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Evaluating the right to primary healthcare of transgender inmates in South Africa
(University of the Western Cape, 2026) Adams, Nicole Bernice
The right to healthcare of inmates remains a grave problem in South Africa. This is due to limiting factors such as overcrowding, and physical violence. Because inmates are in correctional facilities, they are custodians of the State, and the State bears the duty to care for them in a manner that does not violate their constitutional rights. The Constitution, read with legislation such as the Correctional Services Act and the National Health Act contains provisions that protect the right to healthcare of all inmates. This right to healthcare extends to transgender inmates as well. Transgender inmates have the right to primary healthcare in terms of South African legislation, but this right is not adequately realised as it is threatened by structural, interpersonal, and individual barriers which limit access to healthcare. The International law framework, which includes the United Nations Standard Minimum Rules for the treatment of prisoners (Mandela Rules), the UN Basic Principles for the Treatment of Prisoners and the Yogyakarta Principles on the Application of International Human Rights law, sets minimum standards, that when read together, creates the right to primary healthcare for transgender inmates. South Africa, however, are yet to implement sufficient policies based on this international law framework. Despite domestic and international law safeguarding the right to primary healthcare of transgender inmates, there is a clear disjunction between the law and the reality within correctional facilities; such right to primary healthcare has not been adequately realised and fundamental change has not stemmed from legislation. This mini-thesis is therefore aimed at investigating what the primary healthcare needs of transgender inmates are and whether South African legislation, policies and case law adequately safeguard the right to primary healthcare of transgender inmates.
The role of non-executive directors and their impact on environmental, social, and governance / sustainability of companies
(University of the Western Cape, 2025) Totana, Sibulele Mathews
Non-executive directors (NEDs) are key role players in corporate governance. Their role in good corporate governance will never be a mere tick box approach. Ssenyondo claims that this role has never been more critical. These strategic decision makers have proved to be champions of accountability, strategic oversight, and the protection of shareholder interests According to Ssenyondo’s article, through their role as a vehicle of governing oversight and collaboration, they have addressed complex challenges, including the growing prominence of environmental, social, and governance (ESG) imperatives, heightened regulatory scrutiny, and the transformative influence of disruptive technologies.
Green synthesis: The use of brown algae in the synthesis of palladium nanoparticles and their application as catalysts in the synthesis of important pharmaceutical intermediates
(University of the Western Cape, 2025) Mgwigwi, Sinazo
Environmental awareness and concern have led to the development of green chemistry protocols which aim to mitigate the negative impact of the pharmaceutical industry on the environment. The biaryl ring system is common to a number of active pharmaceutical ingredients (APIs). The aim of the current study is to utilize waste biomass generated during the isolation of seaweed natural products to synthesise “green” palladium nanoparticles (PdNPs) that will be used to catalyze biaryl coupling reactions. Green chemistry is defined as the design of chemical processes and products that reduce or eliminate the generation and use of hazardous substances. This protocol is guided by a set of rules, commonly known as the 12 principles of green chemistry. Many synthetic methods that were used before the development of this protocol made use of toxic reagents and solvents that were harmful or detrimental to the environment. Green chemistry, therefore, makes use of less harmful substances, such as plants, seaweeds, and green reagents and/or solvents. This study will further explain the use of Sargassum incisifolium, a species of brown algae found on the west coast of Southern Africa to synthesize palladium nanoparticles. Two types of extracts- an aqueous extract (AE) and an organic aqueous extract (OAE) were prepared from the seaweed. Before any further use, the extracts were characterized by NMR and UV- Visible spectroscopy, and their polyphenolic content, reducing capacity, and radical scavenging ability was determined. Further characterization of the extracts was carried out by FTIR and TGA analyses. The PdNPs were successfully synthesized and characterized by UV-Visible spectroscopy, TGA, TEM, XRD, FTIR, and ICP-OES. Following characterization, the PdNPs were used to catalyze Suzuki-Miyaura carbon- carbon coupling reactions. The TEM results revealed that the AE-PdNPs have an average size of 8.5 nm, while the OAE-PdNPs are 10.5 nm in size. The disappearance of the SPR band at 415 nm in the UV-visible spectra indicated that the Pd(II) in the palladium salt was successfully reduced to Pd(0) by the polyphenols present in the extracts. The XRD data proved that the nanoparticles were crystalline in nature. The OAE PdNPs revealed well-defined diffraction peaks at 2Ɵ 29.3o, 41.2o , 47.4o , 51.3o , and 59.5o which can be indexed to reflections from the (002), (111), (200), (200), and (220) planes of fcc crystal structure of metallic palladium. The catalytic ability of the nanoparticles was then assessed in a model Suzuki-Miyaura coupling reaction using phenylboronic acid and 4-iodoanisole as the starting materials and DMF:H2O (95:5) as the solvent, in the presence of potassium carbonate as the base. This reaction was successfully repeated with different greener solvents, such as ethanol and acetone, and the recyclability of the catalyst was also studied. Cyrene was also employed as a greener solvent; however, this reaction was unsuccessful. Another Suzuki-Miyaura coupling reaction was carried out for the synthesis of 4-bromomethyl-2- biphenyl carbonitrile- an important intermediate of the API losartan. All of the products of the coupling reactions were analyzed by NMR, UV-Visible spectroscopy, FTIR, and HPLC. The HPLC results revealed that both the PdNPs and Pd/C catalysts were recyclable up to 10 cycles and the coupling reactions were successful, with yields of >90% when EtOH:H2O was used as the solvent; and when Acetone:H2O was used as the solvent, the yields dropped to ~70%. It was further revealed that, although the coupling occurred, the products that were formed from these coupling reactions were not the desired products, but may easily be converted into the desired intermediate. The reactions mentioned above have proven that waste biomass generated in the isolation of seaweed natural products were successfully used in the green synthesis of PdNPs. The latter successfully catalyzed biaryl formation via the Suzuki-Miyaura reaction.
Single Exit Pricing (SEP) of Selected Mul source Interchangeable Medicines between 2018-2022: Assessment of Pricing and Product Con nua on in the South African Private Sector
(University of the Western Cape, 2026) Bisetegn, Lydia Daniel
Background In developing countries, medicines represent a major component of healthcare costs. The high cost of drugs can limit funding available for other investments in health and can create unaﬀordable out-of-pocket costs for individual pa ents. Understanding medicine pricing policies and their intended and unintended outcomes is crucial. With South Africa having put in place the Single Exit Pricing (SEP) policy in the 2000s for the private sector market, the eﬀects of this policy on the pricing and con nua on of selected essen al medicines have not been studied for more recent years. The research evaluates the impact of the Single Exit Pricing (SEP) policy on pricing and product con nua on trends between 2018 and 2022. This is the ﬁrst analysis of SEP trends and product con nua on between 2018 and 2022, providing recent evidence for policymakers on pricing regula on, product availability, and generic market dynamics. Method This research used the Mediprax database for a descrip ve, quan ta ve analysis of discon nua ons and pricing for a selected basket of South African registered medicines between 2018 and 2022. The World Health Organisa on and Health Ac on Interna onal (WHO/HAI) classiﬁca on was used for product selec on. The NAPPI® codes in the Mediprax database which are unique iden ﬁca on codes for healthcare products enabling the electronic transfer of informa on for reimbursement were used to represent individual Stock Keeping Units (SKUs) which are unique, alphanumeric codes for each speciﬁc drug variant (with diﬀerent dosage form, strength, or pack sizes) to enable tracking of iden cal inventory. Results The Single Exit Price (SEP) mechanism eﬀec vely capped annual price increases for Schedule 1 and higher medicines, with observed average annual increments between 2018 and 2022 remaining well below the s pulated SEP ceilings of 3.50%–4.60%. Over the ﬁve years, pricing increases of approximately 3.14% for the global core medicines, 2.02% for the regional core medicines, and 2.50% for the supplementary medicines suggest that medicine prices rose broadly rather than exhibi ng sharp escala ons that could undermine access. In prac cal terms, this indicates that SEP func ons as an eﬀec ve price-containment tool, limi ng cost burdens on pa ents and funders while maintaining predictable pricing trends for manufacturers. Most discon nued medicines showed declining or stagnant price increments in the years before discon nua on. Intra-basket comparisons show that these products were discon nued even when trading at compe ve prices. This suggests that discon nua on decisions may be driven by pricing pressures, reduced volumes and heightened compe on. The predominance of generics among withdrawn products across all three medicine categories may indicate that sustained low pricing in highly compe ve markets may reduce commercial viability over me. In total, 55 SKUs were discon nued between 2018 and 2022 from the selected basket, with the highest number of SKUs being discon nued in 2021. Of these discon nua ons, 30 were from the global core list, 15 from the regional core list, and 10 from the supplementary list of medicines. The concentra on of discon nua ons within the global core list despite its rela vely higher average price increments suggests that higher SEP increments do not necessarily translate into improved sustainability for suppliers. Instead, the interac on between SEP constraints, price compe on, and external regulatory inﬂuences appears to shape manufacturer behaviour, leading to SKU ra onalisa on. Conclusions This research concludes that the SEP policy has not had a signiﬁcant impact on the discon nua on of medicines over the period studied between 2018 and 2022. It has resulted in a cost-saving beneﬁt for the private healthcare sector in South Africa. Overall, the ﬁndings indicate that, while SEP can be a contribu ng factor to some product withdrawals by introducing compe on among some stock-keeping units (SKUs), it does not appear to be the primary reason behind the withdrawal of the selected products between 2018 and 2022. By linking SEP price trends to product withdrawals, the study provides ac onable insights for regulators, policymakers, and private healthcare providers.
Investigating the role of HLA class-1 polymorphisms within the Sub-Saharan African population, in the emergence, frequency, and persistence of SARS-CoV-2 variants.
(University of the Western Cape, 2025) Francis, Kriheska
RATIONALE: Various studies have shown the ability of the cytotoxic T cell (by CD8+ T cells) immune response in disease control in the absence of neutralizing antibodies in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) convalescent individuals. Thus, illustrating the important role of the cytotoxic immune response in clearing coronavirus disease 2019 (COVID-19). Human Leukocyte Antigen molecules (HLA) present virus peptides to T cells during the activation of an immune response. However, only a few studies have looked at how the HLA allele repertoire of the infected population impacts immune escape, and none have looked at how the high HLA polymorphism in the Sub-Saharan African (SSA) population impacts the immune escape patterns in viruses circulating within this population. AIM: The Aim of this study was to predict the HLA-mediated cytotoxic T cell immune escape mutations present in SARS-CoV-2 structural proteins isolated from SSA populations. The SARS- CoV-2 isolates for the study were analyzed from five SSA countries namely, Kenya, Democratic Republic of Congo, Nigeria, Ghana and Senegal to ask the question: Do HLA class-1 polymorphisms in SSA populations result in locally specific immune escape mutations in SARS- CoV-2? ANALYSES AND FINDINGS: Immunoinformatic methods were used to predict potential HLA immune escape peptides for the SARS-CoV-2 structural proteins Spike, Nucleocapsid, Membrane and Envelope. SARS-CoV-2 sequences from the five SSA countries and a comparative sample of sequences from China, were used. All sequences downloaded from GISAID were subject to quality control, separated into their respective proteins and infection waves, and the potential HLA 9-mer motif containing peptides were predicted. Binding affinity for all the predicted peptides was measured using the NetMHCpan 4.1 software and results were further restricted to those peptides that had mutations occurring in more than one infection wave. The shortlisted results were summarized in tables and heatmaps. There were various escape mutations predicted for each of the structural proteins. The Spike and Nucleocapsid were the two proteins for which the greatest number of peptides were predicted respectively. The spike protein had between 7 to 37 escape peptides for the five countries, while the nucleocapsid ranged between 2 to 20for the five countries. The membrane protein ranged from 2 to 9 predicted peptides while the envelope ranged from 0 to 9 escape peptides for the five countries. However, due to a lack of HLA frequency data for the studied countries and high HLA admixture in the SSA population, associations between the HLA and the immune escape patterns could not be fully explained. Instead at country-level, clustering was observed for HLA alleles of the Spike protein between more geographically proximal countries indicating that HLA alleles do exert some selective pressure on the escape patterns. CONCLUSION: In this study we were able to predict a substantial number of escape mutations circulating in the SSA population for the four structural proteins in SARS-CoV-2. While most of the high proportion predictions are mutations that have been reported in other studies as SARS- CoV-2 mutations, very few have been linked to T cell escape. Given the limited HLA allele frequency data we could not conclude if the HLA allele frequency in SSA is driving the mutations that occurred at high proportions. However, interesting pattern seen for a few of the escape mutations across countries was the emergence of variant peptides at high proportions but associated with HLA alleles that have a low frequency in the population. This could be an indication that these variants were introduced into the country and subsequently exposed to low selection pressure. In this study, we used large population genomic data to contribute towards understanding the extent of T cell immune escape mutations in SARS-CoV-2.