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TAC Statement on President Mbeki's AIDS Denialist Remarks in City Press

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Yesterday, City Press published views indicative of AIDS denialism by President Thabo Mbeki. We reprint the City Press article for fair use below.

Tragically, President Mbeki continues to belittle HIV/AIDS related deaths to justify his personal denialism.  He undermines government and ANC policy but he lacks the courage to do so openly as an AIDS denialist. 

More seriously, the President’s denialism contributes directly to delayed testing, prolonged illness and premature deaths.  TAC demands that the Cabinet and ANC NEC act to save lives. The time has come to put loyalty to the Constitutional rights to life, health, dignity and equality before loyalty to a leader in denial. President Mbeki deliberately minimizes deaths from HIV/AIDS related illness. His denial is deeply offensive to people who live with HIV/AIDS and our families who bury us. 
  

Reprinted from City Press, 26 February 2006

No Aids death crisis- Mbeki

Jimmy Seepe and Mapula Sibanda

PRESIDENT Thabo Mbeki is adamant that the public service is not facing a major HIV/Aids crisis. This is despite the fact that government does not know the extent of the ravages of Aids on its public servants.

Asked if the government was faced with a national crisis because of the increasing number of public servants dying from the pandemic, Mbeki said no-one had raised the alarm to indicate the effects of Aids on government employees.

Speaking at his official residence , Mahlamba'Ndlopfu, Mbeki said he had not been provided with any information indicating that public servants at different levels of government, like teachers, were dying.

"We need to do some research to say what the level of deaths are in the public service as a result of natural and non-natural causes.

"People die from anything . . . no-one has sounded the alarm where I work daily in the Presidency and nobody has said there is a particularly alarming tendency of people dying. There has not been any indication . . . ;In the presidency nobody has said we are losing 10 percent of our staff every year because of Aids."

Mbeki's statement follows a recent report about a serious concern in the education sector about the number of teachers living with Aids who might die annually if they did not receive antiretrovirals (ARVs).

The findings come from a study by the Human Sciences Research Council (HSRC) that was commissioned by the Education Labour Relations Council last year. It covered more than 20 000 respondents in 54 districts countrywide. The study said a minimum of 10 000 teachers living with Aids urgently need to be put on ARVs. It called for swift intervention from the education department to save the teachers.

But Mbeki dismissed the report as highly speculative.

"Nothing has been said by anybody like the thing you are indicating (the teachers' report) - that you have got this kind of wastage as a result of Aids. I have not seen any such thing."

Mbeki this week questioned the statement by the South African Democratic Teachers' Union (Sadtu) about the large number of teachers dying from the disease.

He said he had asked Sadtu to provide him with facts to substantiate its claim which it did not do.

He said issues critical to government regarding teachers included ensuring the permanent employment of part-time and unemployed teachers.

"There are too many teachers in part-time employment, they need to work full time. The things we should be agitated about are those things (and) not this."

Sadtu president Willie Madisha said the union had not received Mbeki's request to provide him with information regarding its claims.

"We relied on the HSRC which provided us with information after its study indicated that about 12,7 percent of teachers have HIV while 10 000 are in need of immediate ARV treatment," he said. There are approximately 300 000 teachers in South Africa. This means that about 40 000 teachers are infected with HIV.

There is scientific research which was requested and agreed to by all teacher unions in the public service. Education department officials sat in the same forum where all teacher unions came up with this request (for a study on HIV/Aids among teachers)."

Madisha said Sadtu had called on education authorities to institute urgent steps to deal with the large number of vacancies that would be created by teachers dying of Aids.

Mark Heywood, head of the Aids Law Project, said it was "unbecoming for President Mbeki to blame others for not getting any reports". He said Mbeki's inaction to audit the effects of Aids in the civil service was a neglect of duty.

He was privileged to make deductions of the impact of Aids from many sources in government, such as the home affairs department, or the latest survey on mortality rates by Statistics SA.

Mbeki conceded there was a need to research the level of attrition in the public service because of natural and unnatural causes.

Slamming speculative reports that government could not act on, Mbeki compared the latest reports with the Metropolitan report that examined the effect of Aids on business by saying, " . . . in terms of the effect on the economy, they say it is not significant - that's what Metropolitan Life said".

He quoted a mining company, which he did not name, that had pointed to a decline in the rate of HIV infections among employees.

Asked how this had been achieved, he was told it was through the company's aggressive intervention on TB and STDs.

[END OF CITY PRESS REPORT]

 

HIV/AIDS, Age and Death in South Africa

We all know from the deaths in the Mandela and Buthelezi families that children die before their parents because of HIV/AIDS. StatsSA shows how the pattern of death has changed in our country. In 1997, the highest number of deaths occurred in people aged 65-69 years old (7.38%) and 75-79 (7.39%). In 2003, the highest number of deaths occurred in the age group 30-34 (9.78%). In addition, infant mortality rose dramatically between 1997 and 2002 as well (40%), primarily because of the AIDS epidemic. 
 

From the StatsSA data three changes are absolutely clear:

(1) early death; “the figures suggest that there has been a significant increase in the number of deaths amongst men aged 30-44 and amongst women of reproductive ages”;

(2) the provinces worst affected by HIV are experiencing increasing deaths and;

(3) causes of death have changed dramatically.

 

 

Total Recorded Deaths by Selected Age Groups and Year of Death (Source StatsSA)

 

Age

1997

1998

1999

2000

2001

2002

0-4

34 779

41 171

40 139

40 768

41 920

48 572

20-24

13 574

15 682

16 892

18 500

19 655

21 838

25-29

18 227

22 797

26 375

30 348

35 667

41 412

30-34

18 903

24 008

28 404

33 909

39 203

46 758

35-39

18 733

23 419

27 118

31 814

36 568

43 020

40-44

18 086

21 816

24 041

27 868

31 893

36 614

45-49

18 530

21 808

23 445

25 452

28 611

31 681

50-54

17 495

20 202

21 596

24 213

26 864

29 613

65-69

23 501

25 733

25 171

24 522

25 719

26 902

75-79

23 525

23 935

22 292

21 830

22 848

23 875

 

 

Total Recorded Deaths by Province 1997-2002 (Source StatsSA)

Province

1997

1998

1999

2000

2001

2002

W. Cape

33 292

36 347

38 088

38 540

41 042

43 667

E. Cape

45 345

50 918

53 851

60 602

65 719

73 072

N. Cape

8 495

9 441

9 187

9 847

10 421

11 267

Free State

25 375

30 142

31 625

34 101

36 877

40 715

KZN

70 487

83 048

86 156

95 353

105 256

116 982

North West

25 026

29 458

32 395

35 437

39 723

44 269

Gauteng

67 734

75 993

75 445

80 425

86 213

95 186

MPL

20 122

23 926

25 899

28 273

31 548

35 277

Limpopo

22 338

28 302

29 135

31 263

34 901

38 639

Total including outside RSA

318 287

367 689

381 902

413 969

451 936

499 268

 

Natural and non-natural deaths 1997, 1999 and 2001 (Source StatsSA)

Cause of Death

1997

    No.         %

1999

No.           %

2001

No.           %

Natural

264 285    83.0%

328 671   86.1%

401 812   88.9%

Non-natural

54 002      17.0%

53 231     13.9%

50 124     11.1%

Total

318 28      100%

381 902    100%

451 936    100%

 

From the tragedy of the death certificate statistics, another very important set of facts can be learnt: the burden of HIV on the health systems. The table below shows increases in death and illness.

  • TB deaths increased from 22 021 in 1997 to 50 872 in 2001. In just four years the disease burden from these deaths more than doubled.
  •  “Other heart disease” deaths increased more or less in line with population increases from 20 103 in 1997 to 22 602 in 2001, showing that the pre-HIV disease pattern remained high.
  • This conclusion can be strengthened by comparing every HIV-related cause of death with non-HIV related deaths. For instance,cerebrovascular disease increased from 16 992 in 1997 to 22 577 in 2001. It is unclear what the effect  – most of these deaths are probably non-HIV has been on the increase in this category.related. But, comparethisthem to deaths due to influenza and pneumonia, deaths that in this age group are indisputably linked to HIV disease. Influenza and pneumonia deaths increased from 11 503 in 1997 to 31 495 in 2001.
  • Everyone working in the health system knows that additional nurses, doctors, clerks, cleaners, managers or pharmacists were not employed to cope with this demonstrated increase in the disease burden. This has direct consequences for the quality of care and for staff burn-out.

 

 

Ten leading causes of natural death: 1997,1999 and 2001 (Source StatsSA)

Cause on death certificate

              1997

Rank       No.       %

              1999

Rank       No.       %

              2001

Rank       No.        %

Tuberculosis

  1        22 021   6.9%

  1        34 173   8.9%

  1         50 872  11.3%

Other heart diseases

  2        20 103   6.3%

  2        20 120   5.3%

  3         22 602    5.0%

CerebrovascularDisease

  3        16 992   5.3%

  3        19 948   5.2%

  4         22 577    5.0%

Influenza and pneumonia

  4        11 503   3.6%

  4        19 135   5.0%

  2         31 495    7.0%

Diabetes mellitus

  5        10 828   3.4%

  6        12 540   3.3%

  7         14 557    3.2%

Chronic lower respiratory diseases

  6        10 747   3.4%

  5        12 573   3.3%

  6         14 681    3.2%

Ischaemic heart disease

  7         9 794    3.1%   

  7        11 426   3.0%

  8         11 777    2.6%

Malignant neoplasmsof digestive organs

  8         8 914    2.8%

 

 

 

 

Hypertensive diseases

  9         7 706    2.4%

 10        9 427    2.5%

 10        10 748    2.4%

Intestinal Infectious diseases

 

 

  8        11 155   2.9%

  5         16 060    3.6%

Perinatal respiratory and cardio disorders

10       7 125      2.2%

 

 

 

 

HIV diseases

 

 

  9          9 925   2.6%

 

 

Immune Mechanism Disorders

 

 

 

 

9          11 670     2.6%

Other causes

       192 554    60.5%

      221 480   58.0%

        244 897   54.2%

Total

       318 287  100.0%

      381 902 100.0%

        451 936 100.0%

 

 

 

 

 

 

This increasing burden of HIV disease affects people of reproductive age and those who are economically active.  People age 15-49 are dramatically affected by new HIV infection, illness and AIDS deaths.  The table below on underlying causes of death in 15-49 year olds should have been memorized by every politician, faith-based leader, unionist, business leader, civil society organization. Instead, we have a conspiracy of silence and attempts to make these deaths invisible. The impact of every death recorded on these death certificates means the loss of a breadwinner, a parent or a child.  This means an increase in household expenditure on illness (health care), death (funerals) and lost income for families. In the words of Henk Roussouw at the Ruth First Memorial Lecture, Wits University 25 August 2005:

A death because of Aids, a treatable disease, is a loss for every member of the body politic, from the Union Buildings all the way down to Mathibestad, 70km north of Tshwane, population 21 700.

 

Ten leading causes of natural death in age group 15-49 (Source StatsSA)

Cause on death certificate

              1997

Rank       No.       %

              1999

Rank       No.       %

              2001

Rank       No.       %

Tuberculosis

1        13 396  11.9%

1         23 448  15.2%

1         37 917  19.0%

HIV disease

2          5 029    4.5%

3           8 197    5.3%

5           7 564    3.8%

Influenza and Pneumonia

3          4 467    4.1%

2           9 830    6.4%

2         18 632    9.3%

Other forms of heart disease

4          4 218    3.8%

6           4 566    3.0%

6           5 684    2.8%

Cerebrovasculardisease

5          2 707    2.4%

7          3  746    2.4%

7           3 833    1.9%

Certain Immune Disorders

6          2 448    2.2%

4          6  615    4.3%

3           8 948    4.5%

Intestinal Infectious Diseases

7        2 070       1.8%

5           4 951    3.2%

4           8 559    4.3%   

Chronic lower respiratory diseases

8        1 831       1.6%

8           2 709    1.8%

9           3 099    1.5%

Malignant neoplasmsof digestive organs

9        1 736       1.5%

 

 

 

 

Diseases of the liver

10      1 695       1.5%

10         1 968    1.3%

 

 

Other viral diseases

 

 

9           2 004    1.3%

8           3 691    1.8%    

Inflammatory diseases of the central nervous system

 

 

 

 

10         2 968    1.5%

Other causes

        72 531     64.6%

         85 978    55.8%

        99 073    50.0%

All natural causes

     112 310    100.0%

        154012    100%

      199 968   100.0%

 

 

 

 

 

 

 

 

[END OF EXTRACT FROM CHAIRPERSON'S REPORT TO TAC CONGRESS 2005]