South Africa’s epidemics

South Africa is the mixing bowl for a ‘cocktail of four epidemics,’ HIV and Aids, tuberculosis, violence, and poor maternal and child health, says a new report.A special edition of The Lancet, the respected UK-based medical journal released today, paints a depressing picture of the state of the nation’s health.Some of the figures for HIV, TB and violence are among the worst in the world."Racial and gender discrimination, income inequalities, migrant labour, the destruction of family life and persistent violence spanning many centuries but consolidated by apartheid in the 20th century" are to blame for the current health problems, said Professor Hoosen Coovadia who wrote the introduction.

With some 5.7 million people infected with HIV, South Africa represents the world's largest Aida epidemic. An estimated 500,000 people are infected each year and around 1,000 die every day from Aids-related illnesses."Decisive action is needed to implement evidence-based priorities for the control of the HIV and tuberculosis epidemics," the study said. "Until recently the South African government's response to these diseases have been marked by denial, lack of political will, and poor implementation of policies and programmes." And there are still vast racial inequalities in healthcare standards. In 2002, the report said, the child mortality rate among whites was seven in every 1 000 babies born. For African babies, it was 67 in every 1000.

Alcohol abuse come up over and over again throughout the report and the authors said it plays a major role in violence (including murder and rape), road accidents and unsafe sex. There is also a shortage of skilled health staff. Because of a decision to close a number of nursing colleges to save money during former President Thabo Mbeki's administration, the rate of skilled professional nurses has dropped from 149 per 100 000 people in 1998 to 110 per 100 000 in 2007. "As many as 40 per cent of nurses are due to retire in five to 10 years and nursing remains the most crucial area for urgent policy intervention," note the authors.

Even so, "the South African people have shown extraordinary resilience during difficult times,” said Lancet UK editors Dr Richard Horton and Dr Sabine Kleinert."The current leaders have survived apartheid, and often imprisonment, to fight for the future of their country. Civil society, with its strong voice, has brought about many important changes in health. "South Africa is a young democracy with pride and hope, and above all with high expectations for a fair, equitable, and peaceful society”, they said. “Its people deserve a healthy future."

By Hayley Jarvis for SOS Children