I found some of the segments are difficult to get my head around - eg the girl whose hair grows so fast. Some of the language, the Zambian words slipped in, make it hard to immediately understand although mostly the meaning becomes clearer through repeated us or context. The narrative is very rich and I'm sure I missed quite a lot of connections on the first reading.

I loved it from the opening, which made it easier to forgive some of the odd notes later. 

The episode in Italy didn't really seem to have much relevance aside from giving a background to two of the characters - once they got to Zambia it became alive again. Although "the virus" mentioned is clearly HIV, reading it during the Covid panic and an ecological disaster made the final chapters seem extraordinarily prescient.

Above all it gave a picture of Zambia that seemed to ring very true, both historically and as an African perspective. Probably worth reading again to pick up on the bits I missed.