Mbeki Reiterates That ‘External Causes,’ Not AIDS, Lead Mortality Rates Among South Africans
South African President Thabo Mbeki has ordered the government to reevaluate its social policy spending in light of 1995 data from the World Health Organization that said "external causes" such as accidents, homicide and suicide, not HIV/AIDS, constitute the leading cause of death in the nation, South Africa's Business Day reports. The WHO figures, which Mbeki reportedly found on the Internet, showed external causes to be responsible for 19.8% of deaths, while HIV/AIDS accounted for 2.2% of deaths (Business Day, 9/10). UNAIDS spokesperson Richard de Luyt confirmed that the data came from the WHO Web site, but noted that WHO receives the data from national governments (Reuters, 9/10). In an Aug. 6 letter to Health Minister Manto Tshabalala-Msimang, Mbeki asked that she share the statistics with the cabinet's "social cluster" and consider what policies the government has in place to reduce deaths, whether resources are properly allocated in light of the statistics and whether the country's medical institutions are properly prepared to deal with the types of deaths mentioned in the report. The letter, which was confirmed Sunday by presidential spokesperson Bheki Khumalo, echoed statements first made by Mbeki in an interview with the BBC last month. That interview was followed by a similar statement by Tshabalala-Msimang on Aug. 7, the day after Mbeki sent her the letter, citing a 1999 study that found violence to be the major cause of death in the country (Business Day, 9/10).
Coming Under Fire
The decision to review funding based on the WHO data is likely to bring criticism because the pattern of AIDS deaths has been significantly altered since 1995, Agence-France Presse reports. UNAIDS said today that the number of AIDS-related deaths in South Africa has increased "massively" since 1995, and Mbeki's claim that AIDS-related deaths are not the leading cause of death in the country "underestimate[s] the real impact of the disease." The agency estimates that during 1999, 250,000 people died from the disease, but the 1995 figure quoted by Mbeki is 2,653 (Agence France-Presse, 9/11). "The figures from 1995 are absurdly out of date. A reliable argument cannot be made on statistics based on six-year-old information," Democratic Alliance HIV/AIDS spokesperson Kobus Gous said (SAPA News Agency/BBC Monitoring, 9/10). The WHO statistics also include a separate category for tuberculosis deaths (5.3%), even though many of those deaths were probably AIDS-related as well, according to Business Day. In addition, the South African Medical Research Council is expected to release a report in the next few weeks stating that AIDS-related deaths were the nation's leading cause of death from 1999 through mid-2001. A spokesperson for the council said it was in the process of confirming its findings and would not release the report before its president, Malegapuru Makgoba, returned from a trip abroad later this week. The council is believed to be making sure its figures are "beyond reproach" because of pressure from the government to delay releasing its results. The council's report is expected to support a report by ABT Associates, published in June by Business Day, that predicted AIDS-related complications will become the leading cause of death among public service employees by 2003 and will account for 75% of deaths among this group by 2010. Mbeki, who previously caused controversy by publicly questioning the causal link between HIV and AIDS, acknowledged his decision would likely "provoke a howl of displeasure and a concerted propaganda campaign from those who have convinced themselves that HIV/AIDS is the single biggest cause of death," according to his letter (Business Day, 9/10). United Democratic Movement leader Bantu Holomisa said Mbeki's letter "should serve as the final verdict on his incompetence and incapability to look after the best interests of the country" (SAPA News Agency/BBC Monitoring, 9/10).