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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)
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