VZCZCXRO5205
RR RUEHDU RUEHJO RUEHMR
DE RUEHSA #1821/01 1251043
ZNR UUUUU ZZH
R 051043Z MAY 06
FM AMEMBASSY PRETORIA
TO RUEHC/SECSTATE WASHDC 3204
INFO RUCNSAD/SOUTHERN AFRICAN DEVELOPMENT COMMUNITY
RUCPDC/DEPT OF COMMERCE WASHDC
RUEATRS/DEPT OF TREASURY WASHDC
RUEAUSA/DEPT OF HHS WASHDC
RUEHPH/CDC ATLANTA GA 1131

UNCLAS SECTION 01 OF 03 PRETORIA 001821 
 
SIPDIS 
 
SIPDIS 
 
DEPT FOR AF/S; AF/EPS; AF/EPS/SDRIANO 
DEPT FOR S/OFFICE OF GLOBAL AIDS COORDINATOR 
STATE PLEASE PASS TO USAID FOR GLOBAL BUREAU KHILL 
USAID ALSO FOR GH/OHA/CCARRINO AND RROGERS, AFR/SD/DOTT 
ALSO FOR AA/EGAT SIMMONS, AA/DCHA WINTER 
HHS FOR THE OFFICE OF THE SECRETARY/WSTEIGER, NIH/HFRANCIS 
CDC FOR SBLOUNT AND DBIRX 
 
E.O.  12958: N/A 
TAGS: ECON KHIV SOCI TBIO EAID SF
SUBJECT:  SOUTH AFRICA PUBLIC HEALTH May 4 2006 ISSUE 
 
 
Summary 
------- 
 
¶1.  Summary.  Every two weeks, Embassy Pretoria publishes a 
public health newsletter highlighting South African health 
issues based on press reports and studies of South African 
researchers.  Comments and analysis do not necessarily reflect 
the opinion of the U.S. Government.  Topics of this week's 
newsletter cover:  Study Points to Benefits of Providing ARV 
Treatment, Survey Shows HIV/AIDS a Growing Problem for 
Microfinance, Microbicides 2006 Conference Emphasize Women's 
Vulnerability to HIV Infection, Research Reports that High 
Concentration of Lime Juice can kill HIV but too Caustic, 
Obesity in South Africa Increasing, Chronic Disease Mortality 
Will Increase by 2010, South Africa Intends to Strengthen 
Smoking, and  National Survey Shows 12% of SA's Adolescents 
Regularly Gamble Bill.    End Summary. 
 
Study Points to Benefits of Providing ARV Treatment 
--------------------------------------------- ------ 
 
¶2.  A recent study from the Bureau for Economic Research (BER) 
at the University of Stellenbosch found that the macroeconomic 
impacts of HIV/AIDS in South Africa would amount to a 0.44% 
annual loss in GDP between 2005 and 2010.  The study entitled, 
"The Macroeconomic Impact of HIV/AIDS under Alternative 
Intervention Scenarios (With Specific Reference to 
Antiretroviral Treatment) on the South African Economy," also 
found that providing antiretroviral treatment would mitigate 
the estimated GDP loss of 0.44% to 0.4%.  The BER study 
described three model-based scenarios: no AIDS; AIDS with 
prevention programs but no antiretroviral treatment program; 
and AIDS with prevention programs and a large-scale 
antiretroviral treatment program with a take-up rate of 50%. 
The results from the different scenarios indicated the epidemic 
would have a negative impact on overall economic growth and, in 
the absence of antiretroviral treatment, the rate of GDP growth 
could fall from a projected average of 4.4% over 2002 to 2015 
to 4% a year due to the epidemic.  Providing antiretroviral 
treatment could reduce the impact of HIV/AIDS on economic 
growth by on average 17% between 2000 and 2020.  Per capita GDP 
was projected to be about 8% higher in real terms by 2020 
because the reduction in population would be larger than the 
negative impact on GDP.  Certain sectors of the economy would 
experience higher negative impacts from HIV/AIDS.  The general 
government, water and electricity, mining, metals and 
machinery, and electrical machinery sectors were more exposed 
to the supply-side risk and demand-side risks.  The supply-side 
risk was due to high HIV prevalence and relatively high skills 
intensity, while the demand-side risk stemmed from the impact 
of HIV/AIDS on intermediate and final demand and exports. 
Sectors with low overall risk included community, social and 
personal services, clothing and textiles, agriculture and 
construction.  Source:  Business Report, April 24. 
 
Survey Shows HIV/AIDS a Growing Problem for Microfinance 
--------------------------------------------- ----------- 
 
¶3.  According to a study by Africap Micro Ventures, more than 
50% of microfinance institutions across Africa viewed HIV/AIDS 
as a growing problem due to rising default rates.  The study 
focused on 10 types of microfinance institutions including non- 
governmental organizations, commercial banks, and licensed and 
unlicensed financial institutions.  Results showed that, as a 
rule, repayment rates were high at 98%, although one bank 
reported a 50% default rate.  Only a third of the companies in 
the survey had adjusted products to client needs, making 
changes such as flexibility in loan repayments and adjusting 
loan amounts.  At an Africap conference in Cape Town, an 
HIV/AIDS Risk Management Task Force Working Group, composed of 
more than 20 organizations, is trying to finalize an HIV/AIDS 
code of conduct for microfinance institutions.  Source: 
Business Report, April 25. 
 
Microbicides 2006 Conference Emphasize Women's Vulnerability to 
HIV Infection 
--------------------------------------------- ------------------ 
 
¶4.  The international Microbicides conference in Cape Town 
focused on the vulnerability to HIV infection of women in 
Africa and the need to find better ways so that they can 
 
PRETORIA 00001821  002 OF 003 
 
 
protect themselves from infection.  Microbicides are products 
that could reduce the transmission of HIV and other sexually 
transmitted infections when used in the vagina or rectum. 
Microbicides can be formulated in a variety of ways, such as a 
gel, foam, cream, sponge, or intravaginal ring.  Since they can 
be applied by women before and, in some cases, even after sex 
without the man being present, they have more control over this 
prevention method.  In southern Africa over 60% of the infected 
adults are women.  One in four South African women aged 15-24 
is infected with HIV, compared to one in fourteen of the young 
men of that age.  Currently, over six products are in advanced 
clinical studies in Africa involving over 25,000 participants 
(five are being studied in South Africa in at least 12,000 
women).  The Microbicides 2006 Conference, attended by over 
1300 researchers and public health workers, examined four 
issues:  (1) basic science research looking at issues such as 
mucosal immunology, transmission models, microbicide discovery 
and delivery mechanisms; (2) clinical research, including 
preliminary data from some of the large scale studies, (3) 
social and bioethical challenges conducting this type of 
research in vulnerable populations, and (4) a community and 
advocacy issues.  Source:  AIDSMAP, April 26. 
 
Research Reports that High Concentration of Lime Juice can kill 
HIV but too Caustic 
--------------------------------------------- ------------------ 
 
¶5.  Using high concentrations of lime juice as a vaginal douche 
to prevent HIV or other sexually transmitted infections (STIs) 
can cause severe abrasions to the vaginal epithelium, and would 
probably only increase the risk of HIV transmission, according 
to a safety study presented at the Microbicides 2006 
conference.  Although another study suggested that using lower 
concentrations (up to 20%) may be safer, laboratory studies 
have found such concentrations are too low to kill HIV.  A 
laboratory study of lime juice presented at the Conference 
found that it does indeed kill HIV.  At a 10% concentration, 
lime juice can inactivate HIV within five minutes.  But in the 
presence of semen, it takes a 50% concentration at least 30 
minutes to kill the virus.  But the study also found some 
suggestions that lime juice might damage mucosal tissues, 
particularly if the tissue was already irritated.  A second 
preclinical study, which also looked at lemon juice, found that 
both juices were markedly toxic to a variety of human cells, 
and concluded that while the juice might kill HIV in the 
cultures, it killed everything in the culture.  Source: 
AIDSMAP, April 27. 
 
Obesity in South Africa Increasing 
---------------------------------- 
 
¶6.  According to a Medical Research Council (MRC) report 
"Dietary Changes and the Health Transition in South Africa: 
Implications for Health Policy", South Africans are eating more 
saturated fats, sugars and refined carbohydrates, resulting in 
a high prevalence of obesity.  The average South African 
consumed 12% more kilojoules between 1962 and 2001, increasing 
consumption of fat, proteins and carbohydrates.  In the black 
community there was a movement, particularly in cities, away 
from traditional high fiber, high carbohydrate diet to a diet 
richer in saturated fats and refined carbohydrates.  Findings 
in the report indicate that men consume alcohol far more 
frequently than women.  In addition, 17% of children between 
the ages of one and nine were either overweight or obese. 
Fifty-six percent of South African women and 29% of South 
African men were considered overweight.  Source:  Sapa, IOL, 
May 2. 
 
Chronic Disease Mortality Will Increase by 2010 
--------------------------------------------- -- 
 
¶7.  Chronic diseases such as hypertension, high cholesterol and 
diabetes are expected to kill 666 South Africans daily by the 
year 2010, according to the South Africa Medical Research 
Council (MRC).  A new MRC report titled "Chronic Diseases of 
Lifestyle in South Africa:  1995-2005" reported that there are 
about six million South Africans with hypertension, five 
million with high blood cholesterol, 1.5 million with diabetes 
and more than seven million smokers.  According to the report, 
chronic diseases killed 565 people daily in 2000.  Lifestyle- 
related cancers had been increasing in the country.  The report 
 
PRETORIA 00001821  003 OF 003 
 
 
found that increasing urbanization was a factor behind 
hypertension and diabetes.  The report highlights the need for 
proper health care in South Africa for people with chronic 
diseases of lifestyle, particularly at primary care level. 
Challenges facing developing countries include trying to treat 
chronic diseases, lasting the patient's lifetime and needing 
complex health care systems, and acute diseases on limited 
resources devoted to health care.  Very little international 
research and policy activities have addressed the question of 
how poorer developing countries, with multiple burdens of 
disease, can address both acute and chronic conditions. 
Source:  Sapa and IOL, May 2. 
 
South Africa Intends to Strengthen Smoking Bill 
--------------------------------------------- -- 
 
¶8.  A draft of the Tobacco Products Control Amendment Bill, 
tabled in Parliament, proposes new fines and tougher 
enforcement of smoking laws for individuals and businesses who 
ignore anti-smoking laws.  For example, parents who sit with 
children in the smoking area of a restaurant will, with the 
business owner, be subject to higher fines.  If the Health 
Department's proposals are accepted, individuals caught 
breaking the law will have to fork out a minimum of R300 ($50, 
using 6 rands per dollar) or an amount determined by the 
courts.  The draft proposals also suggest an increase in fines 
from R200 ($33) to a minimum of R200,000 ($33,333) for 
restaurant owners who do not enforce the law.  There is also a 
minimum fine of R100,000 ($16,666) for those who sell 
cigarettes to minors or who fail to comply with vending machine 
legislation.  Those who illegally advertise or give away 
tobacco products could be fined R1 million ($166,666).  The 
Health Department wants Parliament to approve the new bill in 
time for implementation by early 2007.  According to Zanele 
Mthembu, the Department's Director of Health Services, 25,000 
South Africans died of smoking-related deaths every year.  The 
proposed bill would close loopholes in existing regulations and 
bring legislation in line with international laws, in 
particular the World Health Organization's framework convention 
on tobacco control.  Source:  The Sunday Independent, April 30. 
 
National Survey Shows 12% of SA's Adolescents Regularly Gamble 
--------------------------------------------- ----------------- 
 
¶9.  At the Fourth Biennial Gambling Conference in Cape Town, 
Philip Frankel, the Head of the Department of Political Studies 
at Wits University, described results from the first nationally- 
based survey on risk behaviors of adolescents.  The survey 
found that more than one third of high school students gambled 
more than R200 per session and that 12% gambled regularly with 
3-5% showing signs of serious gambling addiction.  In addition, 
over one third surveyed believed people should enjoy life and 
stop worrying about condoms, HIV and AIDS.  A quarter believed 
that an understanding of mathematical trends led to a better 
chance of winning the lottery, while almost 37% believed that 
staying at the same slot machine improved their chances of 
winning.  According to the report:  (1) South Africans spent 
R11.6 billion ($1.9) on gambling in 2005, (2) the majority of 
South Africans gambled by buying lottery tickets (45.8%), with 
7.8% buying scratch cards and 7.1% gambling at casinos, (3) of 
those who bought lottery tickets, 72.7% bought Lotto tickets at 
least once a week while one in every 10 people visited a casino 
at least once a week, (3) 1.7% of household budgets in South 
Africa is spent on gambling, and (4) The gaming industry has 
created almost 100,000 direct and indirect jobs in the past 10 
years.  The survey is based on a sample of 40 schools, ranging 
in locations from rural KwaZulu-Natal to Cape Town and 
Johannesburg.  Source:  The Mercury, April 21. 
 
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