GENEVA, Sept 11 (AFP) - A UN specialised agency estimates the AIDS death toll in South Africa in 1999 alone at a quarter of a million people, meaning that six-year-old statistics used by President Thabo Mbeki far underestimate the impact of the disease.
UNAIDS on Tuesday said the number of deaths from the immune deficiency disease in South Africa had increased massively since 1995, a day after a South African paper published a letter from Mbeki stating that HIV/AIDS was not the leading cause of death.
"Routine reporting of causes of death always has a tendency to underestimate AIDS as a cause of death. The reason for this is simply the fact that AIDS 'has many faces' which often leads to a diagnosis other than AIDS, for example tuberculosis, as the cause of death," UNAIDS said in a statement.
Some 250,000 people are estimated to have died due to AIDS in South Africa during 1999, according to the most recent statistics published on the Internet by UNAIDS.
The 1995 figure quoted by Mbeki in a list of causes of death is 2,653.
Mbeki said in a letter to Health Minister Manto Tshabalala-Msimang, a copy of which was published Monday in South Africa's Business Day newspaper, that government's spending on health services should be re-examined in the light of World Health Organisation (WHO) statistics he found on the Internet -- dated 1995.
The WHO 1995 figures appear to back up Mbeki's assertion that AIDS was not the leading cause of death in the country, accounting for just 2.2 percent of fatalities --in 12th place, behind external causes such as homicide, accidents and suicides, and other illnesses.
However, the WHO list includes TB and pneumonia, diseases which are known to be among opportunistic infections that strike HIV patients as separate causes of death above AIDS.
UNAIDS emphasised that, working with South Africa's National AIDS Programme, it found that all unpublished and published information confirmed that the impact of the disease on adult mortality had increased substantially over the past five years.
The agency, which coordinates international action against HIV/AIDS in association with the WHO, acknowledged that AIDS was not the primary cause of death in South Africa in 1995.
"Given the expected underreporting of AIDS deaths, AIDS was not the primary cause of death in South Africa in 1995. Based on the excellent surveillance data produced by the government of South Africa we know that the extensive spread of AIDS only occurred since the early 1990s," the statement said.
UNAIDS noted that due to the delay between HIV infection and death, on average about nine years, there would have been little impact on adult mortality in 1995.
UNAIDS said the prevalence rate of HIV/AIDS infections in South Africa in 1995 was about three percent. Its published prevalence rate for 1999 is 19.94 percent of the adult population.
"Even just basing it on that, the epidemic has grown and so have the number of deaths, substantially," Dominique De Santis, a spokeswoman for UNAIDS said.
Mbeki in his letter warned the health minister that the figures will "provoke a howl of displeasure and a concerted propaganda campaign from those who have convinced themselves that HIV/AIDS is the single biggest cause of death" in South Africa.
The South African leader has been criticised internationally for having said that AIDS might not be directly caused by HIV, despite the fact that South Africa has the world's largest HIV population with 4.7 million infected.
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