the eradication of rinderpest and measles is that humans can move freely, and cannot
be forced to vaccinate or be culled.
10.3.3 Human Immunodeficiency Virus
The successes with the viruses discussed above, utilising large-scale campaigns to
control and vaccinate, could suggest that similar success with human immunodeficiency virus (HIV) would be possible. This may yet be the case, but as of 2019 we
have no successful HIV vaccine or cure, which gives rise to the problem we have
today with this infectious agent. HIV is an example of an invasive disease that has
become endemic, thanks to the long incubation period and social factors aiding its
transmission.
This virus, finding itself at home in humans, has invaded the globe and in
particular, South Africa, spectacularly. The virus is thought to have been a zoonotic
pathogen that jumped to humans when humans had close contact with simians in
West or Central Africa, possibly through consumption of bushmeat (Peeters et al.
2002). The dates of this or these events are disputed, but may be as early (or late,
depending on one’s perspective) as the early 1900s or even earlier. It first gained
serious attention as an unusual health problem of unknown etiology in the early
1980s amongst the gay and drug-using communities in the USA (Luce 2013). It was
first detected in South Africa in 1982 (Gilbert and Walker 2002). The causative virus
was first isolated in 1983 (Barré-Sinoussi et al. 1983; Weiss 2003). The consequences of failure to contain this virus are very evident. UNAIDS estimates that
South Africa has approximately 270,000 new HIV infections and 110,000 deaths
every year (UNAIDS 2016).
The march of HIV through the South African human population, and the politics
surrounding it, have received unprecedented media attention. Part of the reason for
this is that HIV infection is currently irreversible and incurable (Humphry 1993). We
now have drug cocktails that can halt the progression of the disease, but not cure
it. The cost to the country is extraordinarily high. In 2016, UNAIDS estimated that
there are 7.1 million people living with HIV in South Africa. Approximately 56% of
the infected persons receive antiretroviral treatment at a direct cost of over ZAR 66.4
billion per annum. Given our total National Department of Health budget of ZAR
205.4 billion, it can be seen that just this one single infectious agent has been an
incredibly successful invader and now costs us a disproportionate amount of our
health budget, which in turn is 13.9% of total government spend (South African
National Department of Health 2018).
A further problem with HIV is the enhanced susceptibility to tuberculosis (TB)
of HIV-positive individuals (Corbett et al. 2003). The ingress of HIV into
South African society and rapid rise of prevalence, led to a parallel rise in human
TB (caused by Mycobacterium tuberculosis) incidence and prevalence in
South Africa, placing a double burden on the health care system. TB is also more
difficult to diagnose in HIV-positive individuals (Aaron et al. 2004), further complicating the problem.
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L. van Helden et al.
be forced to vaccinate or be culled.
10.3.3 Human Immunodeficiency Virus
The successes with the viruses discussed above, utilising large-scale campaigns to
control and vaccinate, could suggest that similar success with human immunodeficiency virus (HIV) would be possible. This may yet be the case, but as of 2019 we
have no successful HIV vaccine or cure, which gives rise to the problem we have
today with this infectious agent. HIV is an example of an invasive disease that has
become endemic, thanks to the long incubation period and social factors aiding its
transmission.
This virus, finding itself at home in humans, has invaded the globe and in
particular, South Africa, spectacularly. The virus is thought to have been a zoonotic
pathogen that jumped to humans when humans had close contact with simians in
West or Central Africa, possibly through consumption of bushmeat (Peeters et al.
2002). The dates of this or these events are disputed, but may be as early (or late,
depending on one’s perspective) as the early 1900s or even earlier. It first gained
serious attention as an unusual health problem of unknown etiology in the early
1980s amongst the gay and drug-using communities in the USA (Luce 2013). It was
first detected in South Africa in 1982 (Gilbert and Walker 2002). The causative virus
was first isolated in 1983 (Barré-Sinoussi et al. 1983; Weiss 2003). The consequences of failure to contain this virus are very evident. UNAIDS estimates that
South Africa has approximately 270,000 new HIV infections and 110,000 deaths
every year (UNAIDS 2016).
The march of HIV through the South African human population, and the politics
surrounding it, have received unprecedented media attention. Part of the reason for
this is that HIV infection is currently irreversible and incurable (Humphry 1993). We
now have drug cocktails that can halt the progression of the disease, but not cure
it. The cost to the country is extraordinarily high. In 2016, UNAIDS estimated that
there are 7.1 million people living with HIV in South Africa. Approximately 56% of
the infected persons receive antiretroviral treatment at a direct cost of over ZAR 66.4
billion per annum. Given our total National Department of Health budget of ZAR
205.4 billion, it can be seen that just this one single infectious agent has been an
incredibly successful invader and now costs us a disproportionate amount of our
health budget, which in turn is 13.9% of total government spend (South African
National Department of Health 2018).
A further problem with HIV is the enhanced susceptibility to tuberculosis (TB)
of HIV-positive individuals (Corbett et al. 2003). The ingress of HIV into
South African society and rapid rise of prevalence, led to a parallel rise in human
TB (caused by Mycobacterium tuberculosis) incidence and prevalence in
South Africa, placing a double burden on the health care system. TB is also more
difficult to diagnose in HIV-positive individuals (Aaron et al. 2004), further complicating the problem.
264
L. van Helden et al.