South Africa: Aids is Number One Killer in South Africa Says Report.

16 October 2001
allAfrica.com
By Ofeibea Quist-Arcton

Johannesburg — A disputed new report on mortality rates in South Africa, released on Tuesday, said Aids was the biggest killer in the country, and predicted that it would account for the death of between 5 and 7 million people by 2010.

The findings, in a report commissioned by South Africa’s leading Medical Research Council (MRC), are contested by the government which says they are flawed, and that the report exaggerates the scale of the Aids’ problem.

Joanne Collinge, a spokeswoman for the South African Health Ministry, said: "The MRC research is not absolutely definitive and its mortality rates are estimates rather than exact calculations. This is because they rest on various assumptions, because the empirical data just isn’t strong enough at this point in time."

In a recent BBC interview, President Thabo Mbeki cited accidents and violence as the two major causes of death in South Africa, ahead of Aids, in direct contradiction to Tuesday’s figures by the MRC.

The council, South Africa’s most prestigious and autonomous medical research body, is funded by the government.

The MRC report said "South Africa is experiencing an HIV/Aids epidemic of shattering dimensions". Aids, it said, would be responsible for one-third of all deaths in South Africa in 2001, rising dramatically to almost 66 percent in nine years without more direct government intervention and sexual behaviour change. These shocking results need to galvanize efforts to minimize the devastation of the epidemic."

Apart from forecasting that Aids would become the leading cause of death, the figures indicated that average life-expectancy in South Africa would plummet from age 54 in 2001 to 41 in 2010. But the Medical Research Council added that "preliminary modelling shows that, even at this late stage in the epidemic, effective programmes resulting in changed behaviour among adolescents and adults would significantly reduce the prevalence of the disease."

The MRC report was completed earlier this year, but publication was delayed by the cabinet which is reported to have wanted Aids figures issued by the government agency, Statistics South Africa, to be released simultaneously in December. The MRC survey had already been partially leaked to the local media.

President Mbeki’s administration has drawn fire in the past for its handling of what observers consider an Aids pandemic in South Africa. Mbeki’s perceived personal doubts and questioning of the link between the HIV virus and Aids caused controversy and anger both inside and outside the country.

Some have accused the South African president, and some members of his government, of being in denial. Recently, relying on UN World Health Organisation’s 1995 mortality figures for South Africa to show that Aids was not the leading cause of death, Mbeki called for a review of government spending on HIV/Aids programmes, sparking renewed criticism.

The MRC said 40 percent of adult deaths between the ages of 15 and 49 in South Africa were currently linked to Aids. Figures from the United Nations Aids’ agency, UNAids, indicate that more people (4.7 million or one in nine) are living with HIV/Aids in South Africa than in any other country worldwide.

Aids campaigners, including the influential lobby group Treatment Action Campaign (TAC), have accused the authorities of not facing up to the enormity of Aids which they describe as the leading health crisis in South Africa.

Pressure from these groups, health professionals, the clergy and trades’ union appear to have forced the decision to publish the MRC findings on Tuesday, "with the understanding that this is but one contribution to the continuing official process," according to Pretoria.

Rob Dorrington, one of the report’s five respected authors and a professor at the University of Cape Town, told a news conference on Tuesday that the latest figures were "the best that are available in South Africa."

Statistics South Africa, under the umbrella of the Finance Ministry, refutes them, describing the samples used as neither representative or definitive, nor necessarily accurate in reflecting the probability of HIV infection. But Dorrington responded that the government agency’s assessment was "prime evidence of the little knowledge or experience they have in this area."

The president of the Medical Research Council, Dr Malegapuru Makgoba also defended the report. He said it was to allow the government and "our country’s policy-makers to be up to date with the (Aids) epidemic rather than be behind by at least five years". He concluded that "the findings, and the quality of the findings, of the report are unshakeable at the moment. And this is what we stand by."

Aids’ activists have warned that a dispute over figures will set back the fight against the disease in South Africa. Mark Heywood, of the Treatment Action Campaign, who welcomed the findings of the Medical Research Council report, accused the government of questioning the methodology for political reasons.

He stressed that quibbling about numbers simply distracted from the priorities, which he said were treatment and proper health care, as well as education, prevention and HIV/Aids awareness campaigns. "We might be squabbling about percentages, but there is an agreement that we are talking about millions of deaths whatever angle you take on it." Battling the shame and stigma which is still associated with AIDS, he said, was paramount in South Africa.

Heywood told allAfrica.com he felt despondent, frustrated and angry. He said he had helped to bury four colleagues who had died of Aids in the past two weeks and quoted Makgoba as characterising the epidemic as perhaps the greatest challenge to the African renaissance, South Africa’s future and the continent’s progress.

"That requires massive resources and significant political commitment," said Heywood. "We are just trying to say to the government that if you contemplate this extent of disease, illness and death in adults, it is going to undermine our common efforts as a country to reconstruct, improve and develop our society."

The Aids campaigner repeated that what were needed were radical strategies and the means to tackle the pandemic, as well as a government that would take seriously the responsibility to make treatment available for people living with HIV and Aids.

"We don’t think that this epidemic is insurmountable," said Heywood. "We believe that, with the political will and with the commitment of resources, we can in fact prevent what the Medical Research Council predicts from becoming a reality. And that’s our challenge. It presents an enormous challenge and we have to rise to that challenge."

Lucky Mazibuko, a well-known South African newspaper columnist and activist publicly living with Aids, spoke for many in his country when he pleaded that "this is not the time for intellectual and academic debate", but firm action against HIV/Aids.

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