SOUTH AFRICA: The row over whether the South African government is ignoring its AIDS epidemic has resurfaced because a report on the latest HIV/AIDS figures failed to appear on its publication date.
The report, which has been repeatedly delayed since January 12th by the government- established body Statistics SA, provides details of the cause of all deaths recorded by the Department of Home Affairs between 1997 and 2003.
A spokesperson for Statistics SA said the most recent delay was because of "production issues" and the necessity to carry out "quality checks". However, critics of the government's response to the crisis are sceptical about the excuses because of embarrassing mistakes the organisation has made in the past.
Treatment Action Campaign's national manager, Mr Nathan Geffen, said there was always a dispute over the number of South Africa's AIDS-related deaths because of "the denial, which has support from the highest levels in government".
"The argument is that HIV doesn't cause AIDS, and that there are no more people dying than before. If they admit more people are dying, they have to come up with another disease [ to account for the deaths]," he told the Business Day newspaper.
During the run-up to the report's planned release dates, there was a debate over whether the statistics could give an accurate number of people dying from AIDS. Activists claimed they could not because the cause of death of an AIDS sufferer is often misclassified, and attributed to an ailment - such as tuberculosis or pneumonia - which has taken advantage of the person's weakened immune system.
Misclassification of AIDS- related deaths by doctors is done for many reasons. When someone is certified as having died from AIDS their family may struggle to get life insurance or money from a funeral policy. There is also the stigma attached to the disease.
Indeed, Statistics SA's statistician-general, Mr Pali Lehohla, warned that the information in the 2.87 million death certificates analysed in the report had its limits.
"The data cannot provide the number of deaths due to HIV/AIDS. It does, however, provide information on the number of cases where HIV/AIDS is directly recorded on the form as the cause of death," he said.
Research groups say information on who is affected and how sick they are is essential for understanding and planning a response to the disease. Various groups are attempting to do this. The Actuarial Society of SA said recently that about five million people were infected by the end of last year, while the health department estimated the number to be about 5.7 million.
Such is the rising death toll it is not uncommon to see advertisements in local papers for coffin-making courses.
Cremation is frowned upon in Zulu culture and graveyard operators in KwaZulu-Natal's capital, Durban, have been known to reopen graves dug only a few years earlier. Of the 24 cemeteries in Durban, 16 were full by 2001 and with the rise in the death rate, 600 more acres will be needed by 2010.
Ms Cora Baily runs Community-Led Animal Welfare, which operates in some of Johannesburg's most destitute squatter camps. She was introduced to the scale of the problem when young children began bringing their emaciated pets to her for help.
"There were so many children bringing their animals to us for help we decided to go and see the parents, to see what the problem was. When we got there we found the adults were either dead, or too ill to work or do anything really.
"People talk openly to us because we are in their communities a lot and they tell us horrific stories. Children are being raped because there are no parents to look after them. We now find ourselves looking after AIDS orphans, which is ridiculous because we are an animal welfare agency," she said.
Dr Ashraf Coovadia of Coronation Hospital, who has been the head of the paediatric HIV roll-out programme in Johannesburg since 1998, has 1,000 children with HIV in his clinic at any one time.
His anti-retroviral programme, which gives HIV suffers "a new sense of hope", has a two- to three-month waiting list.