ABSTRACT
As the story of the COVID-19 pandemic is being written, a key question is why the disease and its consequences vary so greatly from country to country. Up to the end of 2021, most Asian countries, Australia, and New Zealand contained the virus. The consequences in Europe and North America were almost uniformly catastrophic. Much of Latin America is believed to be facing a severe, but under-reported epidemic. Reliable data are hard to come by in most of Africa, but it seemed both caseloads and case-fatality rates (CFRs) are lower. The exception was South Africa where COVID-19 was significantly worse than in the rest of Africa. The pandemic came in waves and the CFRs and apparent seriousness of the disease appear to have diminished. The first part of 2022 saw a different pattern of transmission and the virus and pandemic is in flux. The comparison between COVID-19 and Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) has been and will continue to be made. COVID-19 is infinitely more serious than HIV, not in terms of deaths or the CFR, but in numbers of infections and the disruption it has caused. On 2 July 2022, The Johns Hopkins Coronavirus Resource Centre recorded a total of 548,552,181 cases and 6,338,040 deaths since the epidemic began in late 2019. There had been 11,751,427,128 vaccine doses administered (see https://coronavirus.jhu.edu/map.html" xmlns:xlink="https://www.w3.org/1999/xlink">https://coronavirus.jhu.edu/map.html (accessed: 2 July 2022)). Since 1981, when HIV/AIDS first appeared, an estimated 79.3 million people have been infected with HIV; 36.3 million have died; and 28.2 million people were accessing antiretroviral therapy as of 30 June 2021 (see https://www.unaids.org/en/resources/fact-sheet" xmlns:xlink="https://www.w3.org/1999/xlink">https://www.unaids.org/en/resources/fact-sheet (accessed: 2 July 2022)). Most people recover from COVID-19. An HIV-infected individual will inevitably need treatment at some point, and once this begins, they need to be adherent for the rest of their lives. This chapter will trace the evolution of the global epidemics and look specifically at how the spread in South Africa compares with other parts of the world. It will also look at what was considered ‘international best practice’ and compare South Africa to this. It will set the scene for the book.
