Peter Doyle, Group MD of Metropolitan, who developed the Metropolitan Model, noted that in Europe and North America the impact of HIV infection had been modest. In Africa, however, it was significant. The situation in South Africa was unique; the country had a modern economy, and was skills-dependent and technologically advanced. The larger social, political and economic impact associated with the South African epidemic, as well as those obstacles that prevented South Africa from formulating an adequate response, were examined.