July was a busy month and I did a great deal of traveling. This began with a weekend in Johannesburg with school friends. We have been getting together every so often for about seven years now. Owen and I flew up to Johannesburg to see David who had organised a packed weekend which included a visit to the Cradle of Humankind at Maropeng  ear Pretoria, listening to Prime Circle at Gold Reef City and going to the Apartheid Museum. The flight up was easy, it was negotiating the wonderful Gautrain ( the rapid transit link between the airport and Sandton) that we found tough. It is an amazingly efficient mode of transport but is hi-tech.

The Cradle is essentially a museum looking at early human history and I found it a little disappointing. Perhaps if we had also visited the Stilfontein Caves, the site of the archaeological dig, it would have meant more. It might also have been that I was caught out again by the Highveld winter. The trouble is that when one flies from Durban in winter the temperature is usually around 20° and in Johannesburg it is 10 or more degrees cooler. I did not have enough warm clothing but now have a new t-shirt from the Cradle, which I bought and put on under my shirt in the store. It is neither very nice nor very warm but did the job.

The Apartheid Museum  is amazing and extremely moving. Having lived through much of this, I found myself moved to tears at various points in the walk around. It was also interesting to realise how much the government of the day had kept from its citizens and the world. I was in England when the Soweto uprising began and vividly remember a fellow student from the township, with whom I had chatted in Afrikaans, saying that he could no longer speak the language. Looking back at a time when news was not instant, (I had to book a telephone call to my parents in Swaziland if I wanted to talk to them), it must have been extraordinarily stressful. The end of ‘legal’ Apartheid began soon after we arrived in South Africa, but was protracted and extremely brutal.

At the end of the weekend I went to Pretoria, using the Gautrain again, to facilitate a meeting for the British Department for International Development (DFID), looking at their AIDS position paper. This was the second in a series of three meetings, the first one having been in London. The Permanent Under-Secretary for State, Lynne Featherstone MP, was at both meetings. It was interesting to see how little formality there was around her participation as compared with many other nationalities’ ministers who have security entourages and inflated egos. Is this a sign of mature democracies?

The following week I hopped on an Emirates flight to Dubai and then connected through to Delhi to run the third and final DFID workshop. I left Durban on Tuesday night and got back on Saturday evening. These seemed long flights but I watched four films, two of which I would recommend, and did a fair amount of work. It is probably 14 years since I was last in India. Delhi is transformed from what I remember. The parts of the city that I saw were clean; there was little pollution; and a sense of hope and progress. Even the traffic seemed to move better. The hotel was slightly shabby, but as one would expect there were huge numbers of staff with infinite talents, including the ability to repair my computer, which did not want to talk to their Internet wireless system. I was able to get to one of the ‘Emporia’ shops and buy some shirts, bed sheets and a few gifts. I also bought a carpet which was packaged on the spot in a hessian bag for shipment.

Emirates is a great airline and I was deeply fascinated to see the multinational composition of the cabin staff. These included a number of South Africans of all races. My ability to speak Zulu is very limited but I did greet the obviously Zulu named stewardess (a name like Ncgobo is a giveaway). What was particularly striking is that these people, mostly in their 20s, do not have the hang-ups about race that I do. They are simply young professional people doing a great job, in an accepting environment. It was so refreshing. This is the direction that our nation needs to go in.

I had to spend a night in Dubai on the way back and I am ashamed to say that I checked into the airport hotel and stayed there. In my defence it is the height of summer and apparently it was 40° and humid outside the building. One of my fellow passengers warned me about this and also remarked that it was very uncomfortable. The hotel was very adequate and a good night’s sleep was much appreciated. They even had a small, but well equipped gym, with a power plate, an astonishing piece of equipment that, I believe, almost does the exercise for you. I would be very happy to travel on Emirates again, perhaps that will be my route from Canada to South Africa in the years ahead.

At the end of the month I drove up to Swaziland for a Waterford Governing Council meeting. It’s a long drive, and so I left ahead of schedule to drive halfway back and stayed overnight at Mkuze. There will be more on Waterford and event  in the next posting since that is where I am going in a few weeks for the ‘decade’ reunion to mark the 50^th anniversary of the school. There are some new photos in the gallery.

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Films

Alceste A Bicyclette, a delightful French film about a TV star going to Ile de Ré to persuade a friend who has become reclusive, to star in his new production of Molière’s infamous comedy of manners ‘The Misanthrope’. The place does not get very good press, it seems to rain there more than one would expect. The way the characters are portrayed is excellent and most of the story is dialogue-driven and about character development.

The Sapphires is an Australian film based on the true story of four aboriginal women who get together to form a group to entertain the American and Australian troops in Vietnam. They have to overcome racial prejudice and function in a war zone. The way these people were treated in Australia is quite shocking. At the end there were pictures of the women as they are now, I found that extremely moving.

Jack Reacher is a straightforward film about the character created by Lee Child. Reacher is a former military policeman who is now a drifting investigator. Five people are shot in a seemingly random manner by a sniper. The police take a ministry veteran into custody, he is beaten up in jail and spends the period of the film in a coma but requests that Jack Reacher be called in before this happens. Reacher then investigates and discovers that one of those killed was being targeted. This is a thriller and great for watching on airplanes. There is unusually no love interest at all!

Admissions is a feel good comedy. A Princeton admissions officer risks and loses her job getting a young man admitted to the university. She does this because she is led to believe that he may be her son, given up for adoption some 20 years before. The film does capture some of the conflicts faced with unwanted pregnancies and families. Her mother is portrayed as a feminist who was quite unbending. Again this is a good film for traveling.

Felix is on a similar theme. The story is about Felix Xaba,  a 14-year-old black boy living in a township outside Cape Town who is admitted to a private school. His mother is a domestic worker. Felix dreams of becoming a saxophonist – like his late father. This is a South African feel good film but quite interesting to think this may be the experience of some of the children we admit to Waterford. I really enjoyed it and would recommend it of all the films I saw as it is well made and thought provoking.

I had an insight into the way that I write articles. Recently I needed to write a paper to be presented at a conference in Cape Town. It became apparent my best modus operandi is to begin on Monday; write furiously for three days, each day starting by reading what I have already written; and then on Thursday and Friday I go back and edit. So the lesson is not to try to start an article in midweek but to save up and get on with it on a Monday. What I have not yet learnt is the best way to do the reading other than at the gym.

At the end of May I went to the conference mentioned where the paper was to be presented. The conference  was organised by the Center for International Governance Innovation, my new employer in Canada, and the American Political Science Association. It was on the future of South Africa and what Nelson Mandela’s legacy might look like.

I traveled from Durban a day before the meeting. I went up to Greyton, about two hours drive from Cape Town, in the Overberg mountains. I spent a night with Tim Quinlan, who worked for many years at HEARD as my deputy. Greyton is really beautiful and I much enjoyed the calm small town feel of the place. I’ve posted a couple of pictures of my stay with this blog. The question is, could I and would I want to live there and while it is great to visit I honestly do not think it would work in the longer term as it does feel very isolated.

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The conference itself was fascinating, and I came away uncertain as to what the future of South Africa looks like. There were a number of criticisms of Mandela. Three stuck in my mind. The first was allowing Winnie to get away without answering for the murder of Stompie Moeketsie in 1991. She was convicted of kidnapping and being an accessory to assault, and sentenced to six years in jail, but this was reduced to a fine and a two-year suspended sentence on appeal. Second, was taking money for elections which allowed a culture of corruption to take root. Thirdly and of course, closest to my heart, not picking up on the threat that HIV posed to South Africa. We worked hard though. The meeting began with a dinner on Friday, on Saturday and Sunday we met from 9 am to 6 am and then had working dinners. Yet another weekend gone! I now need to complete my chapter.

Back in the UK there were a few small wins. We went to the beach, and although it was far too cold to venture into the water the dog had a good run. On the way back to Norwich we stopped at a garden centre and bought some pond weed and water plants. The pond was cleaned a month ago and looked very bare. There will be many happy frogs.

I mowed the lawn and it took nearly two hours. The first challenge is getting the lawn mower to start; it should never be taken for granted that it will indeed fire up with the pull of the cord. It was extremely satisfying when, on this occasion, it started first time. The grass was not too thick, but I still filled  nearly half of the garden waste bin. This activity was instead of going to the gym and it was probably nearly as good the work out as I would have had there. I put in my Zen Player, wore a headband to keep it on and listened to the BBC news.

The dog came out to help, which means her biting at the wheels and waiting for me to throw tennis balls for her. I was also joined by a friendly robin that perched on a nearby branch and talked to me, and a thrush that followed the mower to see what edible goodies I might be turning up. It was actually a rather pleasant and productive way to spend a couple of hours.

Just over six weeks ago we (HEARD) were asked to undertake a study for the Global Fund for AIDS, TB and malaria. The question posed was: how should resources be divided between the three diseases before being allocated to countries? This was asked by the Board. An earlier question: Should resources be divided between the three diseases before being allocated?, was not on the table. We were asked to work to a tight timeline to develop a formula to try  address this question. I put together a team of five staff members led by Catherine Sampson who has joined us for a year and who is a Peace Corps volunteer.

 We were sent a series of dates on which various things had to be delivered and we succeeded in doing the work. There were three groups invited to be involved in the work the others being from the USA and UK respectively. I was delighted to learn we had been the only group that had succeeded in making the technology of video conferencing work for all the meetings, and we were also the only ones to stick to the deadlines we were given. It was a real learning experience for us all and I was delighted by the way people stepped up to the mark.

Books

Ben Goldacre, Bad Pharma: How Drug Companies Miss Doctors and Harm Patients, Fourth estate, London 2012, 430 pages

Ben Goldacre hates sloppy and misleading science, ‘Bad Science’ was the title of his first book. It took a bit of time for me to get into this book, but once I did I really enjoyed it and was almost sorry it came to an end. Although I have to say that it peters out rather than ending with a bang. This may be because he is writing for primarily a British audience and finishes by setting out various things that patients, doctors and the community can do to respond to the mis-selling of drugs. It is an excellent book which describes how  deals? go wrong in the development and selling of drugs. There is a detailed explanation of how trials are carried out and why they so often don’t tell us what we need to know.

What is missing from this is an understanding of the difficulty of publishing null results. This goes beyond science broader research and public community. It then takes us into human psychology and an understanding of what makes us tick. We want news that is interesting and grabs our attention. When it comes to medicine we want to know what will work. The problem is healthcare is a form of market failure. When people are sick, they want to get better right now. Healthcare professionals need to be gatekeepers. It also means that they need to be more honest about what medicine can and can’t do.

We, as a society, need to be accepting of the concept of a ‘good death’, and that will take some psychological leaps. This is a book that should be read by every scientist and social scientist as well as the public who want to be informed about drugs and drug companies. My biggest criticisms are his lack of understanding of economics and an unwillingness to engage with this, but perhaps that is the subject of another  bigger book; secondly one has to ask who ultimately benefits from the pharma industry and why they do it. Given that most pharmaceutical companies are publicly listed it seems that we mislead ourselves willingly.

I am at the end of a long period in Durban. Most of the time was spent in the city although there were a few short trips. The first was up to Nairobi for an AIDSpan board meeting. I flew up on the last Thursday of March and returned on the Saturday. It was an interesting meeting with a great deal of progress in the organisation. It has a new executive director, last year one of the things the board did was to select the person. She is settled in and everything seems to be running smoothly. Although I was born in Nairobi I am not a great fan of the city as it is today. It has grown rapidly and the infrastructure simply does not cope. The theme of many of these successful African capital cities seems to be severe traffic congestion. Nairobi has a particular problem in that the city has roundabouts and the psyche of the drivers does not include giving way.

In front of the White House during the Economic Reference Group Meeting April 2013

A couple of weeks later I went up to Lusaka for the Swedish Sida strategy meeting. This too was a short trip, going up on the Sunday and coming back on the Wednesday. Again it was a productive meeting with like minded people, who are committed to making a difference. It is evident though that the terrain of donors and recipients is changing.

In both locations I had excellent meals in nearby restaurants. In Nairobi we walked across the street to an Indian restaurant where the food was as good as anything I have eaten anywhere in the world. The Lusaka restaurant was also within a few hundred metres of the hotel. It is noteworthy that we now feel comfortable walking in these cities, albeit in a group. Things have changed. I am not sure that I would be happy sending people off on foot in parts of Durban. While one might be safe from assault in Lusaka the lack of streetlights made the walk quite hazardous. In both cities what passes for a pavement would keep Western lawyers happy with litigation four months.

The hotels were adequate: comfortable beds, clean bath rooms, reasonable restaurants, fresh bedding and not too noisy.  Horror stories from fellow travelers include pubic hairs in ostensibly clean beds and walking back into the room to find the cleaner using the guest’s toothbrush in the toilet! For me a decent gym is really important and I am happy to say that both the Jacaranda in Nairobi and the Intercontinental in Lusaka have these facilities.

Increasingly I look at what equipment is provided as both sons of the founder of my gym in Durban Fitness Company are involved with the importation of machines for the South African market. My most recent trip ended in Waterloo, Ontario where I got a great offer at a gym – 14 days for $15, pity I was only there for six days. Much of their equipment is the same as that in Durban. Interestingly rowing machines are not popular in Canada – perhaps because it is hard to watch the TV when the focal length keeps changing.

The international airports in Lusaka and Nairobi both urgently need an upgrade. They are small, crowded and rather dirty. I was extremely unimpressed when I asked a security guard a question in Lusaka. Before he answered me he inserted one grubby finger up his nostril as far as the first knuckle. He kept it there while talking to me. Disgusting! He was a singularly scruffy individual – but dressed in the uniform.

I waited at our wonderful airport in Durban on my return from Lusaka as my sister Gill was flying in an hour later. She had been in Cape Town visiting my brother and came up to spend five nights with me. We did various things around Durban, and she reconnected with a school friend that she had not seen for close to 35 years. It was a significant birthday for her and one of her presents was the trip to Durban.

 I took her up to the Zululand game parks. It is only about a three-hour drive from Durban on a really good road. We went in through the Umfolozi gate at the south of the park and drove through to Hilltop Camp where we spent a night. We did not see a great deal as the grass was thick; it is the end of the rainy season. We did however get close to a rhino and calf, giraffes and an elephant. Usually on visits to the game parks I see something that I have never seen before. On this occasion, we came around the corner to see a large Monitor lizard, locally called a leguaan, licking its lips looking very pleased with itself. The reason for this soon became apparent, a dung beetle had been busy creating the ball of dung it would roll to a suitable location and lay its eggs in. The ball was there, but there was no dung beetle in sight. I guess it was in fact inside the lizard.

Despite the lack of game the countryside was really spectacular. From the game park we gently made our way back to Durban. There was the obligatory stop beside the road at the craft market where Gill bought handicrafts and I got fruit, including fantastic avocados. I dropped her (and the hire car) at the airport and caught a taxi to my office.

I am feeling very much under the whip at work. There is a huge amount going on and so I am very busy. The problem is that much of it depends on input from others, which means that I have to wait. Tim Quinlan, HEARD’s former research director, came up to plan various projects and articles. We sat together on Saturday and worked through one we are co-authoring on the potential role of China in the AIDS response in Africa. What a pleasure to be academic.

I was supposed to travel to the USA via Swaziland where there was a big celebration at Waterford. For various reasons I decided that this was simply asking too much of myself and so did not make it. It is a pity because there was some wonderful press coverage on BBC and in the British and South African Guardian  . We have to make the most of this opportunity to secure funding for the next 10 years at least.

I want to get this posting up on the website so will stop there. The next will cover my travel to the US and Canada and the big news about my plans.