Deaths spiral out of control in Aids crisis

South Africa's mortality rate has jumped by 59 per cent in six years, fuelled by the HIV/Aids epidemic, according to new figures published this weekend by the country's central statistical office.

The report, which has been mired in political controversy even before its publication, says women have represented the biggest increase, while more adults of both sexes now are dying than in 1997.

In 1997 149 men aged between 25 and 29 were dying for every 100 deaths among women. In 2003 that figure had leapt to 77 male deaths for every 100 female deaths.

The figures are based on a survey by the government agency Statistics South Africa which analysed the cause of death of around three million South Africans notified to the Department of Home Affairs between 1997 and 2003.

The poll is a potential bombshell in a country where health professionals and the government have been locked in a bitter struggle over the real scale of the HIV/Aids epidemic.

Although tuberculosis, influenza and pneumonia, and cerebrovascular diseases were listed as the leading causes of death, the Statistician-General Pali Lehohla, said on Friday that the data had 'provided indirect evidence that the HIV/Aids epidemic in South Africa is raising the mortality levels of prime-aged adults, in that associated diseases are on the increase'.

The release of the mortality figures was already controversial even before their publication with claims that the statistics were being suppressed by President Thabo Mbeki, who has long attempted to play down the scale of the Aids crisis and who criticised the same agency in 2001 for the claim that 40 per cent of South Africans were HIV positive.

The report concluded that the average number of deaths rose to 1,370 a day in 2002 from 870 in 1997, an increase that could not be explained by the 10 per cent increase in population during the same period. Dr Steve Andrews, an HIV clinician and consultant in Cape Town, told the New York Times he believed the figures suggested that far from the report having been made more politically palatable, 'we should not be seeing this aggressive move in death rates - not at all'.

The new figures have emerged amid an escalating row over the South African government's handling of HIV/Aids which forced the country's Health Minister, Manto Tshabalala-Msimang, to issue a statement maintaining that South Africa's Aids policy is among the world's best.

'Very few plans are as comprehensive as ours, bringing together elements of prevention, nutrition and a variety of different treatments,' Tshabalala-Msimang claimed. But the government target of having 53,000 people at 113 state-accredited health centres on free antiretroviral therapy by March 2005 is still falling short. Recent figures from the Aids lobby group, Treatment Action Campaign, indicate that only 29,332 people were accessing the drugs.

The escalating Aids crisis - and claims that the government is doing too little to stem the spread of the disease - has seen increasing public discontent.

Last week Aids activists once again marched to parliament to demand a ten-fold increase in the number of people being treated on retroviral drugs by 2006.

Receiving the petition South Africa's presidential head of communications, Murphy Morobe, said that he personally had lost six family members to HIV/Aids over the past three years.

Morobe's remarks are in contrast to President Mbeki's statement in 2003 that he 'did not personally know anyone who had died from Aids'.

The latest official figures will put new pressure on the president, following hard on research published earlier this year in the journal Aids whose authors estimated that more than 112,000 people died of HIV-related illnesses in 2000-01 alone - nearly three times the figure given by South Africa's department of home affairs.

The country has been accused repeatedly of deliberately underestimating the Aids death toll - and therefore failing to allocate sufficient resources.

A 2002 survey by Statistics South Africa showed that only 8.7 per cent of deaths in the country were caused by HIV/Aids.

But medical researchers and Aids charities insisted at the time that it had massively downplayed the scale of the pandemic.