South Africa's death rate
rose sharply over a seven-year period and the
increase is partly due to the country's staggering
AIDS epidemic, the government said.
The government statistical
office said the death rate for women aged 20 to 39
had more than tripled between 1997 and 2004, and
had more than doubled for men aged 30 to 44. It said
those groups had the highest number of deaths from AIDS.
The report gave no estimate
for the increase in HIV deaths,
saying many AIDS-related deaths are attributed on
death certificates to other causes.
''Large increases in the
death rates of women in their 20s and 30s since
the late 1990s are thought to result mainly from
HIV,'' the government said in its
report Thursday.
The government said the
increase in the death rate is also due to
nutritional deficiencies and infectious diseases
such as tuberculosis and malaria.
However, the government said
levels of HIV infection have risen
rapidly and that the average time from becoming
infected to death was eight to 10 years. It was
likely that ''HIV deaths will
continue to increase in South Africa for some years,''
according to the report.
The percentage of pregnant
woman who are HIV-positive had risen from 1% in
1990 to 17% in 1997 and to 30% by 2004, the last
year covered by the report.
Overall, the government has
estimated more than 5.5 million South Africans are
infected with HIV, a number second only to
India and one that amounts to about an eighth of
estimated cases worldwide.
On average, more than 900
people die of the disease in South Africa each day.
South Africa's government has
come under mounting international criticism
because of its handling of its AIDS epidemic.
President Thabo Mbeki once questioned the link between
HIV and AIDS and both he and Health
Minister Manto Tshabalala-Msimang have doubted the
effectiveness of antiretroviral drugs used to
treat AIDS.
More than 80
international AIDS scientists, including an American Nobel
laureate and one of the codiscoverers of the virus that
causes AIDS, released a letter to Mbeki on Wednesday
that called South Africa's AIDS policies inefficient
and immoral and urged the president to fire his health
minister.
Stephen Lewis, the U.N. Special
Envoy for AIDS in Africa, delivered a scathing
attack on South Africa at the International AIDS
conference in Toronto last month, saying the
government was ''still obtuse, dilatory, and negligent''
about providing treatment.
''It is the only country in
Africa whose government continues to promote
theories more worthy of a lunatic fringe than of a
concerned, compassionate state,'' he said.
South Africa called Lewis'
comments ''unacceptable'' and claimed to have the
largest HIV treatment program in the world.
It said it was treating 140,000 people in
treatment programs, a figure less than half of the
380,000 target it set in 2003. The AIDS scientists said
about 500,000 South Africans now need AIDS drugs
to survive.
The increase in the death
rate for almost every age and gender group in the
study was particularly disturbing because the
worldwide trend is for the rates to have declined.
''South Africa is a member of
a select but undesirable group of countries in
which life expectancy at birth declined by four
years or more between 1990 and 2001,'' the government
said. It said all the countries are either in
Africa or part of the former Soviet Union.
The report found that deaths
from murder, suicide, and accidents changed little
and the number of killings had declined since the
late 1990s. But the government said South Africa
probably still has ''the second highest homicide rate in
the world, trailing only Colombia.''
Meanwhile, a killer strain of
extremely drug-resistant tuberculosis has been
found in at least 28 hospitals across South Africa
and almost certainly has spilled across the country's
borders, a specialist said Thursday.
The virtually untreatable
superbug could jeopardize efforts to deal with the
AIDS epidemic, according to experts from the U.N.,
the U.S. Centers for Disease Control and Prevention, and
14 southern and central African nations that convened to
discuss how to combat the threat.
Experts note that TB
diagnostics haven't changed in 100 years and TB
medication in 50 years, and they are calling for
better and faster methods in dealing with the superbug.
They blamed the antiquated methods on the fact
that TB is largely a disease of the poor and is
often spread by overcrowding when an infected person
sneezes or coughs and the airborne bacteria infect
someone else.
Last year the Global Alliance
for TB Drug Development, a nonprofit organization,
began tests on a new treatment that would halve
the time of treatment to two or three months, lowering
the risks of developing resistant strains and expanding
the number of patients receiving treatment.
In South Africa, no one knows
how many people are infected with the particularly
virulent strain announced last week, Professor
Willem Sturm told the conference, highlighting the
dilemma facing already overburdened health workers.
Victims in South Africa were
''all over the place ... you can almost be sure
there will be infection in Mozambique and even
farther (abroad) because people travel--and quite
some distance,'' Sturm told the Associated Press.
The new extremely drug-resistant TB
strain was discovered by rural doctor Tony Moll in
eastern KwaZulu-Natal province, where it killed 52
of 53 HIV-positive patients within 16 days during
a study carried out from January 2005 to March 2006.
Moll became suspicious
he had a superbug on his hands when
HIV-positive patients responded well to antiretroviral
treatment, then suddenly died.
''What's the
point in investing hugely in ARV programs if patients die a
few weeks later from extreme drug-resistant tuberculosis?''
Dr. Paul Nunn, head of the U.N. World Health
Organization's TB resistance program, said on the
sidelines of the conference.
Drug resistance
grows when people do not complete a grueling six-month
regimen of medication that cures the disease. That is
difficult in a country where there is high illiteracy
and where people might have to walk half a day to the
nearest health center, which might be out of
medication. Many of the affected people are poor, and
if they take the medication on an empty stomach
they can often become sicker.
Multiple
drug-resistant TB does not respond to a ''first line'' of
drugs that in South Africa cost about $200 to cure a
patient, compared to R24,000 to cure multiple
drug-resistant TB. Extremely drug-resistant strains do
not respond to a ''second line'' of drugs.
South Africa's
Health Department said this week it was exploring the
feasibility of importing two even more expensive drugs that
might help. But Moll noted the new strain was so
virulent that patients died even before doctors
received the results of their tests. (AP)