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MRC releases new report - Estimates of Provincial Mortality
Jillian Green and Shaun Smillie. 17 May 2005. The Star. Republished courtesy of Independent Newspapers (Pty) Ltd.
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South Africa's biggest killer is HIV/AIDS, according to a new Medical Research Council (MRC) report on cause-specific death rates for each of the nine provinces.
According to the report, Estimates of Provincial Mortality, HIV/AIDS in Gauteng accounted for 33 percent of all deaths in 2000 - one in three - compared with 30 percent of all deaths nationwide.
Compiled by the MRC's Burden of Disease Research Unit, the report shows that overall mortality rates and causes of death differ in the provinces, but that HIV/AIDS is the leading killer across the board.
"These figures are just going to get worse and worse," Mark Heywood, spokesperson for the Treatment Action Campaign, said on Monday.
The findings relating to HIV/AIDS deaths were consistent with other available reports.
"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."
But Dr Letitia Rispel, head of department for the Gauteng Health Department, said it would be difficult to say what the situation would be now without taking programmes implemented since 2000 into account.
"These include the prevention of mother-to-child treatment, wellness programmes and the anti-retroviral rollout programme. Only once we have taken these into account will we get a clear picture."
The MRC report, which also looks at other causes of deaths in the various provinces, shows that these varied from province to province.
For women in Gauteng, the main causes of death, excluding HIV/AIDS, are stroke, lower respiratory tract infections, homicide, ischaemic heart disease, road accidents, TB, hypertensive heart disease, diarrhoeal diseases, septicaemia and diabetes mellitus.
For men, the 10 leading causes of death, excluding HIV/AIDS, are homicide and road traffic accidents, ischaemic heart disease, TB, lower respiratory infections, stroke, suicide, diarrhoeal diseases, diabetes and chronic obstructive pulmonary disease.
This differs from the 10 leading causes of death for Western Cape men. For those, the 10 leading causes of death are homicide, HIV/AIDS, traffic accidents, TB, heart disease and stroke, cancer of the upper respiratory tract or lungs, suicide, chronic obstructive pulmonary disease and lower respiratory infections.
For women in the Western Cape the main causes of death are HIV/AIDS, TB, heart disease, stroke, traffic accidents, homicide, diabetes, diarrhoeal diseases, breast cancer and lower respiratory infections.
And according to the report, Western Cape residents have the highest life expectancy in the country, probably due to a relatively low HIV infection rate.
The report, co-authored by Professor Debbie Bradshaw, director of the MRC's research unit, indicates that South Africa is dealing with a quadruple burden of disease with communicable diseases, non-communicable diseases, injuries (homicide and road traffic accidents) and HIV all having a significant impact on cause-of-death profiles.
The authors recommend, among other things, that provinces improve access to healthcare, ensure basic needs such as access to clean water and sanitation are met, and that they promote active healthy lifestyles.
"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/AIDS," the report reads.
The report's key findings are:
- Life expectancy in KwaZulu-Natal and Mpumalanga is 11 years lower than in the Western Cape, which has the lowest mortality rate and where life expectancy is 63. No life expectancy figure was given for Gauteng.
- HIV/AIDS is the leading cause of death and premature or early death for all provinces.
- Deaths from diarrhoeal disease, TB and nutritional deficiencies are more likely in the poorer, more rural provinces.
- Deaths from non-communicable disease is similar across all the provinces, although the causes differ.
- Death rates from injuries are particularly high in the Western Cape, Gauteng and Mpumalanga, with men having twice the rate of women.
The report is the first to provide cause-specific death rates for each province. "With these statistics, provinces will be able to respond to the specific health needs of the population in that province," the report reads.
The National Association of People Living with HIV/AIDS (NAPWA) was not surprised at the high HIV/AIDS mortality rate. "For a long time we have been seeing parents burying their children, not the other way around - even as people were not saying that it was HIV/AIDS their children were dying from," said NAPWA spokesperson Thanduxolo Doro.
HIV/AIDS was a multifaceted problem, said Doro, and if the government and the business community were to deal with it, poverty had to be fought and anti-retroviral drugs provided.
The national health department said it would comment once it had studied the report.
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