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World’s worst HIV epidemic stymies South Africa’s Covid fight

Raising the risk of more mutated versions emerging and spreading across the globe. 
Farmworkers line up at Schalk van der Merwe's house to register for vaccination. Image: Bloomberg

The world’s biggest number of HIV cases is complicating South Africa’s efforts to fight the coronavirus pandemic, raising the risk of more mutated versions emerging and spreading across the globe.

Many of the country’s 8.2 million HIV-infected people are immuno-compromised and scientists say they can harbor the coronavirus for longer, allowing it to mutate as it reproduces. A study of an HIV positive 36-year-old woman showed that Covid-19 stayed in her body for 216 days and mutated rapidly.

“There is good evidence that prolonged infection in immune-compromised individuals is one of the mechanisms for the emergence of SARS Covid-2 variants,” Tulio de Oliveira, a bioinformatics professor who runs gene-sequencing institutions at two South African universities, said at an August 30 immunology conference. “You have this massive virus evolution, really the virus accumulating over 30 mutations.”

As the world struggles to stay ahead of rapidly emerging variants, getting South Africa’s HIV-infected people vaccinated has become critical. The recent discovery of another mutation in the country after the virulent beta variant late last year shows the risk to everyone of not urgently pushing vaccinations through.

The trouble is most of South Africa’s HIV-infected people are poor and marginalised. Many live in remote areas and have been largely left out of vaccination drives. Awash in vaccines — with more than enough doses to inoculate the country’s 40 million adults — South Africa’s problem now is getting them into the arms of people who desperately need them.

“Speed and coverage is important to make sure that people who are HIV positive are getting vaccinated,” said Glenda Gray, president of the South African Medical Research Council and co-lead of the South African arm of Johnson & Johnson’s vaccine trial.

The country’s vaccination drive has been patchy, at best. In affluent northern Johannesburg, vaccine stations can be found at every mile or two, and popstars and talk-show hosts extol the virtue of getting shots on radio stations targeted at the rich and the urban. In the rural and impoverished Northern Cape, it’s a very different story.

The waiting area of the Upington Clinic. Image: Bloomberg 

A 250-mile drive over two days from the provincial capital of Kimberley across an arid semi-desert to the town of Upington found vaccines available only at one location. That’s because clinics in most towns can only administer shots on certain days and for limited hours. It’s little different in the impoverished townships that sit on the periphery of the biggest cities.

The health system is up against not just the difficulty of getting vaccines to remote areas, but also a lack of information and awareness.

“The young people are scared; they hear rumors that people die after getting the vaccine,” said Lee-Ann Montse, an HIV counselor, as she sat outside the refurbished shipping containers that serve as a clinic in Schmidtsdrift, a village 50 miles west of Kimberley. It doesn’t help that some people live as far as nine miles from the clinic, and in an area with rampant unemployment, transport is a challenge, the 33-year-old said. Some days, only two or three people arrive to register for shots, she said.

The extent of the disinformation and its impact are demonstrated by the experience of Schalk van der Merwe, who grows raisins and nuts and rears livestock near the town of Groblershoop in the Northern Cape.

When he encouraged his workers to register for vaccination, only three were willing. After bringing a nurse from the town clinic to his farm to answer questions, ranging from whether people can get vaccinated if they are HIV positive to if it will affect fertility, 93 people came forward.

“We’ve had a strategy of taking the people to the vaccine, but given the demographic breakup of our country, with 25 to 26 million people who are largely sitting in townships or remote areas of the country,” vaccines need to be taken to them, said Stavros Nicolaou, head of the health-work unit at Business for South Africa, an industry group that’s working with the government. “They don’t have all the information or digital access.”

South Africa has been hit the hardest in Africa by the coronavirus, with about 2.9 million confirmed cases. Excess death numbers show that more than 250,000 people who wouldn’t normally have died have perished during the pandemic — or one in 240 South Africans.

Even in the face of such numbers, people like Themba Maseko say their main preoccupation is unemployment — at 34.4%, South Africa has the highest rate of joblessness among the 82 countries tracked by Bloomberg.

“I don’t see how getting vaccinated will help me solve some of the immediate problems facing me and my family,” said the 43-year-old father of two in Mabopane, a township about 15 miles northwest of South Africa’s capital, Pretoria. Like other impoverished townships, Mabopane counts a sizable number of people who are HIV positive, making it a high-risk area.

South Africa has struggled with HIV and the disease it causes, AIDS, for more than three decades. Last year, 13.7% of South Africans were estimated to be infected with HIV, according to the National Statistics Agency. While deaths have been capped thanks to the world’s biggest antiretroviral treatment program, Covid-19 has added a new wrinkle to their plight.

The beta variant, which cut the efficacy of the AstraZeneca Plc shot and led to dozens of countries banning travel from South Africa, emerged after a surge of cases in Nelson Mandela Bay. That region has the lowest uptake of antiretrovirals used to treat HIV, meaning that many people there may be immuno-compromised, according to de Oliveira.

And while the newer South African mutation is being studied by the World Health Organization to determine if it’s a variant of interest, its emergence shows the risks of large swaths of unvaccinated people. Only about 7.4 million people, or about 18.5% of the adult population in the country, are fully vaccinated.

“South Africa really risks becoming one of the mutation factories of the world,” de Oliveira said.

© 2021 Bloomberg

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250000+86000 = 336000 deaths linked to Covid– This will then be the 4th highest death toll in the world.

I just cannot believe how it can be possible for SA not to be able to classify causes of deaths.

Have you noticed the laziness of government workers?

Oh ja — Of course they only were able to account for 25.6%. If they try harder they might even pass maths !!!

There is a simple solution to AIDS – stop sleeping around! And it doesn’t
cost the taxpayer R9bn in anti-retrovirals. There are exceptions to every rule but the lion’s share of infections comes from a promiscuous lifestyle.

To stop sleeping around is very hard and even couterproductive if getting an erection is the only feat you are capable of.

And come to think of it, these same erections are being used as a basis to make many national strategic decisions.

I realize you’re being sarcastic, but, if you think about it, it is actually a feat. They literally slept themselves to unlimited political power in SA, due to their overwhelming numbers. Some people’s excellence resides in their brain cells; others’ excellence in their sperm cells.

Incitatus, to add to your point, there is an inverse relationship between cognitive ability and testosterone levels. This is why all African and South American democracies are doomed over the long term.

Two viruses infecting a single host cell can swap genetic material, or reassort, creating hybrid strains with characteristics of each parent.

The fur will really start to fly if HIV becomes transmissible by the same route as COVID.

I’d like to see your reference for that claim. Who made the link between sexual activity and the disease you call AIDS?
Don’t be flippant, just tell me where to find the paper you are referencing. Thanks.

Google is your friend, Oubok.

Griet, Try as I might I am unable to find a scientific paper showing that as a fact. The CDC making a statement is not in anyway a scientific paper, please humor me and be a little more specific if you have the time. As Kary Mullis said, if the link between sexual activity and AIDS had been proven someone would have received the Nobel prize for that discovery. Yet no one has. I recall in the 80’s when AIDS first appeared, we were told that millions would contract it and die. But, now we see that the number of infected people seems more or less stable regardless of how much procreating they get up to.

Eish oubones; for a disease that is largely transmitted during sex (and certain types of sex – maybe you need that spelt out too), being less promiscuous (unprotected sex) with fewer partners will certainly reduce transmission, surely? Although maybe you don’t believe it is primarily sexually transmitted as well. I’m not really interested in researching but I believe that initial spread was along the long distance truck routes where sex workers had multiple partners (although maybe you do not believe this either).

Also, how do you think AIDS is transmitted; blood transfusions, treating accident victims without gloves, hospital needle stick?

@ Paul….I’m not saying that AIDS it is not sexually transmitted, I’m simply asking where is the evidence that it is. I believe when someone makes a far reaching statement, such as having sex can cause AIDS, they ought to have some solid evidence to back their claim. What makes me even more skeptical now day’s is the blatant lies that I see the medical and scientific fraternity are capable of. If someone was able to show definitively that AIDS is sexually transmitted, Fauci would have given them a lifetime grant and that person would be as famous as Watson and Crick.
Another incongruity is that often when levels of the common STD’s increase, it does not seem to have a commensurate effect on the levels of AIDS carriers.

Are you telling me that South Africa is the international hatchery for covid, from where it spreads across the globe? I was under the impression that it originated from a pangolin pie in China.

Anyway, the fact that a virus might originate in Africa and spread to Europe is nothing strange. Deadly viruses, that have killed entire communities in Africa, have originated in Europe. It was in fact a virus, and not military power, that enabled the Europeans to colonize Africa and South America.

Maybe this is mother nature’s way of rebalancing the scale after the Europeans spread smallpox across all their colonies. Entire civilizations were exterminated by the spread of this variola virus. The Spanish Conquestadores believed that it was their superior military skills and their divine protector that guaranteed their military successes, while, in reality, it was the invisible variola virus they carried that decimated the local populations.

The fact the Europeans were totally immune to this deadly biological weapon, this “weapon of mass destruction” that they carried across the globe, proves the importance and efficiency of vaccination.

The highly sophisticated Inca Empire disappeared, and the largest part of the Khoi nation died out because they were not vaccinated. They had no choice, but we do.

I disagree. The Khoi-khoi and Khoi-San were decimated by a process known as the Mfekane and Difekane. Nobody likes to talk about it, but that is something that happened in SA history that cannot be denied.

Being vaccinated isn’t a free passport to survival. Healthy lifestyle is. It’s been proven over and over. Natural immunity trumps vaccine acquired immunity by far.

Then there is ‘fire water’ that only those from European descent can handle properly.

What is worrying is that 15-18 yr olds are testing positive for HIV. Those who are a mere 15 yr old, are under the age. In other words they were statutory raped.

Why are those perpetrators not being brought to book. This is a disgrace!

Possibly, or their mothers may have passed it to them.

It seems as if the covid virus selects for intelligence. The virus infects the individuals with the highest IQ first. The most intelligent people get seriously ill and even die. Those who are of average intelligence show some minor symptoms, but soon recover. The fact that I am able to write this, combined with the fact that I haven’t shown any symptoms during this pandemic, proves that the virus is not interested in me.

This also explains why 50% of the remaining population are anti-vaxxers. They don’t need to vaccinate because the virus poses no threat to them.

The logical conclusion to be drawn from your first paragraph is that you consider yourself to be of below-average intelligence. Uncharacteristically modest this morning ?

“Mr. Attlee is a very modest man. Indeed he has a lot to be modest about.” – Winston Churchill

i truly believe that these viruses are purely the result of nature desperately trying to correct the overpopulation of this planet, nothing more and nothing less

That you Sensei…this reads like someone nicked your pen.

Oubok, you made my day! I feel only contempt for the way governments try to contain the spread of a virus with counterproductive and illogical, but politically acceptable, lockdown measures. I also respect each individual’s choice to be vaccinated or not. I never went for the flu vaccine in the past. What gives me the moral authority to demand that people be vaccinated against another strain of the flu vaccine now?

I cannot change the popular perceptions, so I merely try to make fun of them. Entrepreneurship relies on the fact that 90% of people are always wrong, that “a new fool is born every minute”. Politics relies on the fact that 90% of people are always right. Therefore, politics create business opportunities.

I’ve got bad news for you. The virus are seeking those with the most free glucose in their bodies, also those with compromised immunity. Hence the large number of diabetics in the hospitals, those with high blood pressure and obesity, of which all three represents metabolic syndrome.

You are 100% correct of course, but you are killing a good story with facts, my respected compatriot.

This is all part of the hidden cost of doing business in South Africa, The investment cost per job in South Africa is approx R200,000 more compared to the US where it costs R420,000 vs SA’s R620,000. $13,000 does not seem like that much at first but that means it cost almost 47% more per investment per job in SA…

One on hand it is very sad hand, people who have HIV/AIDS live lives that the average person cannot imagine from being negatively discriminated against to being unfairly judged whilst in many cases barely being able to afford a decent meal.
On the other hand, when businesses employee these people they will have to take the necessary precaution in their operation and deal with low production output.

Additionally, the government’s policies like the granting / rewarding parents R400 per child for increasing the human resource available whilst businesses cannot create jobs fast enough due to anti business policies or business limiting policies.

As we have seen in the past we will see well into the future, the ANC will not change nor improve, they will continue to ensure that winning elections at all costs are more important than attending to the needs of the country and its citizens.

All hail the cometh of the Slow Puncture. We need a demographic pruning at this time

An HIV and Covid researcher gave me different picture. If you had three people:
A has covid and HIV
B has covid and TB
C has covid and diabetes

C is multiples of times at risk compared to the others and A & B do not face statistically significant higher risk than somebody with “just” Covid. Diabetes and overweight are massive risk factors.

Shhh – if you mention facts like that you’ll be drawing attention to the irony that government should rather be mandating healthy diets and exercise instead of a medication that barely works except to make the producers exceedingly wealthy.

That SA has not decisively dealt with HIV epidemic in so many years, while other less resourced countries have shows you how backward the cultures are in SA and how politicizing the response has not helped one little bit.

SA has the most Aids infected people in the world (40% of all).

That means SA people has the worst personal values in the world – as you cannot get Aids if you stick to one partner and both are tested.

Ironically, president CR’s good leadership on Covid at the start of the first lockdown, badly showed up the ANC – how four ANC presidents did not provide leadership on the biggest Aids disaster in the world.

good leadership? closing down beaches and stopping people buying booze and cigarettes was good leadership? throwing the economy in the gutter and destroying our future prospects for a generation for a virus with a 99.5% survival rate (for those under 70 and in good health) is good leadership?

Record Hiv and unemployment due to majority of population have their brains in their trousers

what can one expect when we had a president with 4plus wives the last barely 20 and 20 plus children LOL

End of comments.

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