AIDS-Related Illnesses Leading Cause of Death in South Africa in 2000, Medical Research Council Report Says

AIDS-related illnesses were the leading cause of death in South Africa in 2000, accounting for about 30% of all deaths nationwide, according to a Medical Research Council of South Africa report released on Tuesday, South Africa's Star reports. The report, compiled by MRC's Burden of Disease Research Unit, shows that mortality rates and causes of death differ in the country's nine provinces but that HIV/AIDS was the leading cause of death overall (Green/Smillie, Star, 5/17). HIV/AIDS was the leading cause of death in every province except the Western Cape. Debbie Bradshaw, co-author of the report and director of the disease unit, said the study employed several data-collection methods, including death notification forms and census and household surveys (SABC News, 5/17). The report says that the country is dealing with a "quadruple burden of disease," with communicable diseases, noncommunicable diseases, injuries and HIV/AIDS playing large roles in mortality, according to the Star (Star, 5/17). According to official statistics, South Africa has the highest number of HIV-positive residents of any country worldwide. UNAIDS figures released in July 2004 showed that about 5.3 million HIV-positive people live in South Africa, with a possible range of between 4.5 million and 6.2 million (Kaiser Daily HIV/AIDS Report, 4/21).

Recommendations
"The high death rate due to HIV/AIDS highlights the urgency to accelerate the implementation of a comprehensive plan for the treatment and prevention of HIV and AIDS," the report says. The authors recommend that provinces improve access to health care services; promote active, healthy lifestyles; and ensure "basic needs" such as access to clean water and sanitation are met, according to the Star. The report, which is the first to provide specific causes of death for each province, also says the mortality information can help individual provinces respond to their particular health needs (Star, 5/17). Bradshaw said the report could serve as "an important benchmark" against which to monitor progress and encouraged local officials to identify issues that need to be addressed in their areas, SABC News reports (SABC News, 5/17).

Reaction
South Africa's National Association of People Living with HIV/AIDS said it "was not surprised at the high HIV/AIDS mortality rate," according to the Star. HIV/AIDS is a "multifaceted problem" that requires assistance from the government and business community to fight poverty and provide antiretroviral drugs, according to NAPWA spokesperson Thanduxolo Doro. Mark Heywood, a spokesperson for the South African HIV/AIDS treatment advocacy group Treatment Action Campaign, said, "These figures are just going to get worse and worse," adding, "The deaths in 2000 were at the beginning of a period of rapid HIV infection. More people have been infected since then, and more people are going to be dying." However, Letitia Rispel, director of the health department in Gauteng province, said programs implemented since 2000 might have improved the situation. "These include the prevention of mother-to-child treatment, wellness programs and the antiretroviral rollout program," she said, adding, "Only once we have taken these into account will we get a clear picture." South Africa's Department of Health said it would comment once it had reviewed the report (Star, 5/17).

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