Worst Epidemics Research Articles

School’s Role in Obesity Prevention

Fast food, advanced transportation, and behind the desk jobs characterize the lifestyle of the majority of Americans. Unfortunately, this lifestyle has resulted in one of America’s worst epidemics: obesity. In 2000, over 15% of Americans aged 6-19 were obese/overweight. In 2020, this statistic grew tremendously, when obesity was prevalent in 22.2% of people aged 12 to 19-years old in America alone (CDC 2022). In an effort to battle obesity, government and societies have turned to schools to be the firsthand prevention for the pandemic. This has been evident in past national and state legislation regarding what students eat at lunch. However, the focus of these actions has been on school food, but the importance of exercise within schools has been overlooked. Using a survey, the aim of this research is to analyze the exercise patterns of high school students in an Orange County Public School. The findings conclude that about 30% of students are getting the recommended amount of exercise through the school each day, but most of these students are doing so through extra-curricular sports. Therefore, the students who are getting enough exercise are doing s because they want to, not because the school is making them. Consequently, schools need to play a bigger role in challenging obesity by requiring more mandatory exercise for students.

The Medication Therapies and Existing COVID-19 Vaccines, the Nature of Manufacture, and the Degree of Immunity

The globe is currently dealing with one of the worst epidemics, SARS-CoV-2. The various drugs can treat the clinical symptoms of SARS-CoV-2, and combination therapies may be more effective than monotherapy. This study discussed various COVID-19 subtypes, pharmaceutical effectiveness, the advantages and disadvantages of medications, and mortality rates in various countries. The drugs were reviewed as well. The macrolides family can produce anti-inflammatory cytokines against COVID-19, but they may cause side effects such as bacterial resistance. Although anti-malarial drugs may inhibit the entrance of the virus into cells, they are not a common medicine in COVID-19 treatment. The simultaneous consumption of corticosteroids with other drugs can be beneficial for high-intensity patients. In addition, remdesivir may be effective in severe cases of the disease. However, the administration of several drugs can be more effective compared to a single drug. Although pharmacological combinations can be effective in treating SARS-CoV-2, vaccines are considered to be the most successful approach for reducing COVID-19. Pfizer/ BioNTech and Moderna vaccines are based on the mRNA of viruses and provide an efficiency of about 95%. Sputnik V was prepared by two replication-incompetent adenovirus vectors. The AstraZeneca–Oxford vaccine was prepared based on viral vectors, and its efficacy has a variable range of 62%–90%. The vaccines based on an inactivated virus provided innate immunity in the body. Soberana 2 is a recombinant vaccine. Generally, all vaccines may have positive effects on the prevention of COVID-19, but further clinical trials are necessary. These findings suggest each available vaccine is advised for protection against COVID-19.

The assessment of using fiber produced from plastic broom bristles on impact property of Normal-weight concrete slabs

One of the worst epidemics that endangers our life and has an impact on the future is the epidemic of road accidents. The goal of this study is to define traffic accidents, comprehend their causes, pinpoint the key elements that affect the seriousness of driver injuries, and ultimately identify the factors that contribute to accidents, such as excessive speed, alcohol, and drug use, the driver, the road, the vehicle, and environmental factors. Understanding prior research and studies is crucial. In earlier experiments, data visualization is accomplished using the VOS viewer. The Dimension Web of Science and Scopus websites were used to download the information for the keywords in Excel format. By country, it lists these terms by authors and researchers. The researcher was able to conduct a study that was identical to his or her study with the aid of the keywords "driver injury severity", "driver crash", and "crash analysis".

A scientometric analysis and bibliometric review of driver injury severity crashes studies

One of the worst epidemics that endangers our life and has an impact on the future is the epidemic of road accidents. The goal of this study is to define traffic accidents, comprehend their causes, pinpoint the key elements that affect the seriousness of driver injuries, and ultimately identify the factors that contribute to accidents, such as excessive speed, alcohol, and drug use, the driver, the road, the vehicle, and environmental factors. Understanding prior research and studies is crucial. In earlier experiments, data visualization was accomplished using the VOS viewer. The Dimension, Web of Science, and Scopus websites were used to download the information for the keywords in Excel format. By country, it lists these terms, authors, and researchers. The researcher was able to conduct a study that was identical to his or her study with the aid of the keywords " driver injury severity," " driver crash," and " crash analysis.".

Crosstalk between RNA viruses and DNA sensors: Role of the cGAS-STING signalling pathway.

Despite only comprising half of all known viral species, RNA viruses are disproportionately responsible for many of the worst epidemics in human history, including outbreaks of influenza, poliomyelitis, Ebola, and most recently, the coronavirus disease-2019 (COVID-19) pandemic. The propensity for RNA viruses to replicate in cytosolic compartments has led to an evolutionary arms race and the emergence of cytosolic sensors to recognise and initiate the host innate immune response. Although significant progress has been made in identifying and characterising cytosolic RNA sensors as anti-viral innate immune factors, the potential role for cytosolic DNA sensors in RNA viral infection is only recently being appreciated. Among these, the cyclic GMP-AMP synthase (cGAS)-stimulator of interferon genes (STING) pathway has attracted increasing attention. The cGAS-STING signalling pathway has emerged as a key innate immune signalling axis that is implicated in diverse human diseases from infectious diseases to neurodegeneration and cancer. Here we review the existing literature on RNA viruses and their reciprocal interactions with the cGAS-STING pathway and share insights into RNA virus diversity by touching on the similarities and differences of RNA viral strategies.

Epidemics, Inequality, and Poverty in Preindustrial and Early Industrial Times

Recent research has explored the distributive consequences of major historical epidemics, and the current crisis triggered by COVID-19 prompts us to look at the past for insights about how pandemics can affect inequalities in income, wealth, and health. The fourteenth-century Black Death, which is usually believed to have led to a significant reduction in economic inequality, has attracted the greatest attention. However, the picture becomes much more complex if other epidemics are considered. This article covers the worst epidemics of preindustrial times, from the Plague of Justinian of 540–41 to the last great European plagues of the seventeenth century, as well as the cholera waves of the nineteenth. It shows how the distributive outcomes of lethal epidemics do not only depend upon mortality rates, but are mediated by a range of factors, chief among them the institutional framework in place at the onset of each crisis. It then explores how past epidemics affected poverty, arguing that highly lethal epidemics could reduce its prevalence through two deeply different mechanisms: redistribution toward the poor or extermination of the poor. It concludes by recalling the historical connection between the progressive weakening and spacing in time of lethal epidemics and improvements in life expectancy, and by discussing how epidemics affected inequality in health and living standards. (JEL D31, I12, I14, I30, N30, J11, J31)

Long-Term Changes of HIV/AIDS Incidence Rate in China and the U.S. Population From 1994 to 2019: A Join-Point and Age-Period-Cohort Analysis.

Although HIV caused one of the worst epidemics since the late twentieth century, China and the U.S. has made substantial progress to control the spread of HIV/AIDS. However, the trends of HIV/AIDS incidence remain unclear in both countries. Therefore, this study aimed to highlight the long-term trends of HIV/AIDS incidence by gender in China and the U.S. population. The data were retrieved from the Global Burden of Disease (GBD) database since it would be helpful to assess the impact/role of designed policies in the control of HIV/AIDS incidence in both countries. The age-period-cohort (APC) model and join-point regression analysis were employed to estimate the age-period-cohort effect and the average annual percentage change (AAPC) on HIV incidence. Between 1994 and 2019, we observed an oscillating trend of the age-standardized incidence rate (ASIR) in China and an increasing ASIR trend in the U.S. Despite the period effect in China declined for both genders after peaked in 2004, the age effect in China grew among the young (from 15–19 to 25–29) and the old age groups (from 65–69 to 75–79). Similarly, the cohort effect increased among those born in the early (from 1924–1928 to 1934–1938) and the latest birth groups (from 1979–1983 to 2004–2009). In the case of the U.S., the age effect declined after it peaked in the 25–29 age group. People born in recent birth groups had a higher cohort effect than those born in early groups. In both countries, women were less infected by HIV than men. Therefore, besides effective strategies and awareness essential to protect the young age groups from HIV risk factors, the Chinese government should pay attention to the elderly who lacked family support and were exposed to HIV risk factors.

Economic Crisis in Sri Lanka Due to the COVID-19 Epidemic

The COVID-19 pandemic is one of the worst epidemics in resent history. Many countries around the world are currently affected by the epidemic and Sri Lanka is just another country suffering from the epidemic.The epidemic is affecting the economy in many ways. It focuses on how the COVID-19 epidemic has affected Sri Lanka’s economy, employment, GDP, tourism and poverty. Further, steps must be taken to control the spread of the epidemic and restore the economy. Or it may take years for the economy to recover.

History of Pandemics and COVID-19: What We are Learning from this Pandemic to Be Prepared for the Next One

Since the beginning of human history, the pathogens affect the humankind. The emerge of the new outbreak of coronavirus-19 (COVID-19) is not new in the history of plagues. However, this pandemic has a huge difference from the others due to its ability to affect worldwide at the same time, which brings new perspectives to our future. In this review, we listed some of the worst epidemics and pandemics of human civilization and the new outbreak, listing the pathogens, the spread, and the consequences for mankind. Our search included articles in the main database (PubMed/Medline, Elsevier Science Direct, Scopus, Isi Web of Science, Embase, Exerpta Medica, UptoDate, Lilacs, Novel Coronavirus Resource Directory from Elsevier), in the high-impact international scientific Journals (Scimago Journal and Country Rank - SJR - and Journal Citation Reports - JCR), such as The Lancet, Science, Nature, The New England Journal of Medicine, Physiological Reviews, Journal of the American Medical Association, Plos One, Journal of Clinical Investigation, and in the data from Center for Disease Control (CDC), National Institutes of Health (NIH), National Institute of Allergy and Infectious Diseases (NIAID) and World Health Organization (WHO). We prior selected meta-analysis, systematic reviews, article reviews, and original articles in this order. We reviewed 192 articles and used 94 from March to June 2020, using the terms coronavirus, SARS-CoV-2, novel coronavirus, Wuhan coronavirus, severe acute respiratory syndrome, 2019-nCoV, 2019 novel coronavirus, n-CoV-2, COVID, n-SARS-2, COVID-19, corona virus, coronaviruses, history of pandemics and epidemics, pathogens, plagues, with the tools MeSH (Medical Subject Headings), AND, OR, and the characters [,“,; /., to ensure the best review topics. We concluded that this pandemic will change the social and economic order, as well as it is the first that affects us quickly. So, the experience of COVID-19 could teach us how to be prepared for other outbreaks in the future.

The worst epidemics in human history

Today the world's attention is focused on China, on the epidemic caused by coronavirus infection. As of the end of February, more than 77 thousand people affected with the disease had been registered, fatal outcome had been observed in more than 2500 cases. The Chinese authorities announced the beginning of a new epidemic at the very end of 2019. Moreover, if fatal outcomes were observed a month after the onset of mass incidence only within the country, then, in February, they went beyond its borders and were registered in Japan, Taiwan, South Korea, Iran, the Philippines, France and Italy. It is noteworthy that China became a source of the spread of the epidemic process not for the first time. So, in 2002 it was in this country, in Guangdong, that an outbreak of SARS was recorded, and in 1997, avian influenza spread from Hong Kong around the world. To tell the truth, the death rate from these diseases did not exceed thousands of people in both cases, and in the case of bird flu (or avian influenza), development of the disease was observed only in people eating chicken meat. It should be noted that in the entire history of the development of mankind, more people died as a result of epidemics and pandemics, than in all wars combined. Let us recall the worst epidemics in the history of mankind, the victims of which were millions of people.

Rijeka and its surroundings in 1918-1919

The Spanish flu, one of the worst epidemics in history, appeared in 1918, on the eve of the end of the World War I. The characteristic of the epidemic on the territory of the city of Rijeka has been poorly studied. Certainly, the lack of primary sources, such as hospital registries, have made the understanding of the incidence and the course of the epidemic in the city more difficult. Therefore, the death certificates have emerged as the main primary source. The purpose of this paper is to explore and describe mortality caused by the (Spanish) flu during 1918 and at the beginning of 1919, using the death registers of those who lived in the area of the city center and the surrounding parishes. The results of the Spanish flu mortality research in the area of Rijeka are compared to the Spanish flu specific mortality on the territory of the three parishes situated in the wider area of Rijeka – Brseč, Mošćenice and Lovran. The elucidation of the characteristics of the Spanish flu epidemic and its impact on the quotidian life in the city of Rijeka is possible through the analysis of daily newspapers as well. In this paper, we have explored such articles in the La Bilancia, Rijeka’s newspaper published in Italian.

Host-Encoded Sensors of Bacteria: Our Windows into the Microbial World.

Bacterial pathogens can be very efficient at causing disease and are the cause of some of the worst epidemics that have affected humanity. However, most infections are prevented by the actions of our immune system. Immune activation depends on the rapid detection of bacteria by a diverse family of sensory proteins known as pattern recognition receptors. These receptors detect conserved features of bacteria that are not found in humans but are often necessary for survival within the host or environment. In this review, we discuss the strategies used by pattern recognition receptors to detect bacteria and their products. We also discuss emerging evidence that some pattern recognition receptors can be activated by bacterial pathogens specifically, through the surveillance of host activities that are commonly targeted by virulence factors. This collection of surveillance mechanisms provides an interconnected network of defense, which is important to maintain the germ-free environment of the inner organs of humans and other multicellular organisms.

Screening Pregnant Women and Their Neonates for Illicit Drug Use: Consideration of the Integrated Technical, Medical, Ethical, Legal, and Social Issues.

North America is currently suffering from one of the worst epidemics of illicit drug use in recent history: the opioid crisis. Pregnant women are not immune to the ravages of substance misuse which affects themselves, their pregnancies, and the wider community. The prevalence of drug misuse in pregnancy is not well quantified due to the lack of good validated tests, cooperation between clinicians and scientists developing tests, and consensus as to who should be tested and how results should be used. A wide range of tissues can be tested for drug use, including maternal blood, urine, and hair; neonatal meconium, urine, and hair; and placenta and umbilical cord tissues. Testing methods range from simple spectrophotometry and clinical chemistry to sophisticated analytical HPLC or mass spectrometry techniques. The drive for ever greater accuracy and sensitivity must be balanced with the necessities of medical practice requiring minimally invasive sampling, rapid turnaround, and techniques that can be realistically utilized in a clinical laboratory. Better screening tests have great potential to improve neonatal and maternal medical outcomes by enhancing the speed and accuracy of diagnosis. They also have great promise for public health monitoring, policy development, and resource allocation. However, women can and have been arrested for positive drug screens with even preliminary results used to remove children from custody, before rigorous confirmatory testing is completed. Balancing the scientific, medical, public health, legal, and ethical aspects of screening tests for drugs in pregnancy is critical for helping to address this crisis at all levels.

Inconsistencies in reporting risk information: a pilot analysis of online news coverage of West Nile Virus.

West Nile Virus (WNV) has been reported as one of the worst epidemics in US history. This study sought to understand how WNV news stories were framed and how risk information was portrayed from its 1999 arrival in the US through the year 2012. The authors conducted a quantitative content analysis of online news articles obtained through Google News ( N = 428). The results of this analysis were compared to the CDC's ArboNET surveillance system. The following story frames were identified in this study: action, conflict, consequence, new evidence, reassurance and uncertainty, with the action frame appearing most frequently. Risk was communicated quantitatively without context in the majority of articles, and only in 2006, the year with the third-highest reported deaths, was risk reported with statistical accuracy. The results from the analysis indicated that at-risk communities were potentially under-informed as accurate risks were not communicated. This study offers evidence about how disease outbreaks are covered in relation to actual disease surveillance data.

Analysis of Improper Disposal of Solid Wastes in a Low-Income Area of Accra, Ghana

We examined the causes of poor sanitary condition in Gbawe, a low-income suburb of Accra, the capital city of Ghana in the current era of one of the worst epidemics of cholera in Accra which has been linked to improper disposal of wastes. This survey-based study identified improved and unimproved methods for disposal of household solid wastes. The likelihood of a person using an improved method of disposing solid wastes increased with increasing household income but it decreased with increasing number of household members. A conclusion arising from the study is the need for local government authorities to abolish the fees and charges imposed on users of public waste collection centres in order to encourage proper disposal of solid wastes. Indirect methods of financing local authorities such as increased levels of property taxes need to be explored to finance the development and maintenance of adequate numbers of public waste collection centres to encourage proper disposal of solid wastes by householders and the general public.

Kenya Trypanosomiasis Research Institute cryobank for human and animal trypanosome isolates to support research: opportunities and challenges.

Human African trypanosomiasis (HAT) is classified in the category of the most neglected tropical diseases. In man, the disease is caused by two tsetse (Glossina spp.)-transmitted trypanosome subspecies: Trypanosoma brucei gambiense, which is responsible for the chronic form of HAT in West and Central Africa, and T. b. rhodesiense, which causes acute disease in eastern and southern Africa. African animal trypanosomiasis (AAT) is caused by various trypanosome species, the major ones being T. vivax, T. congolense, and T. evansi [1]. Current diagnostic tools are inadequate and diagnosis is complicated, whereas the drugs for treatment are highly toxic and not very effective; patients die if untreated [2]. In 2005, an annual prevalence of 50,000–70,000 cases per year and incidence rates of 15,000–17,000 cases per year were reported [3]. Although recent data from the World Health Organization (WHO) shows that the number of reported cases of HAT declined to less than 10,000 in 2009, leading to speculation that the disease could be eliminated [4], [5], there is great need to maintain vigilance. The East African Trypanosomiasis Research Organization (EATRO) was established to carry out research and develop technologies for effective control of trypanosomiasis. In view of this, a trypanosome cryobank was established in Tororo, Uganda, in the mid-1950s to provide materials for research. At that time, dry ice was used as a refrigerant, but in 1977 it was replaced with liquid nitrogen. Following the collapse of the East African Community in 1977, the Kenya Trypanosomiasis Research Institute (KETRI) was established to take over the functions of tsetse and trypanosomiasis research in Kenya. The cryobank was therefore transferred to KETRI during this period. In 2003, following a reorganization of research institutions by the Government of Kenya, KETRI was merged with the Kenya Agricultural Research Institute (KARI) and renamed the Trypanosomiasis Research Centre (KARI-TRC). KARI-TRC continued with all the research programmes and activities that were being carried out under KETRI, including collection and preservation of trypanosome stabilates. The institution developed a policy on stabilate collection by scientists and clinicians for cryopreservation. We describe the establishment of the cryobank and procedures used in cryopreservation of stabilates and summarize the data (numbers and types) on trypanosome species stored in the cryobank, which are available for use in research by the scientific community. The cryobank contains 2,347 stabilates, including 1,747 primary isolates, out of which there are 42 mixed infections and one miscellaneous Herpetomonas muscorum, and 600 derivatives, including six mixed infections. Primary isolates were collected mainly from countries in the eastern Africa region, including Kenya, Uganda, Tanzania, Sudan, and Ethiopia. However, collections or donations from countries outside the region, including Nigeria, Mozambique, Botswana, Germany, and South America, have been added as part of collaborations between KARI-TRC and other institutions around the world. The stabilates were isolated between 1934 and 2010. The majority of the stabilates were recovered between 1960 and 1970 (Figure 1), the same period when some of the worst epidemics occurred, after which the numbers added have been on the decline. The period from 1940 to 1949 coincided with World War II, when the work on trypanosomiasis research and control stalled: the laboratories in eastern Africa that were the source of isolates were closed, only to resume after 1945 when the war came to an end. Open in a separate window Figure 1 Number of primary trypanosome stabilates collected, preserved, and stored at the Kenya Trypanosomiasis Research Institute cryobank. Trypanosomes Trypanosomes are extracellular protozoan parasites which cause disease in humans and animals. Isolation and cryopreservation of new trypanosome strains from patients in different HAT foci ensures availability of these stabilates for use in parasitological, biochemical, molecular, serological, and pharmacological studies many years after their isolation from the host. Brun et al. [1] observed that one of the major obstacles in the elucidation of the factors responsible for relapses after melarsopol treatment was lack of recent T. b. gambiense isolates from patients from various endemic areas where the problem had been reported. The WHO steering committee on human African trypanosomiasis treatment and the East African Network for Tsetse and Trypanosomiasis (EANETT) have therefore recommended that collection of stabilates be a continuous activity in order to monitor the occurrence and spatial distribution of treatment failure [6]. Since its inception, KETRI has established an institutional policy of encouraging collection of stabilates by scientists and clinicians for cryopreservation. In this paper, we describe the establishment of the cryobank and summarize the data (numbers and types) on trypanosome species stored in the cryobank, which are available for research by the wider scientific community.

Substance Abuse and HIV/AIDS in the Caribbean

The Caribbean and Central America represent a formidable challenge for researchers and policy makers in the HIV field, due to their pronounced heterogeneity in terms of social, economic, and cultural contexts and the different courses the HIV epidemic has followed in the region. Such contrasting contexts and epidemics can be exemplified by 2 countries that share the island of Hispaniola, the French Creole-speaking Haiti, and the Spanish-speaking Dominican Republic. Haiti has experienced the worst epidemics outside of sub-Saharan Africa. Following a protracted economic and social crisis, recently aggravated by a devastating earthquake, the local HIV epidemic could experience resurgence. The region, strategically located on the way between coca-producing countries and the profitable North American markets, has been a transshipment area for years. Notwithstanding, the impact of such routes on local drug scenes has been very heterogeneous and dynamic, depending on a combination of local mores, drug enforcement activities, and the broad social and political context. Injecting drug use remains rare in the region, but local drug scenes are dynamic under the influence of increasing mobility of people and goods to and from North and South America, growing tourism and commerce, and prostitution. The multiple impacts of the recent economic and social crisis, as well as the influence of drug-trafficking routes across the Caribbean and other Latin American countries require a sustained effort to track changes in the HIV risk environment to inform sound drug policies and initiatives to minimize drug-related harms in the region.

The Role of Cultural Practices and the Family in the Care for People Living With HIV/AIDS Among the Igbo of Anambra State, Nigeria

The HIV/AIDS pandemic is one of the worst epidemics that have been experienced by humankind. It is indeed a major event of our time. The pandemic has killed so many people around the world and Sub-Saharan Africa is the worst hit. The nature of the pandemic lent it to stigma and discrimination, which have made caring for people living with HIV/AIDS (PLWHA) a big problem. It has also brought so much suffering on PLWHA around the world. This article examines the role of culture and the family in the care for PLWHA in Anambra State. Quantitative and Qualitative data collection methods (questionnaire and in-depth interviews) are used to elicit information from respondents. A total of 1000 copies of a questionnaire were administered on adult males and females and 914 were completed and analyzed. Furthermore, in-depth interviews were conducted on 10 opinion leaders using an interview guide. Data were analyzed in themes based on the objectives and the data from in-depth interviews were used to support data from the questionnaire. The results showed that certain cultural practices such as cultural obligations to sick, blood relations, collective ownership of children, affinity to blood relations, and strong marital bond enhance care and support for PLWHA. Also, the burden of care for PLWHA was found to be on the family in the study area. In conclusion, cultural practices and the family play major roles in the care for PLWHA in the area and should be harnessed in order to make life more comfortable for PLWHA.

Social cash transfers to support children and families affected by HIV/AIDS

In response to the critical need of affected children and families, the compelling evidence for their benefits, and the receptive environment on the part of governments and donors, several local and international organizations are piloting cash transfers programmes as a mechanism to mitigate the impact of human immunodeficiency virus (HIV) and acquired immune deficiency syndrome (AIDS) on affected communities in sub-Saharan Africa. Few programmes, however, are conceptualized or implemented within a broader framework of social protection, socioeconomic development or human rights. This article traces briefly the philosophical underpinnings of social security in Europe, Latin America and southern Africa to illustrate how income transfers, or social grants, can advance development, increase citizenship in evolving democracies and help to realize human rights, especially through the active engagement of communities in the demand for good quality services of benefit to all. Stand-alone cash transfers programmes, motivated to bring relief to destitute families, have immediate benefits for recipients. However, they can be hijacked by local political and community self-interests and encourage perverse household and community adaptations to receive benefits. In contrast, it is possible to design local cash transfer programmes for the benefit of children that speak into and advance the broader developmental and human rights agenda. HIV and AIDS is intertwined with issues of human rights, no less so than in the case of the poorest families affected by the worst epidemics in the world.

The National Strategic Plan of South Africa: what are the prospects of success after the repeated failure of previous AIDS policy?

Hitherto, the story of HIV/AIDS in South Africa is, to a large extent, one of lost opportunities. Whereas the country has one of the worst epidemics in the world, consecutive national AIDS strategies have been repeatedly marked by failure over almost three decades. Understandably, South Africa's most recent HIV/AIDS policy, the HIV & AIDS and STI Strategic Plan for South Africa, 2007-2011 (NSP), has been greeted with general acclaim. However, what are its real prospects of success against the backdrop of the repeated failures of the past? The first objective of this review is to systematically identify the core reasons for past policy failures. Using a comprehensive analytical framework, this article presents a systematic review of the literature on postapartheid AIDS policy in South Africa. The analysis demonstrates that a complex interplay among the content, context, actors and process of AIDS policy created a gap between policy making and policy implementation, which rendered near-ideal AIDS policies ineffective. Secondly, we evaluate the chances of success of the current NSP by examining both the policy-making phase and the resulting policy document in light of the reasons for past policy failures. Our analysis shows that the NSP contains dynamic and comprehensive policy content, sensitive to the socio-economic and cultural dimensions of HIV/AIDS. However, many of the political actors that hampered treatment implementation in the past, and who deepened the gap between government and civil society, are still in office. Monetary and human resource shortages also create a policy context that is infertile for the implementation of a comprehensive HIV/AIDS strategy, as envisaged in the NSP. Finally, these health system restrictions have a clear negative impact on the process of policy implementation. Without the mobilization of people living with HIV/AIDS and their communities, the NSP will be ineffective in bridging the gap between policy intentions and policy implementation. The strength of this article lies in its systematic analysis of previous policy responses, as a basis for appraising current AIDS policy. Although such an approach tends to simplify the complexities of the actual policy environment, it nonetheless draws to the attention of policy participants the importance of and the complex interrelationships among the different dimensions of AIDS policy.