Number of Deaths in S. Africa Increases 57% Since 1997, Likely Showing Affect of AIDS on Working-Age Adults, Report Says
The number of deaths in South Africa increased by 57% from 1997 to 2002, in part showing that the country's HIV/AIDS epidemic is "cutting a swath through its working-age population," according to statistics released Friday by Statistics South Africa, Reuters/Philadelphia Inquirer reports (Quinn, Reuters/Philadelphia Inquirer, 2/19). The report, titled "Mortality and Causes of Death in South Africa," is based on nearly three million death certificates and shows that the number of deaths increased from 870 daily in 1997 to 1,370 daily in 2002, according to the South African Press Association. The report shows that AIDS-related illnesses are some of the leading causes of death among South Africans ages 15 to 49. Stats SA Director Pali Lehohla said the report gives "indirect evidence that the HIV/AIDS epidemic in South Africa is raising the mortality levels of prime-aged adults." Lehohla said that the death certificate data do not provide accurate statistics on AIDS-related deaths, adding, "To do this, analysis of the data needs to be combined with other sources of information, population projections and demographic modeling" (South African Press Association, 2/18). Among South Africans ages 15 to 49, AIDS-related illness was the fifth leading cause of death in 2001, the most recent year for which detailed statistics are available, according to the AP/Indianapolis Star. AIDS-related conditions accounted for more than 7,500, or 3.8%, of deaths among South Africans ages 15 to 49 in 2001, according to the report. The total number of deaths in South Africa rose from 318,287 in 1998 to 499,268 in 2002 (Zavis, AP/Indianapolis Star, 2/19).
Deaths Among Women, Children
According to the report, the number of deaths among sexually active women increased "significantly," compared with the number of deaths among sexually active men, a "ratio that strongly indicates a country's AIDS-related mortality rate," according to the New York Times. About 149 men ages 25 to 29 died for every 100 deaths among women in that age group in 1997, compared with 77 male deaths for every 100 female deaths in 2003, according to the report. In addition, the report notes that AIDS-related diseases emerged for the first time in 1999 as one of the 10 leading causes of deaths among children under age 15, suggesting that AIDS is "increasingly exactly a toll among" young South Africans, the Times reports (Wines, New York Times, 2/19).
Differences in Numbers
The number of AIDS-related deaths in the report is "considerably fewer" than the number estimated by the United Nations and World Health Organization, which say that at least 600 South Africans of all ages die each day of AIDS-related causes, according to the AP/Star. According to government officials, many AIDS-related deaths are reported as deaths from associated illnesses such as tuberculosis, influenza and pneumonia because of the stigma surrounding HIV/AIDS (AP/Indianapolis Star, 2/19). In addition, South Africa's Medical Research Council said in a report published in the Jan. 28 issue of the journal AIDS that the number of people dying of AIDS-related illnesses in South Africa is at least three times the number suggested by official figures. MRC estimates that about 112,000 people died of AIDS-related causes from 2000 to 2001, almost three times as many deaths as the country's Department of Home Affairs estimated during the same period. In addition, the report says that during the study period about 74% of deaths among children under age five were the result of AIDS-related illnesses, compared with data cited by the government saying that 25% of deaths among young children are AIDS-related (Kaiser Daily HIV/AIDS Report, 2/3).
The latest report "caused contention" even before it was released, as critics charged that the report's release was delayed because of political pressure from South African President Thabo Mbeki, whose government has been accused of "play[ing] down the dimensions of the AIDS" epidemic in South Africa, according to the Times. Stats SA officials said the report was not "politically influenced," the Times reports (New York Times, 2/19). The opposition Democratic Alliance said that the report, which shows a 62% increase in mortality for people ages 15 and older, "made it clear" that deaths from AIDS-related causes among working-age adults is a "real and immediate crisis," according to the South African Press Association. DA health spokesperson Ryan Coetzee said, "While there is already a mass of other evidence showing the impact of HIV on South Africa's population, none of this has so far succeeded in convincing the government of the need to act with urgency and resolve in the war on AIDS." He added, "Perhaps the evidence from an institution which has such close ties with the government will be more persuasive" (South African Press Association, 2/18).
NPR's "Morning Edition" on Monday reported on the increase in the number of deaths in South Africa. The program included comments from Wei Imblobo, director of the Alum Care Group Project, and a woman dying of AIDS-related causes (Wilson, "Morning Edition," NPR, 2/21). The complete segment is available online in RealPlayer.
PRI's "The World" on Friday also reported on newly released statistics. The program included comments from Lehohla, a bioethicist at the University of Cape Town; and David Bourne of South Africa's Medical Research Council (Costello, "The World," PRI, 10/6). The complete segment is available online in Windows Media.