Aids Will Kill 700,000 South
Africans A Year

Chris McGreal in Cape Town
Wednesday October 17, 2001
The Guardian

A devastating report into Aids suppressed by the South African government because it identifies the disease as the largest killer in the country and predicts millions more deaths, was finally made public yesterday after unions, churches and politicians demanded its release.
But cabinet ministers spent recent days trying to discredit what the government-funded Medical Research Council (MRC) called its "shocking" findings because they fly in the face of President Thabo Mbeki's claim that Aids is responsible for only a fraction of deaths.
"The number of Aids deaths can be expected to grow within the next 10 years to more than double the number of deaths due to all other causes, resulting in 5m to 7m cumulative Aids deaths in South Africa by 2010," the report said.
The MRC report estimates that 40% of deaths of South Africans between the ages of 15 and 49 are Aids-related. The worst hit group are women in their late 20s and then men in their 30s. It says one in four pregnant women attending public health clinics carry the Aids virus. A decade ago, the figure was one in 100. At Chris Hani Baragwanath hospital in Soweto, the largest hospital in Africa, 43% of all deaths are because of Aids.
Average life expectancy is expected to drop from 54 years at present to 41 by the end of the decade. At that time, about 780,000 people will be dying each year from Aids, the highest number in any country.
"These shocking projections should galvanise efforts to minimise the devastation of the epidemic," the MRC said.
The authors say their report is the outcome of the most comprehensive investigation to date into the impact of Aids, and that it was subject to rigorous review, including approval by Peter Goldblatt, the doctor who is chief medical statistician for England and Wales.
But the South African government has stopped just short of dismissing the report outright in its attempts to downplay and discredit it.
The health minister, Manto Tshabalala-Msimang, and Essop Pahad, the president's right-hand man, wrote an article in a Johannesburg Sunday newspaper deriding the report as a "massive propaganda tool" in the hands of those who argue for wide distribution of anti-retroviral drugs, and condemning a "sense of hysteria" over the question of deaths from Aids.
"Existing data, including the MRC report, cannot be relied on; at most, it's just a work in progress," the ministers wrote.
Dr Tshabalala-Msimang and Mr Pahad again quoted six-year-old World Health Organisation (WHO) mortality statistics to back up the president's claim that Aids is not the leading cause of death in South Africa. The WHO has said the figures are so out of date as to be meaningless.
The government's statistics office, StatsSA, also publicly ridiculed the MRC report last week by saying the researchers had greatly exaggerated the rates of HIV transmission.
StatsSA estimated the number of people who will die of Aids at no higher than 2m.
One of the authors of the MRC report, Rob Dorrington, poured scorn on that claim.
"It is a great shame that StatsSA chose to trash the MRC report," he said. "Their presentation to the press was riddled with half-truths and misunderstandings. It gives new meaning to the phrase 'lies, damn lies and statistics'.
"They chose to do it in a very public way, without talking to us to check on their understanding of what was going on, and as a result they fed into the debate doubts about the accuracy of the numbers when the very real problem is the number of people that are dying."
The report was ready in July but the government insisted that it could not be released without cabinet approval.
After some findings were leaked earlier this month, the government came under pressure to make the report public. Cosatu, the trade union confederation and an ally of the governing African National Congress, along with the Anglican and Catholic churches and even the ANC's health committee, joined the call.
Instead, the health minister issued a veiled threat to the MRC, describing the leaks as a "serious situation to be attended to".
The row grew when a prominent anti-apartheid activist and former human rights commissioner, Rhoda Kadalie, called on Dr Tshabalala-Msimang to resign.
"We have a genocide on our hands and you and your cohorts have been unwilling to listen to the experts," she said in a letter to a Johannesburg newspaper. "If the president is making it impossible to do your work effectively, why not resign with dignity in defiance of someone who is taking the country down with him?"


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