HEALTH-SOUTH AFRICA: Study Reveals the Grim Extent of HIV/AIDS Pandemic

by Farah Khan

JOHANNESBURG, Nov 29 (IPS) - South Africa would need to reignite a debate on whether to make HIV/AIDS a notifiable disease, believes Health Minister Manto Tshabalala-Msimang. This is in light of a mortality study which reveals the grim extent of the pandemic in South Africa.

The report, released earlier this month by Statistics South Africa and the Medical Research Council (MRC) shows that AIDS is now the biggest killer of young girls and women, aged under 40 years old.

However, all sectors and genders of the population showed heightened mortality from HIV/AIDS.

The study studied death patterns among a representative sampling of South Africans between 1997 and 2001. An earlier attempt by the MRC alone, which revealed the extent of AIDS deaths, was scoffed at by government when President Thabo Mbeki still doubted the scourge.

At the time, the president claimed that more people died of road deaths. After the brouhaha that his claims caused, a new study was commissioned and it is now confirmed the view that HIV/AIDS and related infectious diseases like tuberculosis and pneumonia are the most significant new causes of death.

The health minister made her comments on making AIDS a notifiable disease because the statistics may still not reveal the full picture. Mortality research is based on death certificates and there are numerous reasons that these may not reveal HIV/AIDS reach in a society where stigma is still deeply rooted.

‘'Practitioners consideration of insurance, and other implications, especially among bread-winners, may result in avoidance of the HIV and AIDS notification,'' said the Minister. Insurance companies do not cover HIV/AIDS, except in very limited circumstances.

But any attempts to make AIDS notifiable would have to be very sensitively negotiated because of ‘'attitudes and stigma,'' she said.

While the years between 1997 and 2001 reflect a decline in ‘'unnatural and unspecified'' causes of death (until then, the highest sector), the decline was off-set by a rise in deaths due to HIV, influenza, pneumonia and HIV.

The most shocking finding is that AIDS has quickly come to take first place as a killer of young women, but the report also notes that the number of young men succumbing to the disease climbed three-fold in the period under study.

But the killer treads a racial path. Black women are 15 times more likely to die of AIDS than white women and 14 times more than Indian women. AIDS takes a racial hue in South Africa largely because income patterns are still severely racially skewed.

The number of young women dying from AIDS increased from three percent of the sample in 1997 to over 13 percent in 2001 - a 53 percent increase.

These findings tally with another report released this week, the UNAIDS and the World Health Organisation's AIDS epidemic update, which found that infection and death rates were likely to continue growing until the end of the decade before peaking. The report calls for ‘'massively expanded prevention, treatment and care efforts'', a call the South African government says it is heeding, since turning its back formerly in April on the denialist path that Mbeki once walked.

An annual survey has found the infection rate among young women slowing, a factor that Health Department spokesperson Joanne Collinge says may be the result of an enhanced prevention programme.

Tshabalala-Msimang also said that government would spend R3.3-billion (330 million U.S. dollars) on HIV/AIDS prevention and treatment in the next three years, a massive budgetary jump.

But the Minister said the causes of death survey needed to be considered holistically for the snapshot it provided of the health of the population.

The high number of people dying from unnatural and unspecified causes masked a society in deep trauma. ‘'Unnatural causes such as injuries, motor accidents, suicide and drowning still constitute the highest underlying causes of death among young males,'' said the minister.

She added that, ‘'These findings also confirm the need to intensify campaigns around the problems of violence, alcohol, abuse, road accidents and unhealthy lifestyles in our society.'' (END/2002)