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Introduction: Programme Science (PS) and community‐led monitoring (CLM) intersect in unexpected and promising ways. This commentary examines a CLM initiative in Malawi and South Africa to highlight the crucial role of CLM in bolstering the PS framework. By leveraging data sources often overlooked by conventional research and evaluation approaches, CLM emerges as a pivotal element in enhancing programme effectiveness. This paper delineates the fundamental principles of CLM, presents programme outcomes derived from CLM methodologies and contextualizes these findings within the broader framework of PS. Discussion: The Citizen Science Project implements CLM continuously at 33 health facilities: 14 in Malawi (eight in Kasungu District and six in Dedza District), and 19 in South Africa (all in the West Rand District), representing a total catchment area of 989,848 people. Monitoring indicators are developed in an iterative process with community groups. The indicators are unique to each country, but both focus on the uptake of health services (quantitative) and barriers to access (qualitative). Monthly clinic records surveys capture 34 indicators in Malawi and 20 in South Africa and are supplemented by qualitative interviews with care recipients and healthcare workers. Qualitative interviews provide additional granularity and help confirm and explain the more macro trends in service coverage as described in quantitative data. The resulting data analysis reveals key themes that help stakeholders and decision‐makers to solve problems collaboratively. Noteworthy outcomes include a substantial increase in multi‐month dispensing of antiretroviral therapy (ART) during COVID‐19 (from 6% to 31%) with a subsequent recovery surpassing of HIV service benchmarks in Malawi post‐pandemic. Conclusions: While quantifying direct impact remains challenging due to the project's design, CLM proves to be a robust methodology that generates credible data and produces impactful outcomes. Its potential extends beyond the health sector, empowering community leadership and fostering interventions aligned with community needs. As CLM continues to evolve, its integration into PS promises to improve relevance, quality and impact across diverse disciplines. [ABSTRACT FROM AUTHOR]

Background: The COVID‐19 pandemic necessitated that speech–language therapists (SLTs) make a radical change to provide services to their clients safely via telepractice. For many practitioners, telepractice was an unfamiliar mode of practice that had to be implemented under emergency conditions. Limited literature on SLTs' experiences of implementing telepractice in the Global South during this time is available. Aims: To explore the experiences of South African SLTs (N = 45) who implemented telepractice services during the COVID‐19 pandemic. Methods & Procedures: SLTs across the country were invited via professional bodies to participate in an online qualitative survey distributed in 2021. Data were analysed using thematic analysis principles. Outcomes & Results: We describe participants' reports of their current telepractices, discuss their perspectives on accessibility to telepractice for SLTs, clients and caregivers, and working with specific diagnoses, and consider the support needs of SLTs to enhance telepractice services. Most participants work in private practice or school settings with primarily paediatric caseloads. They reported telepractice as a positive experience and felt it was effective, although they judged that some clients were not well served by telepractice. SLTs felt underprepared for the rapid switch to telepractice and the flexibility required, especially given the limited availability of guidelines given the pandemic crisis. Greater preparation is required for telepractice sessions and more attention needs to be paid to supporting caregiver involvement online. Conclusions & Implications: Telepractice involves various barriers and facilitators, many of which seem common across Global North and South contexts. Support is required to enhance current telepractices in terms of computer literacy, technical education, different telepractice methods and caregiver coaching. Our findings have the potential to enable the development of support, training and guidelines to improve SLTs' confidence in providing telepractice whilst delivering quality services in an accessible and safe manner. WHAT THIS PAPER ADDS: What is already known on the subject: Many SLTs had to transition quickly to telepractice service provision during COVID‐19, with limited existing guidelines and support. Although there is some literature available on SLTs' experiences of implementing telepractice in the Global North, perspectives from the Global South during this time are limited. It is important to understand experiences, barriers and facilitators to telepractice provision to provide tailored support to practitioners. What this paper adds to existing knowledge: Telepractice provides a viable alternative to in‐person therapy for specific clients and contexts. Telepractice presents both benefits and barriers for effective clinical practice across Global North and South contexts. Greater preparation is required for telepractice sessions and more attention needs to be paid to enhancing caregiver involvement online, especially since many practitioners are likely to continue offering telepractice services post‐pandemic. What are the potential or actual clinical implications of this work?: Clinicians felt underprepared for the rapid switch from service delivery mode to telepractice. Greater support, training and guidelines for students and practitioners are required to enhance current practices and ensure practitioners are equipped to provide effective telepractice in the future. In particular, support should cover technological aspects, caregiver coaching and online assessment options, especially for paediatric clients. [ABSTRACT FROM AUTHOR]

Background: COVID‐19 necessitated emergency telepractice for student‐led speech‐language therapy clinical practicals in training institutions, with limited preparation and evidence‐based guidelines. Beyond the pandemic, practitioners and university training sites are likely to continue to offer telepractice necessitating thorough preparation for telepractice services underpinned by a comprehensive understanding of the complexities involved in online therapy. Aims: Adopting realist evaluation principles, our aim in this paper was to explore broadly what works and does not work in a set of student‐led telepractice sessions in a diverse, resource‐limited context. The broader goal of this project was to provide evidence‐based support to enhance the efficiency and success of telepractice sessions in student clinical training contexts. Methods & Procedures: We used qualitative observational methods with reflexive thematic analysis to analyse 28 video recordings and 61 observation notes of student‐led paediatric telepractice sessions from a South African university clinic as part of a pilot study. Outcomes & Results: We identified four overarching considerations for student‐led telepractice: (1) additional, specific preparation is required, (2) with greater management of technology and adaptation of tasks, especially during times of poor connectivity; (3) telepractice relies heavily on caregiver input and collaboration; and (4) promoting engagement online, holding a client's attention, building rapport and offering reinforcement are critical skills that are complicated by the lack of face‐to‐face contact. Conclusions & Implications: Our findings indicate that telepractice pedagogy needs to be explicitly taught and students require practical assistance as they learn how to use this service delivery approach effectively. There are some aspects peculiar to telepractice that require unique consideration and planning, especially in contexts where service providers and users may be unfamiliar with this form of service provision. The findings of this pilot study can be used by clinical educators and student clinicians to enhance clinical training opportunities involving telepractice. WHAT THIS PAPER ADDS: What is already known on this subject: Many speech‐language therapy (SLT) student clinicians had to transition quickly to telepractice service provision during COVID‐19 with limited existing guidelines and support, especially in contexts where teletherapy is typically non‐existent or difficult to access. Although there is some literature available on experiences of telepractice, there is very little evidence‐based research which explores the mechanics of such sessions in real‐time and which offers practical support to student clinicians and clinical educators engaging in this mode of service delivery. What this study adds: This pilot study examined video‐recorded, student‐led, paediatric, speech‐language teletherapy sessions to understand challenges and considerations involved in using telepractice as a clinical training tool. Findings show that additional preparation for telepractice sessions is required, particularly in contexts of poor digital literacy; students must learn to manage technology, especially when connectivity poses a challenge, and adapt therapy tasks for online work with clients; telepractice relies heavily on caregiver input and collaboration, more so than in in‐person consultations, and this relationship requires careful management; and promoting engagement online, holding a client's attention, building rapport and offering reinforcement are critical yet challenging skills in telepractice. What are the potential or actual clinical implications of this work?: Our findings highlight a need to teach telepractice pedagogy explicitly and support students practically in learning how to provide therapy effectively via this mode of service delivery. Observational methods for studying practices in recorded telepractice sessions can be used as part of a reflective approach to clinical training. Using already available data allowed us to unpack the 'messy reality' of clinical training using telepractice. [ABSTRACT FROM AUTHOR]

Patent protection emerged as one of the most challenging barriers to the access to medicines, medical equipment, and vaccines as well for the treatment and containment of Covid‐19 when it became a pandemic. The severe scarcity of vaccines and pharmaceutical products were weakening the fight against Covid‐19, and endeavor to contain the recurrence of pandemic waves while mutation of the SARS‐CoV‐2 was also on the full swing. Therefore, India and South Africa jointly proposed for patent waiver at WTO in October 2020 to effectively deal with the short‐supply of medicines, medical equipment, vaccines and high price concern related to these products. After 20 months of consultation and negotiations with major stakeholders, the WTO came up with decision on patent waiver in 12th Ministerial Conference (12th MC). The time taken to reach to the decision in the pandemic situation and the narrow scope of the decision is a serious concern for the entire world to deal effectively with Covid‐19 and its variants. This paper attempts to analyse the patent waiver in the context of the agreement on Trade Related Aspects of Intellectual Property Rights (TRIPS). It discusses patent barriers, alternative measures and needs for equitable access to vaccines and pharmaceuticals amidst the pandemic. Paper applies the qualitative methodology of research mainly content analysis method in the framework of contextualisation, decontextualisation, and recontextualisation. Results show that suspending certain provisions of the TRIPS required for the production of vaccines and medicines would prove a crucial tool for economies to return to its pre‐Covid‐19 era. Paper concludes that, patent waiver can be one of the most important tool to fight the Covid‐19 (as WHO has not yet declared the end of pandemic) and will pave the way to deal with any such unknown future pandemic effectively. [ABSTRACT FROM AUTHOR]

How does the COVID‐19 pandemic impact migrant worker visibility? This paper examines how the pandemic underscores the invisibility of Zimbabwean migrant farm workers employed at ZZ2, one of the largest commercial farms in South Africa. I argue that Zimbabweans are made invisible in three ways. First, employer and state restrictions on mobility, alongside rising xenophobia in South Africa, leave migrant workers hyper‐visible to ZZ2 management, yet invisible to most people outside the farm. Second, ZZ2 avoids discussion of its migrant workforce in public forums, even as it faces increased scrutiny for its treatment of its workers during the pandemic. Third, the most prominent critic of ZZ2—the Economic Freedom Fighters (EFF)—grants migrant workers only a partial visibility as undifferentiated foreigners with no voice, a construction that ultimately maintains their invisibility at the company. Taken together, these interlocking forms of invisibilization diminish the structural and associational power of workers. [ABSTRACT FROM AUTHOR]

Aim: This paper describes the development of the training programme for South African professional nurses on how to manage critically ill COVID‐19 patients in intensive care units and repurposed general wards. Design and methods: The Analysis, Design, Development, Implementation and Evaluation educational instructional design model guided the development of the training programme. A case‐based study approach and blended learning were used to deliver the six modules. Results: The training programme was developed, reviewed and validated by the coordinating team of facilitators involved in the initiative. Implementation of the training programme and the result thereof will not be discussed as part of this manuscript. Conclusion: The training programme aimed to enhance the knowledge of professional nurses in the management of critically ill patients with COVID‐19. As the pandemic evolves, a need for training and ongoing support was identified, which might address the need for surge capacity and hospital readiness planning. [ABSTRACT FROM AUTHOR]

This paper conducts an analysis of labour market dynamics in South Africa during the initial period of lockdown, from the end of March to the end of April 2020, using the first wave of the NIDS‐CRAM (2020) survey. Within our sample of over 6,000 adults aged 18 to 59, we found that there was a very large decrease in employment. The fraction of the sample that was conventionally classified as employed decreased from 57% in February to 48% in April. If we further exclude temporarily absent workers, which we term "furloughed" employees, this fraction decreases further to 38%. Thus, about one out of every three employed people in our sample either lost their job or did not work and received no wages during April. This has extremely large implications for poverty and welfare. We further analyse the labour market by comparing across demographic groups as defined by race, by gender, by age groups, by geographic areas and by education levels. The over‐arching finding from this analysis is that the job losses were not uniformly distributed amongst the different groups. In particular, groups who have always been more vulnerable – such as women, African/Blacks, youth and less educated groups – have been disproportionately negatively affected. [ABSTRACT FROM AUTHOR]

In an attempt to minimise the negative economic impacts of COVID‐19 on vulnerable households the South African government allocated R50 billion in additional social assistance spending. The cash transfer package included a temporary increase in existing grants and introduced a new "Covid grant." We assess the chosen package and compare it with an initial proposal to increase the Child Support Grant (CSG). Coverage, cost and welfare effects are calculated to measure the relative impacts in each case. We find that while a significant increase in the CSG delivers resources most progressively, the addition of the COVID‐19 grant may potentially reach a much larger group of otherwise uncovered, vulnerable individuals. Critically, this extended coverage comes at a cost to the poorest households, via additional transfers to the upper income deciles. However, we identify several categories of vulnerable household groups which suggests that the workers most negatively affected by the pandemic are not necessarily those in the poorest households. The paper emphasises that social assistance to mitigate the consequences of COVID‐19 should not be viewed necessarily as a standard poverty reduction exercise, but rather as an attempt to mitigate COVID‐19‐related income shocks for the vulnerable who were most negatively affected by the pandemic. [ABSTRACT FROM AUTHOR]

A computable general equilibrium model linked to a microsimulation model is applied to assess the potential short‐term effects on the South African economy of the ongoing COVID‐19 pandemic. With a particular focus on distributional outcomes, two simulations are run, a mild and a severe scenario. The findings show significant evidence of decline in economic growth and employment, with the decline harsher for the severe scenario. The microeconomic results show that the pandemic moves the income distribution curve such that more households fall under the poverty line while at the same time, inequality declines. The latter result is driven by the disproportionate decline in incomes of richer households while the poorest of the poor are cushioned by government social grants that are kept intact during the pandemic. The COVID‐19 pandemic is still unfolding and its economic modelling as well as the data used to operationalise the model will need to be updated and improved upon as more information about the disease and the economy becomes available. [ABSTRACT FROM AUTHOR]

On March 11, 2020, the outbreak of Novel Coronavirus (SARS‐CoV‐2) Disease, or COVID‐19, was officially declared a pandemic by the World Health Organization (WHO). As its effects roll through societies and economies across the globe, women are expected to bear the heaviest impact. Unfortunately, despite gender‐focused reporting on the consequences of the COVID‐19 crisis, few government policies and public health efforts have explicitly addressed the gendered impacts of the pandemic. This academic review paper presents literature, from both academic and media sources, on the early effects of the COVID‐19 crisis on women, specifically within the South African context. Preliminary research and reporting of the effects of COVID‐19 on the South African population indicate that inequitable gendered practices negatively impact women in the general economy, the workplace, and the home. These settings are discussed in this article, along with recommendations to ameliorate the lived experiences of South African women. [ABSTRACT FROM AUTHOR]

Over the months of April and May 2021, South Africa has witnessed several outbreaks of highly infective avian influenza (H5N1) in different poultry farms. This came as a shock to a country that was already battling with the deadly COVID‐19 pandemic. The emergence of the virus has spurred import bans and massive culls in the poultry business. Local experts have also called for a restriction on the movement of people and cars in and out of their chicken farms. Employees have also been encouraged to shower in the mornings when they arrive at the farms and wear fresh clothes, as the flu spreads very quickly. In a country that is already facing the economic implications of the COVID‐19, this has the potential to cause a significant dent in the economy, as well as severely impact people's day‐to‐day life. Bird flu—also called avian influenza—is a viral infection that can infect not only birds but also humans and other animals. The threat of a new influenza pandemic has prompted countries to draft national strategic preparedness plans to prevent, contain and mitigate the next human influenza pandemic. This paper describes the South African burden, current efforts, and preparedness against the avian influenza virus. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic led many governments to implement lockdown regulations to curb the spread of the virus. Though lockdowns do minimise the physical damage caused by the virus, there may also be substantial damage to population well‐being. Using a pooled data set, we analyse the relationship between a mandatory lockdown and happiness in three diverse countries: South Africa, New Zealand and Australia. These countries differ amongst others in terms of lockdown regulations and duration. The primary aim is to determine, whether a lockdown is negatively associated with happiness, notwithstanding the characteristics of a country or the strictness of the lockdown regulations. Second, we compare the effect size of the lockdown on happiness between these countries. We use Difference‐in‐Difference estimations to determine the association between lockdown and happiness and a Least Squares Dummy Variable estimation to study the heterogeneity in the effect size of the lockdown by country. Our results show that a lockdown is associated with a decline in happiness, regardless of the characteristics of the country or the type and duration of its lockdown regulations. Furthermore, the effect size differs between countries in the sense that the more stringent the stay‐at‐home regulations are, the greater it seems to be. [ABSTRACT FROM AUTHOR]

This study analyses whether Coronavirus health shocks and government responses in terms of lockdown policy and stringency measures impact stock markets in Africa. We found that stock markets appeared to be more negatively responsive to growth in total number of COVID‐19 reported cases than the growth in deaths in the case of Nigeria and South Africa. While for Egypt, the stock market reacted significantly negative to both COVID‐19‐related indicators. Our results further show that government stringency policy has significant negative effect on stock market returns in the case of Nigeria and South Africa, but positive in the case of Egypt. [ABSTRACT FROM AUTHOR]

This article investigates the impact of the COVID‐19 pandemic on the long‐term economic growth of South Africa. We embed an epidemiological model in a modified Solow–Swan model and explore various channels such as morbidity, mortality, unemployment, loss of school days and capital accumulation. We demonstrate that COVID‐19 will lower the average annual growth rate of GDP per capita of South Africa by 0.07 percentage points in the next four decades, a 25 per cent decline relative to the no‐COVID benchmark. We show that human capital losses due to school closures account for more than half of the economic slowdown. [ABSTRACT FROM AUTHOR]

Objectives: The adverse effects of the COVID‐19 pandemic on tuberculosis (TB) detection have been well documented. Despite shared symptoms, guidance for integrated screening for TBand COVID‐19 are limited, and opportunities for health systems strengthening curtailed by lockdowns. We partnered with a high TB burden district in KwaZulu‐Natal, South Africa, to co‐develop an integrated approach to assessing COVID‐19 and TB, delivered using online learning and quality improvement, and evaluated its performance on TB testing and detection. Methods: We conducted a mixed methods study incorporating a quasi‐experimental design and process evaluation in 10 intervention and 18 control clinics. Nurses in all 28 clinics were all provided access to a four‐session online course to integrate TB and COVID‐19 screening and testing, which was augmented with some webinar and in‐person support at the 10 intervention clinics. We estimated the effects of exposure to this additional support using interrupted time series Poisson regression mixed models. Process evaluation data comprised interviews before and after the intervention. Thematic coding was employed to provide explanations for effects of the intervention. Results: Clinic‐level support at intervention clinics was associated with a markedly higher uptake (177 nurses from 10 intervention clinics vs. 19 from 18 control clinics). Lack of familiarity with online learning, and a preference for group learning hindered the transition from face‐to‐face to online learning. Even so, any exposure to training was initially associated with higher rates of GeneXpert testing (adjusted incidence ratio [IRR] 1.11, 95% confidence interval 1.07–1.15) and higher positive TB diagnosis (IRR 1.38, 1.11–1.71). Conclusions: These results add to the knowledge base regarding the effectiveness of interventions to strengthen TB case detection during the COVID‐19 pandemic. The findings support the feasibility of a shift to online learning approaches in low‐resource settings with appropriate support and suggest that even low‐intensity interventions are capable of activating nurses to integrate existing disease control priorities during pandemic conditions. [ABSTRACT FROM AUTHOR]

Purpose: We reflect on our experience of running a remote volunteer counseling service, known as the Counseling Collective, to support patients and their families during the second wave of the COVID‐19 pandemic in Cape Town, South Africa, and the learning and implications for practice and policy regarding the effective utilization of volunteers during a crisis or disaster context. Background: The Beta SARS‐Co‐2 variant dominated the second COVID‐19 wave which gained momentum in December 2020, as public sector health teams prepared to deescalate services over the South African summer season. The ferocity with which the wave hit the city soon made it clear that volunteers would be needed to assist with counseling services as the Beta variant caused serious disease, resulting in a significant upswing in hospitalisations and deaths. Methods: Four counselors and a colleague with oversight responsibilities of the volunteers reflected on the service we provided. This was done with the benefit of hindsight a year after the activities of the Counseling Collective were wrapped up. Lessons Learned Virtual volunteers are a largely untapped resource in the South African health care system. Much is to be gained by using this underutilized resource to deliver patient‐centred services, especially in times of crisis. Conclusion: Networks of retired and self‐employed health professionals, particularly nurses,—skilled volunteers—are a valuable resource and can be deployed for critical work using their versatile skillsets, in public health emergencies. Telephonic consultations are a useful modality for providing quality care and need to be built into the business of health services. Skills to conduct such consultations and for the provision of palliative care services need to be mainstreamed into the skillsets of health professionals. Policy and clinical relevance: Public health disaster plans should include a blueprint for the rapid recruitment and deployment of volunteer counselors to assist permanent staff in providing crucial patient‐centred care. [ABSTRACT FROM AUTHOR]

Background: Children with Autism Spectrum Disorder (ASD) remain vulnerable during the Covid‐19 outbreak due to significant changes to their daily routines, social interactions and diets. In addition, these challenges may be exacerbated for children living in low‐ and middle‐income countries (LMIC) such as South Africa where there are already barriers such as poverty, access to resources and availability of support. Understanding the impact of the Covid‐19 outbreak on children with ASD is imperative in order to create awareness as well as provide equitable services and support to both children with ASD and their families. Purpose The study aimed to explore family‐reported changes for children with ASD and their reactions and responses to the Covid‐19 restrictions in South Africa. Method: A qualitative research design was employed. Twelve families consisting of different family compositions with a total of 21 family members (mothers, fathers and grandmothers) participated in the current study using semistructured interviews. Data were transcribed and analysed using a framework method for thematic analysis. Results: Findings indicated that children with ASD present with unique challenges related to Covid‐19. Negative themes such as children's obstructive reactions due to the immediate changes to their routines, increases in emotional dysregulation as well as loss of previously acquired skills as a result of lack of access to services during lockdown were reported. However, families also reported on positive changes such as improved social interactions as children became more accustomed to their new lockdown routines. Implications: The Covid‐19 response has had a negative impact on children with disabilities, specifically around access to services and support for both children with ASD and their families. While the future of the virus and impending lockdown measures is unknown, clinicians, providers and educators need to ensure that provisions are made for children's current adjustments as well as further adjustments to their current routines both during and after the pandemic. [ABSTRACT FROM AUTHOR]

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Governments during the Covid‐19 pandemic in response to the challenge of reaching as many of their citizens as quickly as possible have relied on the use of digital media communication. Various stakeholders, however, have questioned whether strategic use of digital communication by governments has been effective during the Covid‐19 health crisis. We thematically analyzed a public online bi‐country webinar and conducted a netnographic analysis of South African Health Minister Dr. Zweli Mkhize and Namibian Ministry of Health and Social Services Twitter accounts to evaluate the effectiveness of government digital communication during the Covid‐19 pandemic. Stakeholders and social media analysis highlight that government digital communication has lacked engagement, falling short in assisting citizens to understand the effects of the Covid‐19 pandemic. We highlight the shortcomings of governments simply transmitting information on channels built for dialogue, the digital divide limiting reach, as well as how limited engagement opens up opportunities for misinformation. Highlights: •Many governments, including the South African and Namibian governments, have relied on the use of digital media to disseminate as much information as possible.•Various stakeholders have questioned the effectiveness of using digital media as a strategy in reaching citizens across parts of Southern Africa.•Stakeholders acknowledged that the use of digital media by governments, particularly South Africa and Namibia started as a good initial reaction to the Covid‐19 pandemic.•However, these governments were mostly reactive in their online communication with limited engagement that fueled misinformation online and citizens looking to other nongovernment sources for information.•Some of these alternative sources of information became health‐care professionals and other helpful citizens that were online, taking on the communication burden.•The governments were perceived as not being humanistic in their digital communication and part of the challenge was digital inequality that highlighted the need for traditional communication in media convergence.•Inefficient use of digital and social media erodes trust and quality of the relationship between government and their key stakeholders, that is, citizens, reversing any gains made in this case, in the fight against the Covid‐19 pandemic. [ABSTRACT FROM AUTHOR]

Ghana and South Africa proactively implemented lockdowns very early in the pandemic. We analyze a three‐wave panel of households in Accra and Greater Johannesburg to study the mental and economic well‐being of the urban poor between the COVID‐19 lockdown and the "new normal" one year later. We find that even if economic well‐being has mostly recovered, life satisfaction has only improved slightly and feelings of depression are again at lockdown levels one year into the pandemic. While economic factors are strongly correlated with mental health and explain the differences in mental health between South Africa and Ghana, increasing worries about the future and limited knowledge about the pandemic (both countries) as well as deteriorating physical health (South Africa) and trust in government (Ghana) explain why mental health has not recovered. Therefore, we need broad and country‐specific policies, beyond financial support, to accelerate the post‐pandemic recovery of the urban poor. [ABSTRACT FROM AUTHOR]

Introduction: South Africa's progress towards the 95‐95‐95 goals has been significantly slower among adolescents living with HIV (ALHIV), among whom antiretroviral therapy (ART) adherence, retention in care and viral suppression remain a concern. After 2 years of living with COVID‐19, it is important to examine the direct and indirect effects of the pandemic on healthcare resources, access to HIV services and availability of support structures, to assess their impact on HIV care for ALHIV. Discussion: The COVID‐19 response in South Africa has shifted healthcare resources towards combatting COVID‐19, affecting the quality and availability of HIV services—especially for vulnerable populations, such as ALHIV. The healthcare system's response to COVID‐19 has threatened to diminish fragile gains in engaging ALHIV with HIV services, especially as this group relies on overburdened public health facilities for their HIV care. Reallocation of limited health resources utilized by ALHIV disrupted healthcare workers' capacity to form and maintain therapeutic relationships with ALHIV and monitor ALHIV for ART‐related side effects, treatment difficulties and mental health conditions, affecting their ability to retain ALHIV in HIV care. Prevailing declines in HIV surveillance meant missed opportunities to identify and manage opportunistic infections and HIV disease progression in adolescents. "Lockdown" restrictions have limited access to healthcare facilities and healthcare workers for ALHIV by reducing clinic appointments and limiting individual movement. ALHIV have had restricted access to social, psychological and educational support structures, including national feeding schemes. This limited access, coupled with reduced opportunities for routine maternal and sexual and reproductive health services, may place adolescent girls at greater risk of transactional sex, child marriages, unintended pregnancy and mother‐to‐child HIV transmission. Conclusions: Adolescent HIV care in South Africa is often overlooked; however, ART adherence among ALHIV in South Africa is particularly susceptible to the consequences of a world transformed by COVID‐19. The current structures in place to support HIV testing, ART initiation and adherence have been reshaped by disruptions to health structures, new barriers to access health services and the limited available education and psychosocial support systems. Reflecting on these limitations can drive considerations for minimizing these barriers and retaining ALHIV in HIV care. [ABSTRACT FROM AUTHOR]

The South African government introduced the use of an HIV self‐testing (HIVST) kit in 2016 to expand access to HIV testing services and to increase HIV testing uptake among men and key populations who may otherwise not test. By reviewing existing empirical data, including existing guidelines regarding the implementation and use of HIV self‐testing, this research explores the ethical implications of using the HIV self‐testing kit and draws arguments from the ethical principles: respect for autonomy, beneficence, non‐maleficence, and social justice. The implementation of HIV self‐testing in South Africa does not violate any ethical principles; however, the potential occurrences of coercion and intimate partner violence surrounding HIV self‐testing remain issues of concern challenging the principle of non‐maleficence. Furthermore, the available empirical data on potential harm does not provide compelling ethical grounds for restricting the sale of HIVST kits in South Africa. Hence, HIVST in South Africa remains an ethically justified intervention. [ABSTRACT FROM AUTHOR]

During the COVID‐19 pandemic, genetic variants of SARS‐CoV‐2 have been emerging and spreading around the world. Several SARS‐CoV‐2 endemic variants were found in United Kingdom, South Africa, Japan, and India between 2020 and April 2021. Studies have shown that many SARS‐CoV‐2 variants are more infectious than early wild strain and produce immune escape. These SARS‐CoV‐2 variants have brought new challenges to the prevention and control of COVID‐19. This review summarizes and analyzes the biological characteristics of different amino acid mutations and the epidemic characteristics and immune escape of different SARS‐CoV‐2 variants. We hope to provide scientific reference for the monitoring, prevention, and control measures of new SARS‐CoV‐2 variants and the development strategy of the second‐generation vaccine. [ABSTRACT FROM AUTHOR]

Overview: Covid cases surge, worsening Q1 slowdown ▀ Although some of the initial worst fears about Omicron have proved unfounded, the unexpectedly large surge in global Covid‐19 cases is causing more cautious behaviour by individuals and greater disruption to businesses than envisaged. We have cut our Q1 GDP forecast again and now expect world GDP growth of 4.2% in 2022, down from 4.3% a month ago and the 5.8% estimated for 2021.▀ There remain plenty of unknowns regarding the Omicron variant and its health impact. But the evidence from economies such as South Africa, the UK and Denmark suggests that the Omicron wave is likely to be associated with much smaller rises in hospitalisations than earlier Covid waves. And for now, our initial assessment that there would only be a modest reimposition of mobility restrictions is correct.▀ Nonetheless, the rise in global Covid cases to more than double the previous peak has exceeded expectations of a month ago by a large margin and points to greater economic damage via increased voluntary social distancing and disruption to businesses from staff having to self‐isolate. In response, we have lowered global GDP growth further in Q1.▀ As with previous Covid waves, we expect activity to rebound quickly when cases start to fall back, so the downward revision to the outlook in Q1 will be largely offset by a bigger bounce in Q2. Nonetheless, the weak start to the year will dampen overall 2022 growth slightly.▀ Meanwhile, greater disruption in the near term — especially in China where a zerotolerance approach to Covid continues to be pursued— points to slower normalisation of supply‐chain pressures and potentially a slower transition of consumer spending from goods back to services. Partly due to this, we have lifted our 2022 global CPI inflation forecast by 0.3pp to 4.5%. But inflation is still expected to fall sharply over the course of year, limiting the need for aggressive monetary policy tightening. [ABSTRACT FROM AUTHOR]

During the South African lockdown, food relief was largely delivered by civil society, after the government failed to honor its pledge to provide for the population. By taking a local food parcel initiative in a small rural township as an ethnographic case study, this article examines why the attempt to mimic government food distribution generated dissatisfaction and tension in the targeted community. At the heart of this argument is the way the local parcel project created ambiguous anticipation regarding the consequences for residents' experience of dignity, as it undermined an established binary understanding of economic dependency. This understanding clearly distinguishes between relationships within the community and those with the government. Proximity and intimacy increased the risk of public humiliation arising from indebtedness, while dependence on the government did not inevitably generate the same anxiety. Agency is identified as a key signifier to understand strategies for upholding dignity in the different relationships. This article examines different stakeholders' spontaneous and creative attempts to control the relational outcome of the distribution. It discusses how narratives about the distribution as a rightful share to the community's wealth emerged among potential recipients in an attempt to negate any notion of personalized reciprocity following the distribution. [ABSTRACT FROM AUTHOR]

The consequences of COVID‐19 have impacted the poor and vulnerable populations of the world significantly, particularly in countries like South Africa. State institutions have been prioritising mitigating the impacts of the pandemic. And in the academy, there has been an influx of recent scholarship contending with the psychological and physical repercussions of the pandemic. This article focuses on South Africa's rebuilding of public participation in governance in the country post‐pandemic. The article is based on a qualitatively rooted methodology consisting of a wide range of primary and secondary sources, including official state documents, academic books and articles, and reports from non‐governmental organisations and think tanks. The article further draws on the findings of global and continental research and proposes steps for rebuilding public participation in South Africa in a manner that ensures accessible governance for all, especially the poor and vulnerable populations. An exposition of the legislative measures enhancing public participation in South Africa is accompanied by a brief social and economic picture before and during COVID‐19, and a comparative synopsis of old and new direction of the processes and realities of the phenomenon in society. The research‐based key steps leading to successfully rebuilding political and social engagement after COVID‐19 were identified as being founded on a number of steps. The first related to the process of moving from community diversity to communal unity through the continuous development of trust between community and leadership, the processes of community developmental empowerment, the active participation of women in political leadership and the active role of the ward committees in community governance. [ABSTRACT FROM AUTHOR]

Accessible Summary: For young people with intellectual disabilities and/or autism, the transition from children's residential care into adulthood during COVID‐19 has been difficult.Opportunities for greater independence were blocked because of the lockdown.Some of these young people experienced an increase in depression or other mental health difficulties.But more time at home due to public health restrictions also helped to deepen the relationship with caregivers.Service continuity is crucial, both in person and online, to support care leavers with intellectual disability and/or autism, as well as training and support to caregivers to continue with independent and interdependent living programmes at home. Background: This study focuses on young people with intellectual disabilities and/or autism who, due to child welfare concerns, have grown up in children's residential care and are now transitioning out of care at the age of 18 years towards young adulthood. This transition is termed "care leaving" and the young people in transition "care leavers". The care leaving transition can be particularly difficult for young people with intellectual disabilities and/or autism. These challenges can be magnified in a time of a global crisis like COVID‐19, which has resulted in countries being on lockdown and care leavers' transitions being curtailed. Many mental health problems have emerged due to the COVID‐19 outbreak and resultant lockdown that may negatively impact on the care leaving transition of young people with intellectual disabilities. Methods: Semi‐structured interviews were conducted with six care leavers with intellectual disabilities and their three caregivers in June 2020 in the Cape Peninsula region of South Africa to explore the impact of COVID‐19 on their transitional journeys. Findings: Three core themes emerged from the analysis: young people evidenced regression of independence, rather than the expected growth in young adult independence, due to disruptions to routines and opportunities to move out into the world; some young people experienced an exacerbation or emergence of mental health problems, which impacted on their transition to young adulthood; and young people and their caregivers experienced a deepening of caregiver relationships, which enhanced the transition of the care leaver. Conclusions: Services must continue to facilitate progress towards independence and promote personal and caregiver well‐being. Support service for care leavers with intellectual disabilities should be essential services, offered in person or online while adhering to COVID‐19 regulations. Caregivers should be trained in continuing independent and interdependent living programmes for care leavers in their care, supported through in person or online training, mentoring and supervision. Service continuity is recommended to avoid the contraction of young people's social world at a time when it should be opening up. [ABSTRACT FROM AUTHOR]

We study the demographic and economic correlates of the 1918 influenza or "Spanish flu" that killed an estimated 6% of South Africa's population. While the pandemic has received some attention in South African historiography and from social scientists in other contexts, little is known about its long‐term impact on the country. Bringing together data from a range of new sources, including population and agricultural censuses, household surveys, and the voters' rolls, we provide analyses that show, first, the factors that (do and do not) predict flu mortality across South Africa's magisterial districts, and, second, suggest some important consequences of the flu. Our results reveal a large but short‐lived demographic shock, and detectable, if small scale, long‐term economic consequences. [ABSTRACT FROM AUTHOR]

The economic effects of the lockdown period in South Africa will be devastating. We simulated the industry level capacity constraints imposed by the lockdown regulations since 27 March 2020 on all industries in South Africa by reducing the amount of capital and labour available for production. We found a decrease in real GDP to 10% below the baseline level in 2020, and recovery of all industries and macroeconomic variables towards the baseline by 2027. Industries that are suffering and would continue to suffer are the hospitality and tourism industry and all industries related to it, such as transport services, as well as beverages and tobacco. Manufacturing in general is also hard hit because they were prohibited to let large groups of labourers enter their premises. The model shows that most manufacturing will suffer throughout the forecast period, which was modelled up to 2027. [ABSTRACT FROM AUTHOR]

Following years of fast‐rising debt levels, we show that the Covid‐19 crisis worsened an already deteriorating fiscal position in South Africa. To restore fiscal sustainability in the aftermath of the crisis some commentators argue that higher government expenditure will grow GDP sufficiently to stabilise the debt/GDP ratio. We reject this, showing that although a real increase in expenditure stimulates economic growth (a short‐run, once‐off effect), the public expenditure/GDP ratio exceeds the level at which an increase in the ratio positively impacts growth. We then explore the past efforts of government to maintain or restore fiscal sustainability by estimating a fiscal reaction function using a Markov‐switching model. Following the impact of the Covid‐19 crisis on the budget, we subsequently establish the deficit, expenditure and revenue adjustments that the government will have to make to restore fiscal sustainability. Finally, we consider the merits of introducing a debt ceiling. [ABSTRACT FROM AUTHOR]