SOUTH AFRICA: HIV stalls progress on MDGs
 Photo: Anthony Kaminju/IRIN  |
| Child deaths remain stubbornly high |
Nearly 800 South Africans died every day from AIDS-related illnesses in 2009 and more than 1,110 became newly infected daily, according to the South African Health Review (SAHR) 2010, which reveals the immense challenges in achieving the eight goals set by the UN in 2000.
The country has not achieved the goal of universal access to ARV treatment for all those who need it by 2010, despite having by far the largest antiretroviral (ARV) treatment programme in the world, and will struggle to achieve the MDG of halting and reversing the spread of HIV and tuberculosis (TB) by 2015.
An annual publication compiled by Health Systems Trust, an NGO focused on health systems research, the 2010 edition of the SAHR notes that far from achieving a 75 percent reduction in maternal mortality, the number of deaths resulting from pregnancy or childbirth has actually doubled in the past 20 years. Deaths of children under five have also been rising steadily, reaching a peak of 62 per 1,000 in 2007 and then levelling off, but not declining.
HIV is the major cause of the upward trajectory in maternal and child deaths in South Africa. Non-pregnancy related infections, most of them due to AIDS, accounted for nearly 44 percent of maternal mortality between 2005 and 2007, with HIV-positive women nearly 10 times more likely to die during pregnancy or childbirth than HIV-negative women.
South Africa recently changed its treatment guidelines to prioritize ARV treatment for HIV-positive pregnant women, a move that is expected to bring down maternal mortality if fully implemented.
The SAHR notes, however, that “guidelines do not, by themselves, produce access to essential quality care. Significant weaknesses in already overstretched ARV services should urgently be addressed in order to ensure that the increased number of eligible pregnant women actually access treatment.”
The authors add that, even without HIV, South Africa would probably not be on track to meet MDG5 because of the “unacceptably high” rate of deaths due to preventable obstetric causes.
Estimates of child mortality in South Africa are based on incomplete and often conflicting data, but it is clear that the HIV/AIDS epidemic reversed gains made before 1990. Looking at data from 2007, the most recent year with reliable figures, the SAHR notes that although the major causes of childhood deaths were neonatal problems, intestinal infections, acute respiratory infections and TB, in many cases the underlying causes of death were HIV, malnutrition and the loss of a mother. The data also revealed marked discrepancies between provinces, with the Western Cape recording 39 under-five deaths per 1,000 and the Free State 110 per 1,000.
Photo: Anthony Kaminju/IRIN |
| Child deaths remain stubbornly high |
Nearly 800 South Africans died every day from AIDS-related illnesses in 2009 and more than 1,110 became newly infected daily, according to the South African Health Review (SAHR) 2010, which reveals the immense challenges in achieving the eight goals set by the UN in 2000.
The country has not achieved the goal of universal access to ARV treatment for all those who need it by 2010, despite having by far the largest antiretroviral (ARV) treatment programme in the world, and will struggle to achieve the MDG of halting and reversing the spread of HIV and tuberculosis (TB) by 2015.
An annual publication compiled by Health Systems Trust, an NGO focused on health systems research, the 2010 edition of the SAHR notes that far from achieving a 75 percent reduction in maternal mortality, the number of deaths resulting from pregnancy or childbirth has actually doubled in the past 20 years. Deaths of children under five have also been rising steadily, reaching a peak of 62 per 1,000 in 2007 and then levelling off, but not declining.
HIV is the major cause of the upward trajectory in maternal and child deaths in South Africa. Non-pregnancy related infections, most of them due to AIDS, accounted for nearly 44 percent of maternal mortality between 2005 and 2007, with HIV-positive women nearly 10 times more likely to die during pregnancy or childbirth than HIV-negative women.
South Africa recently changed its treatment guidelines to prioritize ARV treatment for HIV-positive pregnant women, a move that is expected to bring down maternal mortality if fully implemented.
The SAHR notes, however, that “guidelines do not, by themselves, produce access to essential quality care. Significant weaknesses in already overstretched ARV services should urgently be addressed in order to ensure that the increased number of eligible pregnant women actually access treatment.”
The authors add that, even without HIV, South Africa would probably not be on track to meet MDG5 because of the “unacceptably high” rate of deaths due to preventable obstetric causes.
Estimates of child mortality in South Africa are based on incomplete and often conflicting data, but it is clear that the HIV/AIDS epidemic reversed gains made before 1990. Looking at data from 2007, the most recent year with reliable figures, the SAHR notes that although the major causes of childhood deaths were neonatal problems, intestinal infections, acute respiratory infections and TB, in many cases the underlying causes of death were HIV, malnutrition and the loss of a mother. The data also revealed marked discrepancies between provinces, with the Western Cape recording 39 under-five deaths per 1,000 and the Free State 110 per 1,000.
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