye says about his work as a logistician with DSS. During this year alone, he conducted inventories in Pretoria, Johannesburg, Durban, Windhoek, Kinshasa, Brazzaville, Maputo, and Gaborone accounting for more than 3,000 DSS assets valued at over $8 million dollars.In contrast, DSS Logistician Megan just finished her first annual inventory and already loves the job. She is currently working in Dar es Salaam and completed inventories there as well as in Lilongwe and Harare. Throughout this process, she accounted for more than 800 assets, ensuring everything was where it needed to be to help those keeping the embassies and consulates safe.The engineering security office (ESO) in Dar es Salaam achieved 100% accountability of all assets, making Megan and her team literally perfect at their jobs.“My favorite part of working with the ESO is the sense of community and transfer of knowledge across missions. The Dar es Salaam ESO team is a fun and welcoming group of experts who are all passionate about their work,” said Megan.
- PEPFAR Launches Nursing Leadership Initiative Across Seven African Countries Office of the SpokespersonOn March 25, Ambassador Dr. John Nkengasong – U.S. Global AIDS Coordinator and Senior Bureau Official for Global Health Security and Diplomacy, overseeing the Department’s Bureau of Global Health Security and Diplomacy – will launch the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) Nursing Leadership Initiative to sustain gains and accelerate progress toward ending HIV/AIDS as a public health threat by 2030. Under the initiative, PEPFAR is providing $8 million in 2024 to support nurses at the forefront of the HIV/AIDS response in Botswana, Côte d’Ivoire, Eswatini, Malawi, Nigeria, South Africa, and Zambia.In these seven partner countries, the initiative invests in activities that will:Enhance nurses’ skillsets to lead planning and delivery of HIV/AIDS services to curb disruptions in access to essential HIV services;Help nurses to identify, advocate for, and leverage innovative digital solutions to enhance quality HIV service delivery;Protect nurses by enhancing their infection prevention and control skills, providing supportive work environments, and supporting mental health needs;Invest in the development, retention, and equitable distribution of the nursing workforce, aligned with each country’s national priorities, to ensure long-term sustainability of HIV service delivery; andEnhance nurses’ communication and leadership skillsets.PEPFAR implementing partners will also support partner nursing organizations in the seven initiative countries to undertake a needs assessment to guide initiative activities.For media inquiries, please contact GHSD_publicaffairs@state.gov.
- FY 2024 Notice of Funding Opportunity for NGO Programs Benefiting Refugees and Asylum Seekers in Zambia and South Africa Bureau of Population, Refugees, and Migration													HomeBureau of Population, Refugees, and Migration Remarks &amp; Releases&#8230;FY 2024 Notice of Funding Opportunity for NGO Programs Benefiting Refugees and Asylum Seekers in Zambia and South Africa				hide		if(window.jQuery) {		jQuery( document ).ready(function() {			if (jQuery(".bc_middle").hasClass("collapse")) {				jQuery(".bc_ellipse").click(function(){					jQuery(".bc_hide").toggleClass("visible");					jQuery(".bc_middle").toggle();					jQuery(".bc_ellipse").toggle();					jQuery(".bc_content").toggleClass("noflex");					jQuery(".block_breadcrumbs_content").toggleClass("noflex");				});				jQuery(".bc_hide").click(function(){					jQuery(".bc_hide").toggleClass("visible");					jQuery(".bc_middle").toggle();					jQuery(".bc_ellipse").toggle();					jQuery(".bc_content").toggleClass("noflex");					jQuery(".block_breadcrumbs_content").toggleClass("noflex");				});			} else {				jQuery(".bc_ellipse").hide();			}		});	}																										FY 2024 Notice of Funding Opportunity for NGO Programs Benefiting Refugees and Asylum Seekers in Zambia and South Africa																																		Funding Opportunity Announcement																														March 6, 2024																																							Funding Opportunity Number: DFOP0009165&nbsp;Assistance Listings (CFDA) number: 19.517 &#8211; Overseas Refugee Assistance Programs for Africa&nbsp;Announcement issuance date: Monday, March 4, 2024&nbsp;Announcement type: Cooperative Agreement&nbsp;Proposal application submission deadline: Wednesday, April 3, 2024 at 11:59:59 p.m. (11:59:59) EDT. Proposals submitted after this deadline will not be considered.&nbsp;																											                        Download Announcement							 [426 KB]																									Tags																					Bureau of African Affairs																								Bureau of Population, Refugees, and Migration																																Refugees																															South Africa																								Zambia
- Secretary Antony J. Blinken, German Foreign Minister Annalena Baerbock, And Indian External Affairs Minister Subrahmanyam Jaishankar At the Munich Security Conference Antony J. Blinken, Secretary of StateMunich, GermanyBayerischer HofMODERATOR:  (In progress) for Germany.  Welcome.  (Applause.)Antony Blinken, Secretary of State of the U.S.  (Applause.)  Nice to have you.And Subrahmanyam Jaishankar, Minister of External Affairs, Republic of India.  Minister.  (Applause.)I hope that based on the topic of the session that you will not all agree with each other and we can have some sparks.  We have about 43 minutes, and I will prepare your questions because I’ll ask a few questions and then I’ll turn to the audience.Minister Baerbock, I’m going to start with you.  Germany’s national security strategy calls for expanding global partnerships and is quite open about the multipolarity of the world today.  How do you go about it at a time when there are so many divisions, and particularly when increasingly we feel the Global South and the Western world are not on the same page?FOREIGN MINISTER BAERBOCK:  Well, first of all, good afternoon.  Very good to have this important session with my dear colleagues.In a nutshell, it’s more important than ever.  Because we are not naïve:  Obviously, there are ruthless actors who don’t want to – to drub up the title of our panel – negotiate the slice of the pie, but they want to rob the whole bakery.  And having that in mind, I believe it’s even more important than ever that those who are at the table negotiating about the slices of the pie stay there, first of all, resolute, respectfully, and also reflective.  And this is the core also of our national security strategy, which we have drafted as the German government, making very clear in the light of this ruthless war of aggression against Ukraine that we are resolute in defending international law.  It’s the best protection for everybody around the world.So there is no question about negotiating whether Ukraine has right of self-defense or not.  We all agreed not only – I don’t like that word, but “Western” actors – we all agreed in our Charter of the United Nations there is the right of self-defense, and we all agreed on the Universal Declaration of Human Rights.Having said that, obviously we have to be respectful that especially within Ukraine – and I think this is the lesson we have learned, and it was very important to speak to partners like India and so many around the world – Brazil, South Africa – we have to be respectful that obviously, in this moment when we said we need the whole international security, others asked some questions, like:  Where have you been when we needed you?  Or asked some question, so actually what does it mean for the future?  Do you also stand with us?  And this is, I would say, maybe something you in the attitude – at least from our foreign politics from Europe to say, okay, we cannot take for granted that everybody just agrees with our European or transatlantic vision.And the third part, I think it’s the most easy, but it’s the strongest asset for democracies.  The strength of democracy, in my point of view, is that we can be self-reflective and self-critical.  So asking in a moment when others – for example, war of aggression – were not saying automatically, okay, we support you, not saying why don’t you get it, but asking ourself why they cannot support us.And I think this is the critical part but the most powerful part, and at least, again, in our national security strategy we try to do it, talking about, for example, our colonialism past.  Understanding why South Africa was mentioning the whole time their ties with Russia in the Apartheid regime.  And being self-critical and saying, oh, yeah, not all democracies have stood back in time at their side, and taking that as something where we said, yes, we might have made a mistake in the past, but we cannot change the past; we can only change the future together.  I think this is the strength of multilateralism, and we see around the world the majority believes in it.MODERATOR:  Do you find that increasingly people are questioning more when it comes to – let’s stick to Ukraine and we’ll get to Gaza in a minute.  But on Ukraine, are people coming around to your point of view or are they distancing themselves more?FOREIGN MINISTER BAERBOCK:  Well, to see it over the least three years, I mean, we have seen the 142 voting in the General Assembly, so it is a majority of states.  Because most of the countries in the world, like mine – we’re not the biggest country in the world; we don’t have the biggest military means.  And this is for most of the countries:  They know that the Charter of the United Nations, the rule of law is their life insurance.So we see this big majority there when you see also the support.  Many have traveled – and I think this is really important to give always the question of war of aggression a human face.  It was not that we convinced some other actors in the world by saying now you have to stand with that, but when a delegation traveled to Kyiv – and not only Kyiv, to Bucha, to Irpin – when they spoke, like we did, to the parents of those where their child had been kidnapped by Russia, then we give this ideation a human face, and that’s all about.  And this is why it’s so important to not only talk about state, but we talk about the people, talk about also the question of the rule of law in front of the International Criminal Court, for example, bringing crimes against humanity in front of the court.  And there we see again the majority of the states is pushing for that one.MODERATOR:  Secretary Blinken, there is a – there is a feeling that – it’s more than a feeling, it’s what we see on – happening on the ground, that the U.S.-China tensions are leading to greater fragmentation and that you’re almost competing for alliances:  who’s our ally?  And we see this within the UN, in various UN institutions, but we just see it all around the globe.  To what extent do you feel that you are challenged in your travels around the world on the fundamental questions?SECRETARY BLINKEN:  Well, first, it’s wonderful to be with my friends, wonderful to be back in Munich at the Security Conference, known among all of us as speed dating for diplomats.  (Laughter.)But we’ve done a couple of things, and I’ll come quickly to your question.  From the start of this administration, we’ve made an investment, a reinvestment, in our alliances, in our partnerships, and in the multilateral system.  We’ve reinvested, we’ve re-engaged, we’ve tried to rejuvenate, we’ve even reimagined.  And the reason for that is simple:  it’s because it’s in our interest to do it.  Not a single one of the challenges that we have to face and that are so important to the interests of the American people can we effectively deal with alone, as powerful and as resourceful as we are.  And so across the board, we’ve seen our comparative advantage as having a strong network of voluntary alliances, voluntary partnerships.  And if you’re not at the table in the international system, you’re going to be on the menu.  So it was very important for us to re-engage multilaterally, and we’ve done that.When it comes to strategic competition – and there’s no doubt that we have one with China – there are a few things to be said.  First, we have an obligation to manage that relationship responsibly, and I think that’s something that we hear from countries around the world, and it’s clearly in our interest to do so, and that’s exactly what President Biden is doing.  And when it comes to other countries, the point is not to say to country X, Y, or Z, “You have to choose;” the point is to offer a good choice.  And if we can do that – and I believe we can and we have and will continue – then I think the choice becomes fairly self-evident.Over the last six or seven months, we have engaged in a sustainable way with China.  I just met my counterpart Wang Yi here in Munich, but that follows a series of meetings, notably and most importantly President Biden and President Xi, and I think we’ve brought greater stability to the relationship, not moving away from or ignoring the fact that, yes, we have a competition, there are areas where we are contesting each other, but there are also areas where we can and should cooperate because it’s in our interest to do that.One of the best examples of that is the agreement reached with China on fentanyl.  The single largest – the number one killer, number one killer of Americans aged 18 to 49 is the synthetic opioid, fentanyl.  Now we have meaningful cooperation from and with China on fentanyl.  That’s going to make a difference in the lives of Americans.MODERATOR:  And do you think it is sustainable to have cooperation on – in some areas, climate being one of them, but to have a strategic competition – the strategic competition that defines geopolitics today and that will go on for a very long time?  Do you think that that is sustainable that both sides sort of can find rules of engagement?  This is where we compete and this is where we cooperate?SECRETARY BLINKEN:  Some fundamentals haven’t changed.  Countries will act in their self-interest.  Where we have to compete, we will.  Where we have to contest, we will.  Where it makes sense to cooperate, we will.  And I think you can do all of the above at the same time.But there’s something else that’s, I think, changed, and it goes back to the first part of the question.  The very fact that we’ve re-engaged and rejuvenated as well as reimagined some of our alliances and partnerships, along with the investments that we’ve made at home in the United States – the investments we’ve made in our infrastructure, the investments we’ve made in science and technology and chips, the building blocks of the 21st century economy, the investments we’ve made in climate technology – you put those two things together:  investments at home, much greater alignment with partners and allies across the board in Europe, in the Indo-Pacific, in Asia on how to approach a question as complicated as relations with China – that puts us in a position of much greater strength in dealing with all of the challenges that we have to deal with.MODERATOR:  Minister Jaishankar, India has more of a multiple-choice mindset.  Is – would that be – would that be right?  From nonalignment to – I think you may have called it or somebody else called it “all-alignment.”  So you can pick and choose alliances, but you can also pick and choose topics.  On Russia, for example, you still buy Russian oil.  Is that okay with your counterpart from the U.S.?  Everything is – your relationship is fine?  You can do whatever you want whenever you want?  (Laughter.)FOREIGN MINISTER JAISHANKAR:  Okay.  First of all &#8212;MODERATOR:  I mean, you’re sitting next to each other, so &#8212;FOREIGN MINISTER JAISHANKAR:  No, no.  First of all, delighted to be here, and I couldn’t find a better set of people to be with on the stage.  So thank you for whoever put us on together.Your question:  Do we have multiple options?  The answer is yes.  Is that a problem?  Why should it be a problem?  If I’m smart enough to have multiple options, you should be admiring me, you shouldn’t be criticizing me.  (Laughter and applause.)Now, is that a problem for other people?  I don’t think so.  I don’t think so, certainly in this case and in that case.  Because, look, we try to explain what are the different pulls and pressures which countries have.  And it’s very hard to have a unidimensional relationship.  Now, again, different countries and different relationships have different histories.  If I were to look, say, between the U.S. and Germany, it is rooted – there’s an alliance nature to it; there’s a certain history on which that relationship is grounded.  In our case it’s very different.So I don’t want you to even inadvertently give the impression that we are purely and unsentimentally transactional.  We are not.  We get along with people.  We believe in things, we share things, we agree on some things.  But there are times when you’re located in different places, have different levels of development, different experiences – all of that gets into it.  So life is complicated.  Life is differentiated.  And I think it’s very important today not to reduce the entire complexity of our world into very sweeping propositions.  I think that era is today behind us.So I agree very much with what Tony said, which is good partners provide choices.  Smart partners take some of those choices.  But sometimes there will be choices on which you say, well, I think I’ll pass up on that one.MODERATOR:  It’s a very good point, which brings me to the BRICS and the rise of middle powers, because that is one of the shifts that we see today.  To what extent do you think that that is a challenge to the West, or maybe that can be sort of the bridge, especially in a world where we will see continued competition between the U.S. and China?  And I’m going to ask Minister Jaishankar first and – but I’d love for both of you to comment as well.FOREIGN MINISTER JAISHANKAR:  Yeah, I thought maybe the BRICS one you wanted the U.S. to &#8212;SECRETARY BLINKEN:  After you, Jai, please.  (Laughter.)FOREIGN MINISTER JAISHANKAR:  But look, again, I think it’s important to go back to how it began.  The BRICS started in an era where Western dominance was very strong.  The premier gathering of the world was the G7, and you had a number of significant powers in the world who felt that, well, they were not part of the G7 but maybe they also brought value to the table by sitting and discussing with others.So in a sense you had a collection of these countries.  It was originally four; South Africa joined later.  And if you look at it, it’s a very interesting group because it’s geographically as disparate as it can be.  Yet it is bound by the fact that these discussions we’ve had over a decade and a half have been very useful for all of us.Now, like any product, you test it in the market at some point.  We tested it last year and asked people, so how many of you want to join BRICS?  And we got almost 30 countries who were willing to join BRICS.  So clearly, if 30 countries saw value in it, there must be something good we have done.So I think it’s important today to make a distinction between being non-West and anti-West.  I would certainly characterize India as a country which is non-West, but which has an extremely strong relationship with Western countries getting better by the day.  Not everybody else necessarily in that grouping might qualify for that description.But the contribution the BRICS has made – if one looks at the G7 and how it evolved into the G20, I think in a way those additional 13 members who came into this bigger grouping, five of them are BRICS members.  The fact that there was another group which was meeting regularly and discussing and debating I think certainly was an input into the expansion of the G7 into the G20.  So I think we did a service to the world.MODERATOR:  Yeah.  Secretary Blinken?SECRETARY BLINKEN:  I’m tempted to say what my friend said and leave it at that.  Look, the – what we don’t need to do and what we’re not doing is trying to somehow design the world into rigid blocks.  Each and every one of the issues that we have to deal with, and deal with in the interests of the American people, may have different collections and coalitions of countries that are focused on it, that bring certain experiences, certain capacities, and I think about it as variable geometry.  We’re putting together a puzzle with collections of countries, and not just countries, organizations of different sizes and different shapes to deal with a given problem.As Jai said, we have – and of course the fact that the relationship between our countries, I would argue, is the strongest it’s ever been, it makes no difference that India happens to be a leading member of BRICS.  We’re a leading member of the G7.  We have the G20 and we have a multiplicity of things that we’re doing together every single day in different ways of organizing ourselves.  India and the United States working together in AUKUS, working together – I mean, excuse me, in the Quad, working together in a variety of other fora.  All of this goes to the point that the complexity and the multiplicity of the challenges that we have demands that we find different ways to work together, and this shouldn’t be done on an exclusive basis.Look, our default, of course, is to work in the first instance with fellow democracies.  That’s only normal and natural.  But we are not only willing, we are actively working with any country that wants to solve a particular problem and wants to do so within the context of a rules-based order.  That’s the way we approach things.MODERATOR:  Speaking of a rule-based order, major powers today are criticized for sort of upholding the rule-based order and upholding values in certain areas but not in others, and a lot of people around the world – and particularly in the Global South but I would say not only in the Global South; even within our Western democracies – are confused.  They look at what’s happening in Gaza and at the intensity of the killing, and they ask:  Where are human rights?  Where are these Western values?  I’m sure you’re having here today and yesterday a lot of similar discussions, Minister Baerbock.FOREIGN MINISTER BAERBOCK:  Yes, and they are so productive because many of them are not only speed dating, but behind closed doors, very trustfully.  And I think the most important job for those who believe in a rules-based international order, be it politicians, be it journalists, be it citizens, is to not be pushed into this speed dating, into this black-and-white world in all of our bubbles.  Because easily – and this is a double-standard question, yeah – if you only look – and you mentioned the situation in Gaza.  If I only see the whole time on YouTube what’s happening in Gaza, and I do that every second day – every day I cannot stand it because otherwise I couldn’t get out of my bed anymore – yeah, your reality is obviously – the only thing what we can and have to do right now is to go in a total ceasefire to rescue these innocent children dying there every day.  Yeah?So, and you’re 100 percent right by that.  But the question is to really come to this reality is to force myself – not myself, but all these persons who are saying this is the moral right thing to do – to then also ask:  So how do we come to that?  And this is then when some might ask:  So why you, German foreign minister, didn’t call for immediate ceasefire the last – months ago?  Because I also looked at the other side, at the other YouTube videos, at the other bubbles, yeah, where we saw, I saw for days after the 7th of October – I didn’t only see it, I spoke to the father whose wife and two little girls had been kidnapped by terrorists from Hamas.  I saw the video where women have been not only raped, but murdered afterwards.  And in that moment for me it was clear, again, that we can also not only relate to the past saying, okay, we know how negotiations about – with terrorists are working.  Because if you saw that video and if you were ready to see this woman suffering there, you understand that this is not only a military logic.  Because those people who are doing this, raping a woman and killing her afterwards, they don’t want to exchange soldiers for political prisoners.  They enjoy slaughtering women.I’m saying that because I think this is really important, bringing it down to the people.  Because then you understand in this kind of situation, how do we come now to a ceasefire?  That the release of hostages, the release of these women is crucial because otherwise we can never save the children in Gaza.So this comes all back to what my dear colleague Jaishankar has said.  If we are not capable of stepping out of right or wrong, yes or no, black or white, we will in this world of dilemmas never do what our job – I would say the three of us here – is:  to do all the best to rescue people.  And this is why we have been working so intensively for those partners, Arab partners, in the last three months to see how we can come together for the most important point right now:  freeing the hostages, having a humanitarian pause to bring in humanitarian support into Gaza, and not stopping even though the headlines are there every day:  You cannot fix it anyhow.I think the biggest favor for those who do not care for human rights and the international order is that we are giving up and that we are not being ready to look at these different topics from our different side.  And this is why – at least for me; I would say for all the three of us – use our competences, use our channels we are having.  And there again diversity is beneficial.  If we are not all the same, but if we are trying to solve this horrible war in the Middle East from our different perspectives, then we can also bring security both for the people in Israel and the people in Gaza.SECRETARY BLINKEN:  I have to say I fully subscribe – (applause) – fully subscribe to everything that Annalena said.  And I think as people in positions, for a brief period of time, of responsibility, but also, and maybe foremost, as human beings – as mothers, fathers, children, brothers, and sisters – we’re intensely driven to try to prevent or stop human suffering, including the suffering of men, women, and children in Gaza.  The question is how to do it most effectively and how to take account of the incredible complexity that Annalena just outlined so well.But there’s another element to this that we have a responsibility to do something about.  The greatest poison in our common well is dehumanization.  And we see that in all directions.  And if you lose sight of the humanity of someone else, then your heart is hardened to a point where anything is acceptable and anything is possible.  Part of our responsibility is to do what we can to push back, to avoid, to call out dehumanization wherever it’s coming from, in whatever direction.  Because if we can’t get at that, it’s very hard, if not impossible, to do other things.MODERATOR:  One other criticism that I think I’m sure you hear a lot is U.S. policy has, of course, shifted in the last couple of months, but yet you want the fighting to stop, but there is no sign whatsoever that you’re not willing to send weapons to Israel, for example.  So that also confuses people.  When they look at the rhetoric versus the action, what would you say to that?SECRETARY BLINKEN:  Well, first, we’re committed to Israel’s security.  That’s been clear from day one.  It remains clear.  And we understand and support the proposition that Israel has to find ways to make sure that what happened on October 7th never happens again.  (Applause.)  So we start there.But we’ve also said – and not only said, we’ve acted on the proposition – that, of course, the way Israel does that matters profoundly.  The way it does it in terms of trying to ensure greater protection for civilians who are caught in a crossfire of Hamas’s making.  That’s absolutely essential.  Making sure that people in need get the assistance they need.  We are working on this every single day.  And as we’ve seen this evolve over the last four months, things have happened as a result of our engagement, our intervention, that I would say probably would not have happened, almost certainly wouldn’t have happened without it.  But it’s not enough; it’s insufficient.  And that’s why we’re at it almost, literally, 24 hours a day.FOREIGN MINISTER BAERBOCK:  May I add one thing on that?MODERATOR:  What is – yes, sure.FOREIGN MINISTER BAERBOCK:  Because for the full picture – and this is what we are discussing, and this is a good thing.  In these horrible times, I’m always trying to see the glimpse of hope at the horizon.  The good thing is that over the last three months, yeah, all these discussions were helpful in a way.  First we didn’t have any humanitarian support; now we have at least a few trucks – not enough trucks.  But also from the other understanding – and this is why I totally agree with the security guarantees for Israel – you cannot just say we need a ceasefire and the Israeli government, the IDF has to stop, and then we just wait and see what happens through the regrouping of Hamas.  No, we have to give an answer to both legitimate security concerns.So our part of discussion is, for example, in the north, yeah?  If people go back to the north, how do we as an international community secure that Hamas is not regrouping there, using, misusing against civilians as human protection shield?  And this is also part of our common international security response.  (Applause.)MODERATOR:  Minister Jaishankar, what is the view from India?  What would you – if you had some advice for your colleagues, what would you be – what would you tell them?FOREIGN MINISTER JAISHANKAR:  Well, I don’t have advice for my colleagues, though I – particularly, I think all of us follow the enormous efforts which Tony is putting in right now.  But look, the way we look at it, there are different dimensions, different elements to this.Number one, we must be clear that what happened on October 7th was terrorism.  No caveats, no justification, no explanation.  It was terrorism.Number two, as Israel responds, it is important that Israel should be – should have been very mindful of civilian casualties, that it has an obligation to observe international humanitarian law.Number three, the return of hostages is today imperative.Number four, there is a need for a humanitarian corridor, a sustainable humanitarian corridor to provide relief.  And eventually, there has to be a permanent fix, a long-term fix, otherwise we’re going to see a recurrence.And I think today, suddenly – India has long believed in a two-state solution; we have maintained that position for many decades.  And I think today, many more countries in the world today feel not just that a two-state solution is necessary, but it is more urgent than it was before.MODERATOR:  Let me take a couple of questions.  I think there is a gentleman there, and then there and there.  Okay, three.  Let’s take – let’s take all three questions.  Actually, we’ll take four questions very quickly.PARTICIPANT:  Four is here?MODERATOR:  Yes, four is there.QUESTION:  Nathalie Tocci, Rome.  A question – in fact, both to Secretary Blinken and to Foreign Minister Baerbock.  I mean, the logic of the argument of being somewhat reticent on pushing for a ceasefire, as far as I understand, is basically that of saying, well, one needs to make sure that what happened on the 7th of October does not happen again.  And so the question that I ask you is, do you think that what is happening now, what has happened over the last four months, will actually reduce the chances of what happened on the 7th of October happening again?  Will it actually make Israel more secure or not?MODERATOR:  Okay, so there is &#8212;FOREIGN MINISTER BAERBOCK:  And I (inaudible).MODERATOR:  Okay, so I thought that question was that side, but okay.QUESTION:  Okay, thank you very much.  Oleksiy Goncharenko, a member of the parliament of Ukraine.  Secretary Blinken, you said those who are not at the table are in the menu.  Ukraine was at the table in Budapest when we voluntarily gave up our nuclear weaponry.  Now we are in the menu.  So the question is, what is the way for us?  We are confronted with a nuclear power.  Either we will become a member of NATO Alliance with a nuclear power or we should restore our nuclear status.  I don’t see any other option.  What option do you prefer and what you will answer on this?  Thank you very much.MODERATOR:  Okay.  There’s a question here, question there, and then we’ll do one round.  Would that be okay?PARTICIPANT:  Do you want me to get &#8212;MODERATOR:  Yes, I mean, I have said – yeah, here we go.QUESTION:  Thank you.  My name is Shafik Gabr, from Egypt.  My question is to Secretary Blinken.  You’ve invested an incredible amount of time trying to bring a settlement in the issue of Gaza, and at the very same time we all feel in the region that things can spill over in a very dramatic way.  Especially, there are many excuses of why not to have a solution, but to do things step by step.  That is not going to work.  So my question to you is, sir, why, with all the countries, including the United States, including the UK, just what Cameron has just said, proclaiming a two-state solution is not something the United States puts on the floor now and be able to achieve that?MODERATOR:  Okay, thank you.  Thank you.  Finally, there’s a question there, and then I’m afraid &#8212;QUESTION:  I have a loud voice; I don’t need a microphone.  Hello, my name is Masih Alinejad.  I’m an Iranian troublemaker for mullahs, and I have a simple question.  We cannot talk about global security by forgetting about Iran, by burying the human rights abuses under the carpet.  I am here today with a woman who was in the front line of last year’s uprising.  She was shot in her eye; she lost her eyes because of the Revolutionary Guards.  So my question is very clear:  How we can reach to peace and security in the world without designating the Revolutionary Guards as a terrorist organization, which the United States of America did that – thanks – but why the allies are not following the United States?  The democratic countries are not as united as autocracy, because Islamic Republic is helping Putin, is helping Hamas, all the proxies in Yemen.  So as we see, unfortunately, dictators are more united than democratic countries.  Do you have any common strategy to isolate Islamic Repulbic and address Khamenei and his gang of killers the way that you address Putin?  Thank you so much.MODERATOR:  Thank you.  Thank you.  (Applause.)  All three of you, you can pick the question you want to answer.  I know one was directed – a couple were directed at Secretary Blinken.  So maybe &#8212;SECRETARY BLINKEN:  Want me to start?MODERATOR:  Maybe you start.  Yeah.SECRETARY BLINKEN:  Good.  So to the question, is Israel more secure now after – four months after October 7th, I think the answer is, in the near term, in the immediate, yes it is, in terms of dealing with the immediate threat, the horrific terrorist group that attacked it in the most unimaginable ways on October 7th.  Is it more secure for the long term?  That’s a different question.  Because the fundamental question we have to ask ourselves is – and Jai mentioned this – how do we make sure that the cycle one way or another doesn’t repeat itself, whether it’s a year from now, five years from now, or 10 years from now?I think there’s an extraordinary opportunity before Israel in the months ahead to actually once and for all end that cycle.  And it’s because there are some new facts that didn’t exist before when there were efforts to make peace between Israelis and Palestinians, starting with the fact that virtually every Arab country now genuinely wants to integrate Israel into the region, to normalize relations if they haven’t already done so, to provide security assurances and commitments so that Israel can feel more safe and more secure.  At the same time, there are genuine efforts underway led by Arab countries to reform, revitalize, revamp the Palestinian Authority so that it can be more effective in representing the interests of the Palestinian people and could be a better partner for Israel in that future.  And there’s also, I think, the imperative that Jai mentioned that’s more urgent than ever:  to proceed to a Palestinian state, one that also ensures the security of Israel and makes the necessary commitments to do so.If you put all of that together, you have an integrated region where people are actually working together for the common good, a region in which Israel is secure in ways that it’s never been before, and where the number one threat to its security as well as the security of many of us – just alluded to in the last question, Iran – is isolated along with all of its proxies.  That future, that path is there, it’s clear, it’s hard, it’s complicated, but it’s real.The alternative is an endless repetition of the cycle that we’ve seen year after year, decade after decade, generation after generation.  It’s incumbent upon all of us who have relationships with and responsibility for different countries in the region, things that we bring to the table ourselves, to make the hard decisions, do the difficult things to actually make that path clear, real, and one that – whose attraction is overwhelmingly powerful.  I think the more we’re able to do that and the more we distinguish between that path and the alternative, the greater the chance we’ll actually see movement in that direction.I’ll say just very quickly on Ukraine, I think you’ve heard throughout this conference, including by the fact that we have an extraordinary delegation from the United States Congress here – Republicans, Democrats, Senate, House – that there is enduring support for Ukraine, and that’s not just from the United States, it’s from country after country in Europe and well beyond, for a whole variety of reasons, starting of course with the aggression that the Ukrainians have suffered, but also because that aggression has gone to the very principles at the heart of the international system that each of us has a stake in preserving, and that’s not going away.So there’s a tremendous determination on the part of dozens of countries to do two things.  First, to make sure that Ukraine has what it needs to deal in the immediate with the ongoing Russian aggression; but second, to put Ukraine on a path where increasingly in the months and years to come it’s able to stand strongly on its own two feet militarily, economically, and democratically.  That is the strongest possible rebuke to Putin.  It’s the strongest possible rebuke to all those who would seek to undermine Ukraine.And I’ll just conclude with this:  The real lesson to be drawn from what we’ve seen – including, as you rightly said, Russia tearing up and then spitting on the Budapest Memorandum, among many, many other agreements – is that this aggression against Ukraine has been an absolute strategic debacle for Vladimir Putin and for Russia.  Russia is weaker militarily, it’s weaker economically, it’s weaker diplomatically.  Europe has ended its energy dependence on Russia in the space of two years.  Ukrainians are more united than they’ve ever been, including against Russia, which was not the case certainly in 2014 – not desirable, but it’s the result of Russia’s actions – and certainly since 2022.  We have the NATO Alliance, a defensive Alliance with no intent of ever attacking Russia, only there to defend its members, that is now stronger and larger.  All of this a result of actions that Russia has taken, precipitating the very things it said it wanted to prevent.So I think as those lessons are digested, not to mention the horrific losses that Russia has suffered as a result of Vladimir Putin throwing its young men into a meatgrinder of his own making, I think the more those lessons are digested, the more you’re going to see that this is not repeated.  But that requires all of us to maintain the solidarity that we’ve demonstrated with Ukraine, a solidarity that is important not just for Ukraine, but for all of us.  The stakes couldn’t be higher.So my belief, again, listening to everyone here over the last couple of days, talking to our members of Congress who are with us, is that not only is that support there, it will be sustained, and Ukraine will succeed.MODERATOR:  Thank you, Secretary.  Minister Baerbock.FOREIGN MINISTER BAERBOCK:  Well, I guess the question from Iran was for us.  So the question was, why do you not follow the example and list them as terrorists, in a terrorist sanction regime, the Revolutionary Guard?  We have discussed it quite often, but the quick answer is because I’m defending rule of law, trying without any double standards.  And our legal situation in the European Union – and you can like it or not, but this is how – in which context we are working – in our European legal system, we have a sanction system for listing under terrorism if terrorism occurs in another country, especially in the European Union.  It was after the attacks on the U.S. on the 9th of September.So we need a legal ground to list them.  So far, we do not have the evidence and proof that there have been these terrorist attacks in the European Union.  There were different cases.  It’s a different legal system in the U.S.But – and this is important for me because I hear this argument again and again – this is not because we shy away with regard to the Revolutionary Guard or the crimes against women,  youth, civil society, its own population.  No.  We use the instruments we are having as a European Union to defend human rights.  And we set up for the first time in history of the European Union a sanction systems because of human rights violation.  And for me this is even stronger.  In the past, it was the same with Daesh and the crimes against Yezidi women, yeah?  They have been brought to court not slaughtering women, not saying these are the worst sexual violence crimes you commit, but under terrorism.I think this is wrong.  We have to name the crimes, and the crime is targeted directly to women, directly to human rights.  We say we sanction you because of what you have done to you shooting in your eyes, killing your friends, killing your sisters.  And it’s the same effect.  And this it comes all down to me – for me, politics, it’s not about symbolic action.  It’s about what matters for the people.And under the sanction system, human rights sanctions from the EU, Revolutionary Guard – we named them – cannot enter the European Union.  We have frozen their assets.  So the result is exactly the same what the U.S. has done under the terrorist sanction system.  So if you’re asking, do we act as a result in the same way?  Yes, we do, but we call it human rights sanction system because these are the worst human rights violations you can see.And this comes also back to the other question about symbolic politics or what matters in reality.  We would have been at a total different stage if, after the 7th of October – this was a question from Italy – after the 7th of October, we could have had a common resolution.  We were in Cairo at the so-called peace summit together with different countries, many Arab partners, and also from the European Union.  We tried to fix a text where we would say, okay, after these horrible crimes of the 7th of October, there could be the momentum now for whatever generations have dreamt of:  a two-state solution pathway.  But in order to do that, we have to guarantee that the 7th of October never happens again to Israel and we have to guarantee that Palestinians have the security to live in peace and security for them.Unfortunately, those meeting there together, not everybody was ready to name the 7th of October what it was:  a terrorist attack from Hamas on Israeli people.  And this is why we passed this momentum.  I regret it, but this is how life is.  So now again we have to work again if we now, after four months where we see that the current situation only brings misery for everybody, if we can regroup again.  And this is why what we have described before, for us it’s so important to work together as European Union, as the U.S., with Arab partners to find what we need:  guarantees that Israelis can live forever in security; that the 7th of October can never happen again; and the same counts for Palestinian people – it has to be an irreversible path towards a two-state solution.  And this is our job which we have to do right now, and we can only do it together with the different partners.Neither the U.S., definitely not Germany, but also not one Arab country alone can go this path.  We have to group and unite together for the peace in the Middle East.  (Applause.)MODERATOR:  Inshallah, as they would say in the Middle East.  One &#8212;FOREIGN MINISTER JAISHANKAR:  So I’ll just take a minute.MODERATOR:  One minute, yes.FOREIGN MINISTER JAISHANKAR:  I think a very large number of countries, especially of the Global South, believe that terrorism shouldn’t be countenanced or justified.  But they equally strongly believe that a two-state solution should not be delayed.  These are not choices.  These are both musts.  And unless we are able to address both these issues, we are not going to really solve the problem.MODERATOR:  Well, thank you all.  I know that we’ve gone over time, so apologies for that.  And thank you to the audience.  (Applause.)
- Under Secretary Fernandez’s Travel to South Africa HomeOffice of the SpokespersonPress Releases&#8230;Under Secretary Fernandez’s Travel to South Africa				hide		if(window.jQuery) {		jQuery( document ).ready(function() {			if (jQuery(".bc_middle").hasClass("collapse")) {				jQuery(".bc_ellipse").click(function(){					jQuery(".bc_hide").toggleClass("visible");					jQuery(".bc_middle").toggle();					jQuery(".bc_ellipse").toggle();					jQuery(".bc_content").toggleClass("noflex");					jQuery(".block_breadcrumbs_content").toggleClass("noflex");				});				jQuery(".bc_hide").click(function(){					jQuery(".bc_hide").toggleClass("visible");					jQuery(".bc_middle").toggle();					jQuery(".bc_ellipse").toggle();					jQuery(".bc_content").toggleClass("noflex");					jQuery(".block_breadcrumbs_content").toggleClass("noflex");				});			} else {				jQuery(".bc_ellipse").hide();			}		});	}																										Under Secretary Fernandez’s Travel to South Africa																																		Media Note																														February 2, 2024																																							Under Secretary for Economic Growth, Energy, and the Environment Jose W. Fernandez will travel to Cape Town, South Africa, February 4-7.  Under Secretary Fernandez will lead a delegation of U.S. government officials who will participate in the “Investing in African Mining Indaba.”  On February 5, the Under Secretary will speak on a panel discussing the security of critical minerals supply chains.  During his time in Cape Town, he will conduct a number of bilateral discussions with government and industry officials. As part of the U.S. government’s sustained, high-level engagement on critical minerals diplomacy, this trip will mark Under Secretary Fernandez’s third visit to South Africa to participate in this forum, with a particular focus on U.S. support for developing transparent, sustainable, and diverse supply chains for the critical minerals that underpin the clean energy transition.  For further media information, please contact E_Communications@state.gov.						Tags																					Bureau of African Affairs																								Office of the Spokesperson																																Official International Travel																															South Africa																																Supply Chains																															Under Secretary for Economic Growth, Energy, and the Environment
- Improving Retention and Viral Load Suppression Rates Scale-Up of Adherence Clubs for Stable Antiretroviral Patients in Cape Town, South Africa WHAT WAS THE PROBLEM?Antiretroviral drugs (ARVs) are usually delivered at facilities, and distribution is frequently associated with long waiting times for patients. Additionally, where multi-month scripting or other differentiated-care models have not been implemented, clinic congestion impacts patients and providers, and is a barrier to patient adherence and retention.FULL SOLUTIONWHAT IS THE SOLUTION?The Western Cape Government Department of Health adopted the adherence club (AC) model for the Cape Metro district in January 2011. The ART-AC model provides patient-friendly access to ART for clinically stable patients, ART distribution, and care and support to groups of stable patients. ACs can reduce the burden that stable patients place on healthcare facilities, freeing healthcare workers to treat new and unstable patients. This innovative solution addresses congestion in health facilities caused by large volumes of patients, and provides more flexible and convenient services for stable patients (MacGregor et al., 2017).      ACs meet either at a health care facility, or at a community-based venue for symptom screening, group discussions, ART distribution, and care and support to groups of stable patients (Tsondai et al., 2017).  Each AC is composed of approximately 25 to 30 patients who meet for 30 to 60 minutes five times per year to receive their pre-packed ART supply. This is a two-month supply, until year-end when they receive a four-month supply. Annually, both blood is drawn for viral-load (VL) monitoring at month four, and a clinical consultation occurs at month six. ACs are facilitated by lay health care workers (LHCWs) and usually supported by nurses, particularly for blood draws and clinical consults.  Thus, the ACs are initiated by, and connected with, specific health facilities. A number of non-governmental organizations (NGOs) provided limited technical assistance support.WHAT WAS THE IMPACT?An epidemiological study of AC implementation scaled up across an entire district in a high-burden setting assessed retention in care, and VL suppression (indicating adherence). The study sample size was 3,216 adults in 100 ACs linked to 15 health care facilities in the Western Cape. Retention was 95.2% (95% CI, 94.0-96.4) at 12 months and 89.3% (95% CI, 87.1- 91.4) at 24 months after AC enrollment. In the 13 months prior to analysis closure, 88.1% of patients had VL assessments; of those, 97.2% (95% CI, 96.5-97.8) were virally suppressed. Significantly, risk of loss to follow up from ACs was higher in younger patients and patients accessing ART from facilities with larger ART cohorts. These results provided substantial reassurance that stable patients on long-term ART can safely be offered differentiated care, particularly ACs (Tsondai et al., 2017). By March 2015, 55 of 70 health facilities providing ART services in Cape Town had ACs (Wilkinson et al., 2016). From 2011 through March 2016, ACs have been further scaled up to reach approximately 32% of 142,000 patients on ART (MacGregor et al., 2017).HOW DOES IT WORK?PROVIDERSMost ACs studied were facilitated by LHCWs (such as lay facility counselors or community health workers) with management support, blood draws, and clinical consultation from nurses and/or clinicians. The AC model gives patients the flexibility to ask a third-party ‘buddy’ to attend the AC meeting for ART pick up at every alternate standard AC meeting.PATIENTSParticipation in ACs is voluntary. Eligible patients have to be “stable,” have two consecutive suppressed VLs (&lt;400 copies/ml), and have been on ART for 6 months or longer (Tsondai et al., 2017).  Additionally, patients had to be referred by a physician, and they are only eligible if they did not have other chronic conditions requiring more frequent clinical consultations (Wilkinson et al., 2016).SCALING UP ACSFrom 2011 to 2015 the cohort in ACs almost doubled in size, growing from 5,683 patients (7.3% of people living with HIV  attending facilities) to 32,425 (25%).  In March 2015, 55 of 70 health facilities providing ART services in Cape Town had ACs, which increased from 16 facilities in 2011. From 2011 to March 2015, ACs had been scaled up to reach 25.2% of the 128,697 HIV patients accessing health services in Cape Town public health facilities. By March 2016, ACs have been further scaled up to reach approximately 32% of 142,000 patients on ART. The number of patients in each AC remained between 24 and 27 since scale up started in 2011. The overall ART program in Cape Town also grew from 2011 to 2015 from 53 facilities providing ART to 66,626 patients (in 2011), to 70 facilities and 128,697 patients (in March 2015).  The ART cohorts in these 70 facilities ranged from 26 to 8,884 patients (Wilkinson et al., 2016).The AC model was scaled up in three waves of implementation. The first wave identified 15 willing ART facilities struggling with congestion, with ART cohorts of more than 1,000 patients. The majority of these facilities’ ART cohorts exceeded 2,000 patients. The second wave dropped the clinic size criteria, and the last wave allowed all remaining willing facilities to implement the AC model.  A collaborative quality improvement approach was taken to support implementation. The approach included setting up a provincial steering committee, nominating and training AC model mentors who supported a number of facilities during implementation and met bi-monthly to assess issues and determine resolutions arising from implementation, and providing two or three learning sessions six months apart for facility teams in each implementation wave. An important lesson learned from the scale up is that constant monitoring and adaptation are needed to meet new and emerging challenges in AC implementation (MacGregor et al., 2017) NGO support was limited to providing technical support in the provincial steering committee and learning sessions with scale up driven by the Western Cape and city health departments. No additional funding was provided to the Western Cape Health Department to support scale-up of ACs. LHCWs were already employed as adherence counselors or community health workers by various health department-funded NGOs. AC implementation was driven by the provincial steering committee members and AC model mentors, mostly sub-district HIV managers and clinic doctors, with an additional one to three part-time mentors from NGOs (Wilkinson et al., 2016).Challenges to scale up have primarily been associated with the complexity of managing a large program, and dwindling political support at the later stages of scale up (MacGregor et al., 2017). Since scale up started in 2011, the AC model of care has adapted to ensure that it meets new challenges and increasing demands on the health care system.  For example, the model was initially clinic based, but in 2012 it became clinic and community based, and a variety of group specific clubs have been formed (e.g. male clubs, female clubs, youth clubs, family clubs, etc).Specifically, when scaling up ACs in large areas (like Cape Town) the following factors need to be considered:If eligibility to join a club changes over time, it is necessary to ensure that member recruitment strategy is changed to meet new criteria.It is important to maintain linkages between ACs and clinics so that patients from the ACs can easily access medical care, when needed.Ensure continuous monitoring of alternative club structures to ensure high-quality services across the whole spectrum of care options for HIV positive patients.In terms of the workforce, it is important to have a management group dedicated to the ACs.  Specifically, a management team should ensure that:There are clear roles and responsibilities for all involved workers, and that the workload is reasonable to ensure quality.Implement activities to motivate the team.The following information management and communications components are necessary to ensure successful scale-up:Utilize tools to schedule AC sessions and activities.Systems for filing documents.Appropriate systems to document and communicate challenges.Appropriate system to monitor and track patients who default from ART (MacGregor et al., 2017).GOVERNMENT &amp; NGO SUPPORTThe support of the Western Cape Government Department of Health contributed to the success of ACs.  Additionally, there were advocates of ACsfrom Médecins Sans Frontières (MSF) who initially implemented the AC model, and from the government, who provided strong leadership to ensure that the program was scaled up.  Support from LCHWs, with whom club members trust and feel are accountable for their health, was another key factor to success.  Trust and solidarity among club members is essential to the long-term sustainability of ACs.MONITORINGA collaborative quality improvement (CQI) approach was used throughout implementation. The CQI process included: establishing a provincial steering committee; selecting and training AC model mentors to support the facilities during implementation by providing guidance and helping to troubleshoot challenges; and offering facility teams two to three learning sessions six months apart. NGOs provided technical support in the provincial steering committee and learning sessions.  Also, these HIV care programs report into routine HIV program monitoring and reporting systems in the Western Cape. It is recommended that differentiated-care models like ACs maintain monitoring systems that are disaggregated, and can compare patient outcomes to those in standard care models.RESOURCESTsondai, P. R., Wilkinson, L. S., Grimsrud, A., Mdlalo, P. T., Ullauri, A., &amp; Boulle, A. (2017). High rates of retention and viral suppression in the scale-up of antiretroviral therapy adherence clubs in Cape Town, South Africa. Journal of the International AIDS Society, 20, 21649-n/a. doi: 10.7448/IAS.20.5.21649Wilkinson, L., Harley, B., Sharp, J., Solomon, S., Jacobs, S., Cragg, C., . . . Grimsrud, A. (2016). Expansion of the Adherence Club model for stable antiretroviral therapy patients in the Cape Metro, South Africa 2011–2015. Tropical Medicine &amp; International Health, 21(6), 743-749. doi: 10.1111/tmi.12699MacGregor, H. M., Andrew; Jacobs, Tanya; Ullauri, Angelica. (2017). “Scaling up ART adherence clubs in the public sector health system in the Western Cape.” Globalization and Health, 14(40). doi: 10.1186/s12992-018-0351-zRevised by the PEPFAR Solutions Team, May 2018&nbsp;
- Secretary Blinken’s Call with South African Minister Pandor Office of the SpokespersonThe below is attributable to Spokesperson Matthew Miller:Secretary of State Antony J. Blinken spoke with South African Minister of International Relations and Cooperation Naledi Pandor today regarding the conflict in Gaza, including the need to protect civilian lives, ensure sustained humanitarian assistance to Palestinian civilians, and work towards lasting regional peace that ensures Israel’s security and advances the establishment of an independent Palestinian state. The Secretary reaffirmed support for Israel’s right to ensure the terrorist attacks of October 7 can never be repeated. Secretary Blinken and Minister Pandor also reaffirmed the importance of the U.S.-South Africa partnership and cooperation on shared priorities, including health, trade, and energy.
- Welcome Corps:  First Year of Refugee Private Sponsorship a Big Success Lenore T. AdkinsWhen Edwige* left Cameroon seeking refuge and political freedom, she resettled in the United States.Now, through Welcome Corps, a U.S. Department of State program, she and six other members of Boston’s Mission Maranatha church have formed a private sponsor group that is helping Ibrahim*, a newly arrived refugee from Somalia adjust to life in the United States. “Because of my faith, I believe that we should share the love of Christ in practical ways, not just preach to people, but demonstrate the love of God by doing good deeds, by helping our neighbor,” Edwige says in a Welcome Corps story video interview. Edwige, a former refugee herself, pays it forward by helping another refugee in Boston through Welcome Corps. Photo Courtesy: Welcome Corps / Axie BreenWelcome Corps empowers everyday Americans to sponsor refugees. In groups of five or more adults, Americans form sponsor groups to help refugees build new lives in the United States. This involves greeting refugees at the airport, securing and preparing initial housing, enrolling children in school, helping adults secure jobs, and helping them settle into their new communities. A consortium of nonprofit organizations specializing in resettling refugees has partnered with the Department to implement the program and support sponsors. The consortium, led by the Community Sponsorship Hub, includes Church World Service, the International Rescue Committee, International Refugee Assistance Project (IRAP), Integrated Refugee &amp; Immigrant Services (IRIS), HIAS, and Welcome.US. Beyond the consortium, dozens of community organizations have signed up to serve as private sponsor organizations (PSOs), providing technical expertise and support to sponsor groups as they carry out core services for refugees once they arrive in the United States.As a member of the consortium, IRIS provides support to sponsor groups throughout the application process. But IRIS also serves as a PSO, and in that role, they have supported the Mission Maranatha sponsor group with additional training, answering questions about local benefits for refugees, and how they can best deliver on their core responsibilities.“We’re basically here to provide resources to help them through ... any kind of little challenges that they might come across,” said IRIS Welcome Corps Coach Cindy Dunn. Fleeing war and violence in Somalia, Ibrahim landed in South Africa. In 2013, he moved to a refugee camp and three years later, he was admitted into a resettlement program. After Welcome Corps launched in 2023, Ibrahim resettled in the United States, with help from a private sponsor group.  Ibrahim, center, shares a moment with Ann O’Brien, director of sponsorship at IRIS, at left and Dr. Simone Bamba, pastor of Mission Maranatha church in Boston. Photo Courtesy: Welcome Corps / Axie Breen“Every time, I used to dream of coming to the U.S.,” he said in the video. “Today, my dream came true.” In the year since the State Department launched Welcome Corps, more than 15,000 American sponsors have applied to receive more than 7,000 refugees through Welcome Corps, exceeding the Department’s first year mobilization goal. Included in that milestone are more than 100 private sponsor groups from 32 states that have signed up to be matched with refugees they did not know from around the world. Under the U.S. Refugee Admissions Program, these refugees, from around the world, were already being considered for U.S. resettlement.Welcome Corps is one of the ways the Department is expanding domestic resettlement capacity and reaching the Administration’s target of admitting up to 125,000 refugees in fiscal year 2024. In the first year of the program, sponsors have welcomed nearly 100 refugees from various countries including Cuba, Ethiopia, El Salvador, Venezuela, and Syria. They settled in several states, including Arizona, Massachusetts, Illinois, and Texas. Last summer, the program added the Welcome Corps on Campus program, which helps qualifying refugee students pursue higher education in the United States, while private sponsor groups within their new college or university forming to support them. Nineteen universities have applied to welcome 35 refugee students for the fall 2024 semester.Welcome Corps recently expanded to let private sponsor groups refer refugees they know for consideration under the U.S. Refugee Admission Program. This marked the first time Americans have been allowed to refer specific refugees for resettlement. Willy Buhendwa Muhigirwa leads the Association for Congolese in Austin (ACA), a 12-member group that is supporting a Venezuelan refugee family, their way of giving back to a country that welcomed them. He pointed out that there are millions of refugees who have been displaced in many countries, including his own, due to war. They have no shelter, no water, no electricity, no food, no hope and are desperate.“We thought this was a good opportunity to change other people’s lives,” he said. “Some of us came here as refugees and understand the advantage of being helped.” ACA is helping Ronald*, his wife, Yoliana*, and their baby daughter Romina*. They arrived in the United States about a week before Christmas in 2023, and the group has helped them secure housing and register for English classes, furnishing their apartment before they move in, and finding employment for them.“We&#8217;ve had everything we&#8217;ve needed for living, for eating,” Ronald said. “ care and attention dedicated to our child, that group is always looking after her and after our needs to be met at every point.”*DipNote used first names to protect people’s privacy. About the Author:  Lenore T. Adkins is a public affairs specialist in the Bureau of Global Public Affairs and also produces The Week At State newsletter.