JOHANNESBURG, South Africa – In an implicit but devastating account of the havoc AIDS is causing here, South Africa's government reported yesterday that annual deaths increased 57 percent from 1997 to 2003, with common AIDS-related diseases such as tuberculosis and pneumonia fueling much of the rise.
The increase in mortality spanned all age groups but was most pronounced among those ages 15 to 49, where deaths more than doubled.
Working-age adults are more sexually active than the rest of the population, and the opportunity for transmitting HIV is greatest among members of this group.
The report, by the government agency Statistics South Africa, caused contention even before its release, which came more than a month after the originally scheduled date. Critics charged – and the agency denied – that the delay was because of political pressure from President Thabo Mbeki's government, which they say has long played down the dimensions of the AIDS crisis here.
Mbeki's office sharply rebuked the agency in 2001 after it reported that 4 in 10 deaths among working-age adults probably resulted from AIDS, saying that statisticians could not prove their conclusion.
The statistics agency has denied that its report was politically influenced.
The report notes that both the total number of deaths and their causes are undoubtedly inaccurate because death reporting is not consistent in rural areas, and medical expertise is uneven across the nation.
The report states that 499,000 of South Africa's roughly 44 million people died in 2002, up sharply from 318,000 in 1997.
Much of that increase appears to result from HIV, the virus that causes AIDS. Experts agree that there are at least 5 million HIV-positive citizens here, the most of any nation.
Diagnosing AIDS as a cause of death can require advanced medical knowledge and equipment. Moreover, an unknown number of AIDS deaths go unreported because South African life insurance policies frequently do not cover AIDS-related deaths.
Nevertheless, the agency reported that the new figures "provide indirect evidence that HIV may be contributing to the increase in the level of mortality for prime-aged adults, given the increasing number of deaths due to associated diseases."
Dr. Steve Andrews, an HIV clinician and consultant in Cape Town, said the sobering figures in the report suggested that it had not been politically varnished. Given the improvement in medical care and living standards in South Africa, he said, "we should not be seeing this aggressive move in death rates – not at all."
The report concluded that the average number of deaths in South Africa rose from 870 per day in 1997 to 1,370 in 2002, an increase that could not be explained by the 10 percent increase in population during the same period.
