Introduction

Globally, humans have suffered, experienced, and endured deadly pestilences over the centuries. Historically, the worst pandemics ever recorded in the world include the 14th-century Black Death, the Spanish and Indian flu, HIV/AIDs, the plague, the various waves of Cholera, and Ebola,^1–3 and the most recent novel coronavirus – SARs-CoV-2, commonly known as COVID-19.⁴ These among others have been a great threat to humanity from one generation to another, with their impact being massive loss of lives, economic losses, social and racial stigma among other health-related ills.^1,2 Nonetheless, with credence to the inquisitive human mind, through science and technology, researchers and healthcare practitioners have tirelessly and effectively worked on vaccines and treatment plans to save lives.

This paper aims to compare selected aspects of the coronavirus and HIV/AIDS. It is beyond the scope of this paper to cover every aspect of these diseases. Therefore, our focus will be on the following components: their etiology and epidemiology; response and treatment; myths, misconceptions, and conspiracies associated with the two diseases; and their impact. From these aspects, we shall provide a candid discussion on the similarities and differences, and henceforth draw insightful lessons on how to prepare for and respond to pandemics in the future.

Before delving into the core issues, we briefly bring to the fore how these diseases unfolded into the global scene. On March the 11th, 2020, the World Health Organization officially declared COVID-19 a pandemic, after the virus had spread to 114 countries, infecting more than 120,000 and killing over 4000 people worldwide.^5–7 This was in the early days of the disease outbreak, but its imminent danger was being felt. This is because, as evidenced by international organization reports and eclectic research studies, viral infections were spreading too quickly, perhaps due to human movements and interactions across the globe.^3,4,7 With the perceived or real danger of the disease, scientists and significant others were putting resources and knowledge together to move with speed to strategically mitigate the spread and counter the mushrooming of misinformation, and disinformation that had become rampant in social media, hampering public health efforts across the globe.^4,7 An outbreak that was seen as one country’s (China) problem, like wildfires became a global health emergency and placed the world at a standstill for almost two years. By 22nd August 2023, COVID-19 was associated with over 769.77 million cases, and over 6.95 million deaths worldwide.^4,8

As intimated earlier, COVID-19 like other pandemics is riddled with a myriad of myths and conspiracy theories. For instance, a study in Ethiopia reported that protection from the virus was placed on religiosity and the effectiveness of consuming some food items, being exposed to hot weather, using traditional medicine, and alcohol drinking.⁹ In addition to these, 36.9% of the respondents held false assurances that they were living far away from areas where COVID-19 was rampant, and no local cases were reported.⁹ Inarguably, this posed a danger of exposure to the virus by failing to adhere to the public health regulations. A quantitative study investigating the perceptions of respondents on various aspects of COVID-19 found the following;

the novel coronavirus is deadly (83.3%), hand sanitizers do kill the virus (67.5%), face mask offer protection against the virus (55.8%), drying the hands with a hand dryer helps to prevent the virus (44.2%), coronavirus affect only the elderly (95%), the virus can spread by mosquito bites (87.5%), antibiotics are effective for treatment (60%) and homemade remedies can cure the coronavirus. (54. 2%)¹⁰

These statistics indicate indeed that there was a sense of confusion, misinformation, and conspiracies about the disease, which we believe impacted either positively or negatively in responding to and managing of COVID-19 pandemic outbreak. The question of how some of these theories helped people to cope with the disease remains an opportunity for further research. It is of paramount importance to explore these misconceptions and keep the public fully educated and informed about the facts of a pandemic outbreak to protect themselves.

Comparatively, while the COVID-19 outbreak was first reported in China and illusionary perceived as a Chinese disease, HIV/AIDS is attributed to the African continent. Mythically, HIV/AIDS was perceived as a “black peril” and debates that Africans as a racial segmentation were more susceptible to the virus were part of public discourse for years.^11–13 Just like COVID-19, the early years of the HIV/AIDs outbreak were characterized by denial, fear, confusion and high levels of ignorance, which were reflected in the inconsistent explanations about the origins and transmission of the disease, as demonstrated in other sections of this paper. Apparently, misconceptions about HIV transmission are still prevalent, despite significant efforts in creating public awareness, available medication, and scientific evidence about the epidemiology of the disease.¹⁴ Previous studies from, Kenya, South Africa, Ghana and Indonesia reported misconceptions such as HIV could be spread through mosquito bites, touching an infected person, a healthy-looking person cannot be HIV positive, HIV can be cured by having intercourse with a virgin, eating fresh vegetables, and making ancestral sacrifices.^15–19 It is against this backdrop that, curious questions remain as to who or what is responsible for these pandemics’ outbreaks, how and why the public responds in the way they do, and how best can the public respond to future pandemics among others. This paper compares selected aspects of the two pandemics to understand the similarities and differences and draw insightful lessons on pandemic outbreaks to inform public healthcare interventions.

Problems Statement

The history of mankind has been confronted by unprecedented disasters including health-related pandemics. Pandemics in the past and even in the modern dispensation have massive effects on the human species. Recent pandemics such as Coronavirus and HIV/AIDS have caused millions of deaths,²⁰ economic losses,^7,21–23 societal disintegration and perfidious impacts on mental health.^24,25 Moreover, these diseases create fear, uncertainty, stigma, and labelling among individuals, families, communities, and countries. A recent study revealed that people tend to avoid contact with individuals affected with COVID-19 (74.3%) or AIDS (59.0%), including their family members (70.4% for COVID-19 and 47.9% for AIDS).²⁶ Irrefutably, the implications for the fear of contagion are avoidance, blame, and secondary discrimination, which may stifle the efforts by governments and the World Health Organization in combating the pandemics.

However, through significant scientific breakthroughs in terms of discovering and developing vaccines, and social measures such as quarantines, countries have been able to combat the spread of viruses, hence saving lives. However, despite these milestones, the COVID-19 pandemic has tested and challenged countries’ healthcare systems as well as administrative structures that are not yet holistically prepared and resourced to detect, predict, and control the spread of pandemics. Therefore, as alluded to by other researchers, there is a need to focus on developing better ways to prevent the emergence of new pandemics and creating a holistic response system around the globe.²

The public health messaging of pandemics is of paramount importance to effectively and efficiently respond to and manage the impacts of diseases. Research indicates that information on pandemics such as COVID-19 and HIV/AIDS are marred and muddled by misinformation, misconceptions, disinformation, conspiracies, and myths from different sources such as social media, all rendering the efforts to combat the disease less effective.^7,26 A study by Olson and Nelson indicates some conspiracies about COVID-19 as being a group of elites using COVID-19 to gain power (new world order debate); the COVID-19 virus is not more contagious than the flu; the 5 G networks and technology being the cause of the disease; and that the virus was produced in a lab in Wuhan China among others.⁷

On the other hand, even after HIV/AIDS has been in the public domain for decades, the latest studies continue to show misconceptions and dominant myths about the disease.^27,28 This is detrimental to the prevention and management programs towards the elimination of the virus. Therefore, demystifying misconceptions and mythical nuances about pandemics and epidemics is unequivocally vital in averting the health hazards to healthcare providers, the public, and loss of financial resources for any country. Thus, comprehensive knowledge of HIV/AIDS and Coronavirus, for instance, is fundamental for behavior change and uptake of recommendable healthcare services.

Materials and Methods

The origins and impacts of pandemics are multifaceted. For instance, HIV/AIDS and Coronavirus have economic, social, health, political, religious, and technological dimensions. This means to understand these aspects different research approaches such as quantitative, qualitative, and mixed methods should be used.^29–31 This paper adopted a discourse analysis, a sub-method of qualitative research to compare selected aspects between COVID-19 and HIV/AIDS pandemics. Although COVID-19 is a recent pandemic compared to HIV/AIDS, which spans close to half a century, the two diseases appear to have some interesting commonalities that prompt or motivate a research investigation. Through a literature search, no straightforward publications comparing the two pandemics were found; hence this paper seeks to address that gap. However, there is a plethora of literature on these pandemics, thus providing adequate information to conduct a comparative analysis. Notably, this is not a systematic review, but a discourse analysis of various literatures to inform discussions driving to a meaningful conclusion on the subject. The primary research paradigms informing this analysis are the pragmatism and interpretivism paradigms.^29,31 These paradigms are critical in analyzing and understanding social issues from multiple lenses in social settings. This is useful in this paper that entails, the health, social, economic, and political dynamics of diseases.

The paper utilized journal articles published in the English language, from across the world. These articles used quantitative, qualitative, and review methods. These multiple methods provide confidence that the information reported in this paper is valid, verifiable, and reliable. The articles and other relevant information from credible organizations such as the World Health Organization and Centers for Disease Control and Prevention were searched using words and statements such as COVID −19; HIV, AIDS, myths about HIV, myths about COVID-19; vaccines on COVID-19; origin of COVID-19/HIV/AIDS, treatment, and management of HIV/AIDS/ COVID −19 etc. Google Scholar was the main source of these articles.

The analysis focused on comparing aspects such etiology and epidemiology of the pandemics, myths and conspiracies, response and treatment, and economic and social impacts among others. Unearthing the similarities and differences, either behavioral or medical, was imperative in drawing insightful and informative lessons on current and future preparedness for response and management of pandemics of mass destruction.

Limitations

This paper focused on comparing two pandemics whose lifespans are different in various contexts. The major limitation of this analysis is that it has not compared regions such as Africa, Asia, Europe, and America to indicate variations in the various aspects and impact of the diseases. Perhaps, such findings would indicate how different communities respond and manage outbreaks of pandemics. As such the findings are more inclined to the African contexts. Nonetheless, the findings are insightful on the impact and other characteristics of the pandemics across the globe.

Findings

Aetiology and Epidemiology of HIV/AIDS

It is important to understand the genesis of diseases and how they spread across populations. Such knowledge and understanding expedites their effective and efficient interventions. The term aetiology refers to the origin and causes of diseases or factors that predispose towards certain diseases; while epidemiology, on the other hand, focuses on public health issues, the appropriate responses, interventions, and solutions.^3,32 The early cases of HIV/AIDS were reported in the 1980s in humans and were associated with a type of ape (Chimpanzee) in Central Africa, where people are believed to have encountered the animals through hunting in the late 1800s.³ This implies that the human socioeconomic activities of hunting and gathering wild fruits might have predisposed them to the chimpanzee’s simian immunodeficiency virus (SIV), which is believed to have mutated intoHIV.³ Notably, therefore, there are possibilities that people lived with virus for quite a long time before it was scientifically discovered.

HIV is mainly transmitted from person to person through blood or body fluids, sexual intercourse, and breastfeeding.^20,33 HIV attacks the body’s immune system and progresses to AIDS if the immune system is severely weakened.^20,33,34 As of the year 2022, 39 million people were living with HIV/AIDS, and over 40 million had died globally since the onset of the virus.²⁰ Notably, the African continent has been hardly hit, with statistics indicating that 3.2% of the population was living with the virus in 2022.^20,34 Perhaps, a sharp difference between HIV/AIDS and coronavirus is their gestation period, meaning the time it takes from inception to attain a full-blown status. HIV/AIDS has a longer gestation period of 7–10 years if no interception of ARVs occurs, while coronavirus has a very shorter gestation period of between 7–14 days. This means one can succumb to death after the 14th day from the time the virus got into one’s body.³⁵

Etiology and Epidemiology of Coronavirus

Just like HIV/AIDS, the outbreak of COVID-19 is attributed to animals. The genesis of COVID-19 is believed to be a zoonotic transmission associated with animals such as bats and pangolins in a Chinese seafood market.^36–38 Credible scientific evidence shows that bats and pangolins have a gene sequence like SARs-Cov-2 at 96.2% and 99% respectively.³⁸ Therefore, these animals are strongly believed to be the source of coronavirus disease.³⁹ The transmission, however, remains to be person-to-person accounting for the widespread of the disease across the globe in a short period.^36,40

COVID-19 patients manifest clinical features such as fever, cough, fatigue, dyspnoea and conjunctivitis, to mention but a few, varying from asymptomatic to symptomatic.^41–43 Other patients reported loss of senses such as taste and smell.⁴⁴ Research shows that the mean incubation period of COVID-19 is three to nine days, with an asymptomatic period lasting for fourteen days.^36,37 The clinical diagnosis includes physical examination, nucleic acid detection, and CT imaging among others (Ullah et al, 2021).

The Myths and Conspiracy Theories on HIV/AIDS and COVID-19 Pandemics

Myths consist of narratives that influence people’s everyday lives. Myths are usually endorsed or dispelled by political leaders, community rulers, and religious personalities among others, and they shape people’s beliefs on various lifestyles.⁴⁵ Thus, cultural, political, and religious beliefs have a significant impact on the public’s mindset in a particular region or country.⁴⁵ Myths related to various pandemics have been prevalent from time to time, and it takes decisive interventions to demystify them through an evidence-based approach. In the current dispensation, myths about pandemics are shared widely and easily from one person to another, a human behavior that has been catapulted by the plethora of social media platforms and mobile phone technology. Myths about pandemics can be very dangerous, as they can lead to over-complacency or other health hazards.⁴⁶

Myths and Conspiracy Theories About COVID-19

The onset of global pandemics such as COVID-19 is characterised by the diffusion of misinformation about the virus, its origins, and effective prevention and treatment strategies. Since the outbreak of COVID-19, researchers have investigated and recorded numerous myths and false theories about the disease. For instance, a study by Coffie, Nkukpornu, Kankam and Ocloo identified that the study participants believed COVID-19 is a disease for white people and not black people; the disease only attacks and kills people living in cold regions; the African blood is immune to coronavirus; the disease is not real, it is stage managed; taking alcohol, ginger, garlic and exposing oneself to hot temperatures can prevent or cure COVID-19.⁴⁷ The conspiracy theories around COVID-19 also include the impact of advancement in technology, with the 5G mobile network being perceived as a cause of the pandemic, and that the vaccine would change the human DNA.⁴⁸ Moreover, there are false theories about the vaccine containing a microchip, that would be used to control people’s lives using a 5G network. Thus, the vaccines were perceived to have the potential to cause infertility and being used as a bioweapon against black people.^38,48

To counter all these myths and conspiracies, the World Health Organization prepared and released shareable infographics about the disease, more especially on prevention to debunk the misconceptions.⁴ However, despite this, research indicates that exposure to correct graphic information did not affect misperceptions about the prevention of COVID-19.⁴⁹ This shows how people quickly get entrenched in false information, perhaps due to fear, and such information being first-hand, before the correct public health information publication. Regrettably, misinformation, misconceptions and misperceptions pose serious challenges in the management of infectious diseases. Indubitably, they derail the uptake of vaccines, treatment, and other preventative behaviors such as social distancing, masking, or quarantine procedures.⁴⁹ Consequently, the control and management of the viruses becomes expensive and mortality rates increase.

As alluded to earlier, religious beliefs influence how people respond to pandemics. A study on myths about COVID-19 in the United States of America revealed that Christian nationalism was negatively associated with COVID-19 vaccine confidence and negatively related to the odds of COVID-19 vaccine uptake.⁵⁰ Their study concluded that Christian nationalism was one of the strongest predictors of COVID-19 vaccine hesitancy and was negatively associated with having received or planning to receive a COVID-19 vaccine.⁵⁰ This behavior is not unique in America, but prevalent in other continents such as Africa, where church leaders and personalities perceived COVID-19 as a demonic attack, and the mark of the beast described in the Bible, hence urging people to shun away from the vaccines. Despite the virtues associated with Christianity, Christian nationalism has been antagonistic to science in matters of vaccine, and reproductive health (modern birth controls) among other contentious issues.⁵⁰

The presence of myths, conspiracies and disinformation results in serious health, social and economic ramifications as people tend to gain a false sense of security of being immune to the infection, hence exposure to high-risk situations. Myths associated with pandemics mainly prevail around causation, disease transmission, and cure. Inopportunely, public stigma is embedded in mythical thinking, hence shaping the behavior of people towards the disease and those infected.⁴⁶

Myths and Conspiracies About HIV/AIDS

Just like the COVID-19 pandemic, HIV/AIDS has had an equal share of myths, especially among the black African populace.⁵¹ Previous studies have documented various HIV/AIDS myths and misconceptions aligned to racial segmentation, cultural, political, religious, and sexual behavioral lenses. The racial myths include HIV being manufactured by whites to reduce the black African population; and HIV being caused by supernatural forces or witchcraft.^17,52 A cross-sectional study on HIV/AIDS in South Africa indicated that a misconception that “witchcraft plays a role in HIV transmission” was significantly related to less positive attitudes about condoms, less belief in condom effectiveness for HIV prevention, and lower intentions to use condoms among men.¹⁷ The study also reported that the misconception that “vitamins and fresh fruits and vegetables can cure AIDS” was associated with lower intentions among men to use condoms.¹⁷ Their study further revealed that women who linked HIV/AIDS to witchcraft had a higher likelihood of unprotected sex with a main partner; and that ARVS were poisonous and made people sick.¹⁷ This is a relatively similar scenario to the COVID-19 vaccine rollout across the globe but with more hesitancy in Africa.⁴ Thus, these misconceptions and mythical thinking hampered effective HIV/AIDS prevention measures in African settings.

In America, various studies undertaken in the early 1990s revealed genocidal misconceptions associated with HIV/AIDS among the Black American population.^53–55 Moreover, other studies have revealed racial-based and cultural-based misconceptions, where the black population had a false belief that their White counterparts were responsible for the contagious epidemics and pandemics.^56–59 Arguably, this presents serious racial illusions and delusions about the diseases, a behavior that stifles public health interventions towards effective prevention, management and treatment of HIV/AIDS. The contemporary myths and misconceptions about HIV/AIDS, like the case of COVID-19, are primarily on disease causation, mode of transmission and the effects of the virus on human populations.⁵⁹ A critical analysis of these myths indicates that they are rooted in political history (racial mistrust), sociocultural values and religious ethos, all shaping how people perceive life challenges and the source of solutions.

For instance, the perceptions that HIV was created by whites to annihilate populations in sub-Saharan Africa elucidate some of the sociopolitical tensions and feelings of malevolence embedded in memories of imperialism and the colonial era.⁵⁷ On the other hand, the perceptions that HIV/AIDS is caused by supernatural spirits mirror the deep African traditional view that diseases without cures are a result of malicious spiritual attacks.⁶⁰ These metaphysical perceptions extend further to bring some sense of self-guilty that HIV/AIDS infection is a consequence of violating some moral codes that regulate sexual activities, hence the punishment from God or gods for sexual promiscuity.⁶⁰ From a morality point of view, HIV/AIDS was perceived as the disease of homosexuals.⁶¹ Even though research indicates a high prevalence of HIV/AIDS among gays and lesbians,^62–64 the mythical perceptions that the disease is for homosexuals create an environment of vulnerability to infections among other segments of the population. Irrefutably, research has shown that these misconceptions and myths undermine the effective and efficient delivery of HIV/AIDS prevention and management interventions in the world.

Response to the HIV/AIDS & COVID-19 Pandemics

Generally, pandemics are sporadic, and every disease is different from another. With such unpredictability of outbreaks, governments and international health organizations adopt a reactive approach to intervene. The response to pandemics includes activities such as creating awareness, prevention (could be through vaccinations, personal hygiene, restrictions or using protective gear such as condoms for HIV or masks for COVID-19), and treatment. Basically, at the onset of the pandemic, there are no clear methods of prevention, vaccines, and treatment plans. Resultantly, the prevention measures are hurriedly designed like in the case of COVID-19 which included maintaining social distancing, using masks, hand washing and sanitizing.³⁸ Research shows that the adoption of protective health behaviors such as personal hygiene, social distancing and wearing of masks slows down the transmission of COVID-19.⁶⁵ Although the efficiency of these preventive measures is low, the COVID-19 vaccines were approved for use within a short period with the hope of higher efficacy.⁴ The vaccine uptake, however, was faced with hesitancy on the basis of safety and the institutions manufacturing them.^38,66 Nonetheless, the vaccines for COVID-19 were availed within a short scope of time, while the HIV/AIDS vaccine is yet to be confirmed. The quick response in providing vaccines for the COVID-19 pandemic sparked informal racial debates in some African-Black communities that their White counterparts were quick to save their lives through vaccines, whereas HIV/AIDS has been there for decades without a potent vaccine. Perhaps, this is why COVID-19 was politicised by some presidents such as the late Tanzanian president Magufuli,^67,68 and the former US president Donald Trump.⁷ While the Tanzanian president Magufuli denied the existence of COVID-19 and its devastating effects while insinuating that it was laboratory produced,⁶⁷ Donald Trump castigated lockdowns and the restrictions as activities against human rights hence downplaying the seriousness of the pandemic.⁷

These political utterances about the COVID-19 pandemic preventative measures catalysed citizens to believe that public health measures were an impingement upon their freedoms and that doing independent treatments or preventative measures, were appropriate. These utterances perceptively presented hegemonic ideologies confusing the truth of the disease, and endorsement of the myths that some elites and powerful sovereignties were trying to use COVID-19 for political control.⁷ Similarly, a former South African president has been recorded for being a famous HIV/AIDS denialist.^69–71 His utterances of denial as the then sitting president, that HIV does not cause AIDS and deaths is attributed to massive deaths in South Africa and affected the access and update of ARVs. Therefore, when senior government leaders become agents of disinformation and misinformation, the public healthcare efforts in responding to the pandemics through awareness, vaccination and treatment are severely undermined.

The Impact of COVID-19 and HIV/AIDS

Indubitably, every pandemic has a serious impact on health, social, economic, and political systems. In this section, we focus on the social and economic impact of these pandemics. Socially, COVID-19 brought about stigma and stigmatisation among individuals and communities. A study on stigma related to COVID-19 shows that survivors were stigmatised (60.82%), and the disease intensified social rejection, financial insecurity, internalised shame, and social isolation.⁷² This stigma was not only meted towards the survivors but also the family members and spouses. Consequently, the loss of life, economic losses, and stigma during the COVID-19 pandemic led to depressive conditions, which further affected people’s health.⁷²

All pandemics have pecuniary implications that have significant effects on the national and global fiscal and financial budgets. This is because with the outbreak of pandemics, the financial commitments burgeon and become a serious burden for countries. Researchers have delineated the pecuniary concerns associated with COVID-19 to be costs to the health system, both public and private. They include medical treatment of the infected and strain to health care systems to deal with extra routine health issues.⁷³ Moreover, emergency events, quarantines, and social distancing measures impacted on the financial markets.^73,74 Additionally, the public health responses such as awareness programs, testing and quarantine, and income support packages placed extra financial burdens on government and philanthropic institutions.⁷³ As a result of lockdowns and related restrictions, many people lost employment, which affected economic productivity and income levels from households to national levels through loss of foreign direct investment.⁷⁴ On the other hand, HIV/AIDS has cost nations and international organizations billions of money on medication (ARVS), condoms and awareness campaigns.²⁰

Discussion

Pandemics have negatively impacted humans from ancient days to the current dispensation. The magnitude and the impacts of the pandemics have had different scales, from the loss of human life to economic and social disruptions. Of great interest is what lessons we draw from these pandemics for better preparation in the future. This is important to depart from a false sense of disease normalisation and blinding prospects for the future. This paper focused on four aspects of COVID-19 and HIV/AIDS pandemics, which are the etiology and epidemiology, myths and conspiracies associated with pandemics, response to the pandemics and the economic impact. The analysis discovered some similarities and differences that are outlined in this section.

Firstly, the analysis revealed that the genesis of these two pandemics is associated with animals, and then transmitted from person to person. HIV/AIDS is attributed to human interactions or contact with apes in central Africa, while COVID-19 is attributed to bats and pangolins in China. Geographically, HIV/AIDS is traced in Africa, while COVID-19 is traced in Asia – China. Apparently, the interactions between humans and animals through hunting for food and the trade of exotic pets harbour potential risks of spillover of zoonotic pathogens. This implies that the outbreak and spread of infectious diseases are likely to be common in the future due to increased human activities and their effects on the environment. Therefore, institutions and centres concerned with public healthcare globally should equip themselves for such eventualities in the future.

The analysis revealed that both pandemics were marred with misinformation, misconceptions, disinformation, myths, and conspiracies. All these were around causations, racial extermination, and prevention and treatment. Notably, in both pandemics, there were misconceptions that the whites were on a secret agenda to exterminate the blacks through incurable diseases and holding back treatment. These views were more prominent in Africa and other mixed-racial continents such as Asia and America. The tendency for information, including false information to spread is increasingly enabled by technological advancements and access to social media.⁷⁵ Most people are likely to believe the information they receive from social media without even a sense of verification; hence an apparent behavior of endorsing myths is seen in this analysis. Considering the pernicious ramifications of spreading false information about HIV/AIDS and COVID-19 through social media and other platforms, it is essential to explore and counter such behaviors.

Generally, conspiracy theories can surge when societies are in moments of crisis such as during a rapid political change, natural disasters, and disease outbreaks as witnessed during the COVID-19 pandemic.⁷⁵ Research on why people might hold on conspiracy beliefs suggests that is a result of a vacuum, when important psychological needs are not being met, such as experiences of anxiety, uncertainty, and threats.⁷⁶ Arguably, therefore, if conspiracy beliefs address psychological needs, the motivation to endorse them is justified as a remedy. Contrary to this, however, a different study revealed that conspiracy beliefs do not reduce anxiety, uncertainty aversion, or existential threat, but increase these negative feelings.⁷⁷ Nonetheless, emerging research demonstrates that appealing positives of conspiracy endorsement are overshadowed by evidence of the dangerous consequences of these beliefs.^78,79

Misinformation that promotes false preventives or cures can hinder necessary behaviors to reduce the spread of diseases.⁴⁹ For instance, a South African study shows that HIV/AIDS stigma in South Africa is driven by ignorance about the AIDS etiology and epidemiology, weaker campaign infrastructure in the rural areas, poverty of the people, denialism, and myths.²⁸ In the same vein, a study in Ghana indicated that respondents with high knowledge of how HIV may be transmitted, highly educated, and wealthier had lower tendencies to endorse myths about the disease, compared to the less educated and poorer ones.¹⁸ Indeed, myths and misconceptions are significant factors influencing people’s behavior towards the disease. Previous studies have found that the youths who endorsed HIV and AIDS myths experienced their sexual debut much earlier, and were more sexually active, and more likely not to use condoms compared to those rejecting such myths.^60,80 Similar evidence has been found among those who believed HIV/AIDS is transmitted through superstition and witchcraft.^60,80,81 Similarly, during the COVID-19 pandemic, such behavior has been reported across the globe. Accordingly, the COVID-19 pandemic has been described as a pandemic mother of myths and conspiracies.⁷ This is because of the perceptions that a group of elites is using the COVID-19 crisis to gain power; the spread of COVID-19 is connected to 5 G networks and technology; and the virus behind COVID-19 was produced in a lab in Wuhan among others.⁷ This observation corroborates with Ullah, Khan, Tahir, Ahmed and Harapan study that lack of knowledge, false religious beliefs, anti-vaccine misinformation and disinformation have been attributed to COVID-19 hesitancy globally.³⁸ Consequently, the outcomes are dreadful, hence the World Health Organization recognizes vaccine hesitancy as the world’s top threat to public safety in combating pandemics and epidemics.³⁸

Incontrovertibly, clear understanding and high knowledge about multiple aspects of diseases are vital in dispelling myths and beliefs that hamper effective public health interventions. The importance is vividly supported by research indicating that individuals with a clear understanding of the scientific truths surrounding HIV/AIDS and COVID-19 transmission reject the myths and all misconceptions and misinformation embedded in them.^38,60 As noted earlier in this paper, these myths and misconceptions remain a barrier to positive behavior change in communities prone to both epidemics and pandemics. To debunk myths and conspiracies about pandemics such as COVID-19, research suggests three approaches, which are question-answer format, fact-myth, and fact-only: with the question-answer approach being more effective than fact-myth in the longer term.⁸²

The impact of COVID-19 and HIV/AIDS has a multifaceted dimension including psychological, social, economic, political and health outcomes. These pandemics are associated with pangs of stigma and stigmatisation towards patients, family members and healthcare workers associated with treating such diseases.^28,38,60 Disease-related stigmatisation can lead to discrimination, marginalisation, and stereotyping, making victims vulnerable and therefore shunned from available public treatments and other interventions.

Economically, the impact of the two pandemics discussed in this paper unearths some economic paradoxes. While there were economic turndowns during COVID-19, due to loss of jobs, loss of life, low productivity, restrictions on movements, huge expenditure in purchasing protective gear, and other medical emergencies, there were unprecedented opportunities for markets to develop new products and services to combat the virus. For instance, the pharmaceutical industries had an opportunity to develop and manufacture vaccines, surgical masks, and oxygen, which were not in existence or in higher demand before the outbreak of the pandemic. Opportunely, COVID-19 provided a fortune for a segment of the economy, though amid global health agony. Similarly, HIV/AIDS has placed a serious burden on fiscal budgets in countries especially in Africa, eating into the budget share that would contribute to more economic development projects. Nonetheless, the disease has presented an opportunity for research in finding the cure, treatment, prevention, and advocacy activities that also attract economic value. Arguably, therefore, pandemics and epidemics have embedded negative and positive economic and market dynamics.

Conclusion

This paper compared selected aspects of the HIV/AIDS and COVID-19 pandemic. The study established some similarities in the etiology and epidemiology of the diseases, although the incubation periods differed significantly. The COVID-19 pandemic sporadically spread across the world, which triggered a speedy response and intervention as compared to HIV/AIDS. Of great interest, the two diseases are characterized by myths and conspiracies around origin, transmission and treatment that strongly influence human behaviors response to public health information. Perhaps, this indicates a lacuna among the structures responsible for information dissemination on disease outbreaks and control. The impact, though with relatively similar outcomes, seems to vary with HIV/AIDS being more severe, perhaps due to its longevity. The paper finds that the ability to access up-to-date health information and resources, and timely use is important for the management of pandemics and countering misleading mythical information about diseases. The analysis reveals eminent public panic and the quick spreading of false information about the diseases. The media and more especially the social media platforms being avenues of information sharing should be properly used and regulated to disseminate credible and verifiable information. Public health institutions and practitioners have a duty of demystifying all the myths and falsehoods associated with pandemics such as HIV/AIDS and Coronavirus, such that they are not used as reference points should such pandemics occur in the future. There is a need to increase the awareness of pandemic preparedness among communities around the world to avoid the extreme burden on healthcare systems. Governments around the world, international health organizations, and Centers for Disease Control must fully prepare for unprecedented pandemics in the future through vaccine development of infectious pandemics, and timely dissemination of public health awareness information.

Acknowledgments

We wish to acknowledge the valuable inputs and comments from the reviewers and editors to improve the quality of this manuscript.

Disclosure

The authors report no conflicts of interest in this work.

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In the essays “Geo-spatial Verities” and “Mlozi Bin Kazbadema of Mpata,” Phoya reminds the reader that almost none of the current inhabitants of Malawi are native to the land. He illustrates how the indigenous people were the Akafula, who were displaced by the country’s modern-day tribes, who migrated from other regions of Africa. For example, the waNkhonde came from present-day Cameroon and Congo, the Tumbukas from Tanzania, and Yao from Mozambique, with the Ngonis epitomizing this cross-border composition through their shared origins with the Zulus, the Shanganes in Mozambique, and the Ndebeles in Zimbabwe. Probably the most surprising aspect of this varied history is masked in language, specifically, in names. Phoya shows, for example, how a Malawian name such as Mandala is derived from Mandla while Gomani stems from Ngcamane, highlighting their eSwatini origins. Malawi is, therefore, seemingly a confluence of Africa.

I wonder whether this is one of the reasons Phoya claims “Malawi is a construct—a new one at that.” The country is a collection of people displaced, a refuge that the British drew random borders around. If Malawi is nothing but this, how bizarre would it be for it to smother the freedoms of those also fleeing conflicts and looking for a corner of the world to call home? Unfortunately, following a concerning pattern in Southern Africa, Malawi has also veered into scapegoating refugees for its social and economic problems. It seems states that are failing to deliver sustainable social and economic progress for their people in the face of growing inequalities, deploy the same playbook of redirecting their failures to an “outsider.”

Phoya also touches on another depiction of Malawi’s past that is often ignored: the centrality of the colony in the development of cities. Blantyre is the most glaring example of this. Apart from being named after the birthplace of David Livingstone (more about him later) and being home to the Queen Elizabeth Central Hospital, Phoya mentions how Chipembere Highway (the city’s major road) resulted from “colonial engineering.” It primarily connects Blantyre (a former missionary outpost) to Limbe, a rail station that facilitated the core motive of colonization—the transfer of resources (in this case, tobacco).

Although the book engages with numerous historical figures to varying degrees, I focus on David Livingstone, John Chilembwe, Kamuzu Banda, and Madonna (only because the book is named after the essay on her). Apart from Madonna, these people have had the largest impact on Malawi as we see it today.

Starting with David Livingstone, Phoya stresses that “In the beginning of Malawi, there was a people, an African people mostly. And a lake, and David Livingstone.” Upon witnessing the East African slave trade (and “discovering” Lake Malawi), Livingstone made it his mission to “save” the native Malawian, both spiritually and economically. Following his pleas to British authorities, missionaries began arriving in Malawi, and they were followed by businessmen to introduce commerce—as typified by the African Lakes Company—that would supposedly counter the slave trade.

As in many other colonies, the spread of Christianity,  and the capitalism that accompanied it, came with the stratification of society along racial lines, the mass theft of land, and the shift toward commercialized social and economic relations. Christianity and capitalism walked hand in hand, as Desmond Tutu once aptly remarked: “When the missionaries came to Africa they had the Bible and we had the land. They said ‘Let us pray.’ We closed our eyes. When we opened them we had the Bible and they had the land.”

The economic blueprint that settlers imposed remains a central pillar of contemporary Malawi. The tobacco industry, which was primarily set up to cater to colonial needs is still Malawi’s main export, and the shadow of imperialism is ever-present, as theorized by economists Utsa and Prabhat Patnaik. The racialized social and economic features that followed from David Livingstone’s vision of Malawi, as seen in the emergence of the white settler class that controlled (and exploited) the country’s production processes, set the backdrop for the emergence of John Chilembwe, one of Malawi’s earliest revolutionaries. 

Although Chilembwe is often remembered as the man who staged an unsuccessful revolt against the colonial administration, Phoya shows that there was more to the man. Educated at Virginia Theological College against the backdrop of US Jim Crow, Chilembwe was heavily influenced by the radical black American theological tradition—a theology that did not shy away from the seemingly “political” concerns of social justice. Phoya highlights how these were central to Chilembwe’s progressive principles: his championing of education for Africans, his critique of Malawians participating in British wars, and his support for women’s rights and labor rights.

It is impossible not to see how Chilembwe’s values also mirrored other theologians, especially those of the liberation theology tradition, characterized by its “commitment to prioritize the material needs of the poor, as well as their knowledge, experience and spirituality.” Seen in this light, Chilembwe’s rebellion is not simply a miscalculated or desperate ploy as it is mostly remembered, but also a reflection of his broader influences, politics, and vision of society. Yet portrayals of Chilembwa still mainly focus on his failed rebellion and perceived role in laying the groundwork for the rule of Kamuzu Banda.

Dubbed the father of the nation, Banda was also a cunning manipulator of history. Phoya points out that Banada exaggerated his achievements such as claiming he was Malawi’s first medical doctor (it was Daniel Malikebu), and reorchestrated the story of Chilembwe, the sole standing memory of resistance against imperialism in Malawi, to situate himself in it. Using his control over the media, he pushed the narrative of a Chilembwe that was nothing more than someone who staged a revolt and prophesied the coming of an eventual savior—Banda himself. This amounted to a pernicious strategy to consolidate his legitimacy against the backdrop of colonization. Thus, the nuances of Chilembwe’s radical character were lost, with only fragments that upheld Banda’s narrative.

I did have a minor concern with the role Phoya says Malawian culture played in the broader process of Banda’s narrative. He points out that the “Malawi culture allowed” Banda to manipulate the story of Chilembwe to suit his agenda. Reading this, one assumes that there is a “uniqueness” to Malawian culture, suggesting it makes Malawians more gullible than other groups of people. It is difficult for me to imagine how Banda’s existing legitimacy and goodwill that came with his symbolic role in fighting against an oppressive colonial system would have been undone by a different culture. It may have been useful (even if anecdotally) to show how exactly the culture was complicit and to point out how different cultures managed this pre/post-independence period differently given their historical, material, and social conditions.

Overall, Phoya’s depiction of Banda (in the context of Chilembwe), lays bare an intriguing contradiction. While Banda relied on Chilembwe’s legacy, it is interesting to see that the two individuals held different beliefs, and by implication, different visions of Malawi. While Banda was cozy with the apartheid government of South Africa and maintained colonial economic structures after independence (settlers being replaced by the local political elite), Chilembwe was a pan-Africanist, vehemently opposed to supporting colonial powers, and a strong advocate for labor rights and land reform.

Banda’s fall from grace in 1993 was meant to usher in a new era of peace, prosperity, and freedom. Unfortunately, his departure coincided with the infamous structural adjustment programs, coupled with the continuing paternalist governance structure, which failed to stymie corruption and significantly reduced the state’s capacity to provide accessible essential services. Phoya illustrates how this epoch is epitomized by the singer Madonna’s relationship with Malawi.

Using Madonna’s establishment of the Mercy James Pediatric Surgery and Intensive Care Unit as a point of entry, Phoya argues that Madonna’s relationship with the country typifies white saviorism. It is important to recognize that Phoya does not downplay the importance of the medical center, but rather questions how Madonna (and other NGOs) perceive themselves in relation to Malawi. More specifically, he illustrates how their work downplays the ability of Malawians to decide what they need and as seen in the name of Madonna’s NGO, Raising Malawi, exaggerates a paternalistic role.

Given the centrality of Madonna to his essay, I would have loved a more detailed discussion and illustrations of the various ways her white saviorism is reflected and reproduced. While the author aptly sets the backdrop for the discussion of Madonna and her relationship with Malawi by highlighting the complicity of the state in the entire process, I believe more could be done to acquaint the reader with the underlying contradictions and implications of white saviors. How does white saviorism manifest in a country like Malawi? What are the implications of such a phenomenon on the broader development of the country?

Overall, the book is a much-needed contribution to the emerging literature reclaiming the history of Malawi. Considering the growing economic and political uncertainty that has engulfed Malawi and its people, Madonna Is Our Mother is a jolting reminder of both the realities of our past and how these set the backdrop for the country’s contemporary predicaments.