South Africans are dying younger and in greater numbers, and HIV/AIDS is to blame, according to a report released this week by the South African Institute of Race Relations.
Average life expectancy declined from 62 years in 1990 to 50 years in 2007; it is projected to fall even further by 2011, to 48 years for men and 51 for women, according to the Institute's annual South Africa Survey.
The authors note that among 37 developed and developing countries, South Africa is one of only six where life expectancy fell between 1990 and 2007, with only Zimbabwe showing a steeper decline.
Of South Africa's nine provinces, those with the highest HIV prevalence rates also had the lowest life expectancy - KwaZulu-Natal at 43 years, followed by Free State and Mpumalanga, both at 47 years. The leading causes of death were tuberculosis (TB), influenza and pneumonia, all common opportunistic infections associated with HIV/AIDS.
Seventy percent of people diagnosed with TB in South Africa were co-infected with HIV, and "it is thus reasonable to assume that at least 70 percent of observed mortality from tuberculosis, and by extension a comparable percentage of deaths from influenza/pneumonia, also has HIV and AIDS as an underlying cause." Nearly half of all deaths in 2008 were thought to be HIV/AIDS related - up from a third in 2001.
Gail Eddy, a researcher at the Institute, commented that although neither the public health system nor the government's antiretroviral (ARV) treatment programme were reaching all those in need, particularly in rural areas, a slight decrease in mortality rates in the last two years may be the result of ARVs gradually becoming more widely available.
The HIV/AIDS epidemic contributed to a 43 percent reduction in population growth between 2001 and 2008; a fall in birth rates also played a role.
Although fewer children are being born, HIV/AIDS is creating an increasing number of orphans: of the estimated 2.5 million children who had lost a parent by 2007, more than half were orphaned as a result of HIV/AIDS. According to the survey, by 2015, 32 percent of South African children will have lost one or both parents to the virus.
Eddy noted that the government's social grants programme was not addressing the need of orphaned children for psychosocial support. NGOs were attempting to fill the gap created by a chronic shortage of social workers but many were underfunded. "There's a need to strengthen government/NGO partnerships," she said.
The report was released amid mounting controversy over mortality figures quoted by President Jacob Zuma during a speech on 29 October. He said that 756,000 deaths had been recorded in 2008 - an astounding 30 percent increase from the previous year.
He attributed the increase to the AIDS epidemic, an admission that the AIDS lobby group, Treatment Action Campaign, welcomed as "the ushering in of a new era", after a decade of government denial about the extent of AIDS by former President Thabo Mbeki. However, a number of researchers have questioned the figure, reportedly supplied by the Ministry of Home Affairs.
Eddy confirmed that the figure was significantly higher than the one provided by the Actuarial Society of South Africa, on which the Institute based its calculations.
"I think it was really a miscalculation," she said. Estimating HIV/AIDS deaths in South Africa is particularly problematic because the disease is not notifiable.
See also: SOUTH AFRICA: A mixed bag of new HIV figures
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