Sunday Times, South Africa - July 9, 2000
Laurice Taitz

The figures, finalised by the Department of Home Affairs last week, were presented to stunned members of Thabo Mbeki's presidential advisory panel on AIDS on Tuesday by the president of the Medical Research Council, Professor Malegapuru Makgoba.

"If we had been involved in a major war, that would be the only other thing that could explain the high numbers of young men and women who are dying in our country," he told the panel, which includes the Minister of Health, Dr Manto Tshabalala-Msimang, who was hearing the dramatic statistics for the first time.

His presentation was greeted with a "stony silence", putting an end to the debate raised by dissident scientists on whether AIDS was causing a dramatic increase in deaths in South Africa.

The figures were released on the eve of the 13th International Aids Conference, which opens in Durban tonight.

"This is the first data presented that actually gives South Africa a picture of what is really happening. These are not projections. These are real figures," Makgoba told the Sunday Times.

The figures, for 1990 and 1999/2000, prove once and for all that AIDS is taking a devastating toll among South Africa's most economically productive citizens - those aged between 15 and 49 - with more men between 35 and 40 dying in the 1999-2000 period than in any other age group.

"These figures show that something is decimating our population. If you look at changes in death patterns . . . you can see what used to happen before AIDS became an issue in South Africa. That's the reality," said Makgoba.

The death rate has risen despite better access to health care and improvements in the quality of life of most South Africans in the 10 years since 1990.

"In any normal population you expect the old to die, not the young - but here you have young people dying and young women dying earlier than young men, which is unheard of in biological terms," said Makgoba. "It can only be explained by the peak incidence of AIDS, which is between the ages of 20 to 30 for women."

People aged between 15 and 49 form the most productive section of the South African economy and pay the bulk of taxes.

Alan Whiteside, a health economics researcher at the University of Natal, who was present when Makgoba presented his figures, said: "The full impact will unfold over the next few years and there is no doubt that it will be devastating in all sectors, starting with health and education."

AIDS deaths are expected to hurt all South Africans:

An estimated R7.2-billion was spent on educating those of a productive age who died of AIDS in 1999-2000;

By 2003, 12% of highly skilled workers, 20% of skilled workers and 27.2% of low-skilled workers will be infected, according to a study by ING Barings. It will cost an estimated R250 000 to replace each skilled labourer lost;

Medical aid claims are expected to rise rapidly and some schemes could face bankruptcy;

It will cost the public health system R16 900 a year to treat each AIDS patient; and

Eskom estimates it will spend R400-million a year on pensions, medical aid, lost productivity and the recruitment of new workers from 2005 onwards.

Other data presented by Makgoba showed that tests used to diagnose HIV did so with more than 99% accuracy.

Presenting data from his own published research, the Medical Research Council's Dr Salim Abdool Karim said South Africa was being hit by many strains of the AIDS virus, unlike other countries which had to cope with only one.

"We have multiple small epidemics which are coalescing - a result of migrancy and the huge burden of sexually transmitted diseases," he said.

Makgoba also presented a study compiled by researchers at the perinatal clinic at Chris Hani Baragwanath Hospital in Soweto, which followed up on the babies born to HIV-positive women and compared them with children born to HIV-negative mothers.

It found that one in three babies born to mothers diagnosed HIVpositive died within 12 months, compared with one in 59 babies born to HIV-negative mothers.

Additional reporting by Cornia Pretorius and Celean Jacobson
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