BackgroundThe ethical concerns associated with HIV prevention and treatment research have been widely explored in South Africa over the past 3 decades. However, HIV cure research is relatively new to the region and significant ethical and social challenges are anticipated. There has been no published empirical enquiry in Africa into key informant perspectives on HIV cure research. Consequently, this study was conducted to gain preliminary data from South African HIV clinicians, researchers and activists.MethodsIn-depth interviews were conducted on a purposive sample (...) of fourteen key informants in South Africa. Audiotaped interviews were transcribed verbatim with concurrent thematic analysis. The perspectives of HIV clinicians, researchers and activists were captured. Analyst triangulation occurred as the data were analysed by three authors independently.ResultsThe rapid evolution of HIV cure research agendas was prominent with participants expressing some concern that the global North was driving the cure agenda. Participants described a symbiotic relationship between cure, treatment and prevention research necessitating collaboration. Assessing and managing knowledge and expectations around HIV cure research emerged as a central theme related to challenges to constructing ‘cure’ - how patients understand the idea of cure is important in explaining the complexity of cure research especially in the South African context where understanding of science is often challenging. Managing expectations and avoiding curative misconception will have implications for consent processes. Unique strategies in cure research could include treatment interruption, which has the potential to create therapeutic and ethical conflict and will be perceived as a significant risk. Ethical challenges in cure research will impact on informed consent and community engagement.ConclusionsIt was encouraging to note the desire for synergy amongst researchers and clinicians working in the fields of prevention, treatment and cure. Translation of complex HIV cure science into lay language is critical. Moving forward, RECs must be adequately constituted with scientific expertise and community representation when reviewing cure protocols. It is hoped that knowledge and resource sharing in the context of collaboration between research scientists working in cure and those working in treatment and prevention will accelerate progress towards cure. (shrink)

This paper explores the reparations debate in post-apartheid South Africa and outlines the recommendations for reparations made by the Truth and Reconciliation Commission. Although reparations were discussed at the multi-party negotiations at the end of apartheid, the new democratic constitution that came out of those negotiations did not provide for reparations. The legislation that created the TRC, however, established a special committee to formally examine the reparations issue and make policy recommendations to the President. The CRR made its recommendations — (...) widely considered to be one of the world’s most ambitious and comprehensive reparations policies — in the TRC’s 1998 Report. However, the South African government did not respond to these recommendations, arguing that since the work of other committees within the TRC was not yet finished, it could not consider the CRR’s proposed policy. Victim groups and civil society disagreed, and an acrimonious conflict ensued over the perceived slow pace of government action on reparations. Victims also pursued lawsuits for reparations against multinational corporations that conducted business with the apartheid government. In 2003, the government finally enacted a reduced version of the CRR’s original reparations policy. (shrink)