HIV/Aids is the main cause of death among females between the ages of 15 and 39, but the majority of South Africans who died between 1997 and last year did so from unnatural causes.
These findings were part of the long-awaited report released in Pretoria on Thursday by Statistics SA (Stats SA).
At a news conference the Medical Research Council (MRC) and Stats SA agreed that the number of HIV deaths is rising and that HIV has become one of the major underlying causes of death in South Africa, especially among young women.
The report was commissioned by the Cabinet to help clarify trends and programmatic challenges in respect of various causes of death. It was a response to a controversial MRC report last year that found 40% of deaths of those aged between 15 and 49 in 2000 were due to Aids.
It also predicted that Aids will kill between five million and seven million South Africans by 2010.
The report found that the five leading causes of death among South Africans are unnatural, ill- defined causes, tuberculosis, HIV and influenza/pneumonia.
The task team included representatives from the MRC, the departments of health, home affairs and social development who were charged with looking at the general causes of death in South Africa.
”This is not some government cover-up. The two reports are inter-related,” says David Bourne, MRC doctor in the burden of disease unit at the University of Cape Town.
He says that the MRC was interpreting data while Stats SA was reporting on the death certificates.
”The MRC was looking at death without cause, while Stats SA looked at death with cause,” says Bourne.
Stats SA’s report confirms the MRC’s finding that Aids has become the single greatest challenge to the South African health-care system.
”In view of the task team, the Stats SA report confirms the opinion that the number of HIV deaths is rising and that HIV has become one of the major underlying causes of death in South Africa,” says the report.
Taking the statistics from a random selection of death certificates it found that unnatural causes like injuries, suicides, car accidents and drowning caused most deaths of South Africans regardless of race, gender and age.
”Causes of death differ significantly by age group,” says the report.
It found that children from birth to 14 primarily died from intestinal infectious diseases and malnutrition.
The findings of the study suggest that females were more likely to die of HIV/Aids and influenza and pneumonia.
Males, on the other hand, had a high prevalence of tuberculosis and unspecified unnatural causes. The proportion of males dying of unspecified unnatural causes was about three times that of females.
”The proportion of male deaths due to HIV infections doubled from 3,9% in 1997 to 7,6% in 2001.”
It does find that there has been an increase in ill-defined deaths over this period. Most death certificates did not stipulate whether the person died of HIV/Aids and were vague, hence the difficulty in attributing the cause of death to HIV/Aids.
In a statement at the briefing, Dr Ayanda Ntsaluba, Director General of the Department of Health, says 50% of people who had TB were HIV-positive. He says the report emphasises that the government needs to increase funding for the fight against HIV/Aids.
”HIV/Aids is certainly the predominant cause of death among young women,” he said.
Dr Gugu Gule, Deputy Director General of Stats SA, said there is no difference between the MRC and the Stats SA reports.
She recommended that a follow-up study be done to try to identify better ways to capture data, especially with regard to HIV/Aids as most death certificates do not stipulate the cause of death.
Gule says that should funds be available Stats SA will try to look at the statistics of each province to make it as distinguishable as possible.
The report highlighted the fact that a massive social policy response is needed for HIV/Aids. Jack van Zeidam of the Department of Social Services said government policy should focus on interventions to target HIV households where most children suffer before their parents die of Aids.
The health department says the key challenge arising from the study is the need to gather more information on so-called unspecified unnatural causes of death.
”The findings also confirm the need to intensify campaigns around the problems of violence, alcohol abuse, road accidents and unhealthy lifestyles in our society,” says Jo-Anne Collinge, spokesperson for the department.