VZCZCXRO2233
RR RUEHDU RUEHJO
DE RUEHSA #1385/01 1101537
ZNR UUUUU ZZH
R 201537Z APR 07 ZFF4
FM AMEMBASSY PRETORIA
TO RUEAUSA/DEPT OF HHS WASHDC
RUEHPH/CDC ATLANTA GA 1757
RUEHC/SECSTATE WASHDC 9278
INFO RUEHTN/AMCONSUL CAPE TOWN 4207
RUEHDU/AMCONSUL DURBAN 8759
RUEHJO/AMCONSUL JOHANNESBURG 6548

UNCLAS SECTION 01 OF 02 PRETORIA 001385 
 
SIPDIS 
 
SIPDIS 
 
CDC ATLANTA FOR STEVE BLOUNT 
DHHS FOR OGHA 
 
E.O. 12958: N/A 
TAGS: ECON SOCI SF
SUBJECT: SOUTH AFRICAS NATIONAL POLICY ON AGING 
 
REF: STATE 29783 
 
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Summary 
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¶1.  (U) South Africa shares mortality risks and aging 
challenges similar to many developing countries.  According 
to South Africa's 2001 census, South Africa had 2.2 million 
people aged 65 years or older, representing 4.9 percent of 
the total population.  There is a significant 
non-communicable or chronic disease problem among the 
elderly.  Current disability statistics are difficult to 
ascertain.  HIV prevalence in persons over 60 years of age is 
4.0 per cent of males and 3.7 per cent of females among the 
5.4 million people in South Africa living with HIV and AIDS. 
South Africa's aging challenges are compounded by its growing 
HIV and AIDS problem.  The South African Government's program 
to provide subsidies for those who care for orphaned children 
is undermined when the elderly themselves fall victim to 
chronic disease and HIV and AIDS.  End Summary. 
 
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South Africa's Elderly Population 
--------------------------------- 
 
¶2.  (U) South Africa shares mortality risks and aging 
challenges similar to many developing countries.  According 
to South Africa's 2001 census, South Africa had 2.2 million 
people aged 65 years or older, representing 4.9 percent of 
the total population.  This elderly population was 68.9 
percent Black, 21.6 percent White, 7.2 percent Colored and 
2.3 percent Indian.  The elderly population dropped from 
788,000 aged 65-69 years to only 157,000 aged 85 years or 
more (of which one-third was male and two-thirds was female). 
 According to the same census, the majority of the elderly 
population live in the more rural provinces and, if there, 
live in more traditional housing situations.  Sixty-eight 
percent of the elderly report being regarded as head of 
household.  Those in the more populated provinces are more 
often institutionalized or living in homes for the elderly. 
 
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Causes of Death 
--------------- 
 
¶3.  (U) There is a significant chronic disease problem among 
the elderly.  The most recent study of disease among the 
elderly is the Medical Research Council's (MRC) Revised 
Burden of Disease Report, which contained 2000 data that was 
published in 2003.  According to this report, the leading 
specific causes of death among older persons are ischaemic 
heart disease, stroke, hypertensive heart disease, chronic 
obstructive pulmonary disease and diabetes mellitus. 
Ischaemic heart disease and stroke together account for 
almost one-third of deaths.  The South African health website 
confirms this information, with the major cause of death 
being non-communicable or chronic diseases.  When lumping the 
individual causes of death together into disease categories, 
cardiovascular disease is the primary cause of death, 
accounting for 43 percent of individuals over 60, followed by 
malignant neoplasms (16 percent), respiratory disease (10 
percent), infectious/parasitic disease excluding HIV/AIDS (8 
percent), and diabetes mellitus (6 percent). 
 
¶4.  (U) These figures are reinforced by earlier studies.  The 
Human Science Research Council (HSRC)/University of Cape Town 
Centre for Gerontology Multidimensional Survey of Elderly 
South Africans in 1990-91 found that the most prevalent 
self-reported condition affecting Blacks, Asians and Coloreds 
was high blood pressure (hypertension).  This condition went 
untreated for 11 percent of both urban and rural Blacks.  A 
subsequent national household survey by Hirschowitz and Orkin 
in 1995 confirmed the importance of hypertension and also 
found that 70 percent of the elderly (age 65 and over) had a 
chronic illness or ongoing health problem.  More than half of 
survey respondents reported having a disability, the most 
common being difficulty with vision. 
 
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Disability Prevalence 
--------------------- 
 
¶5.  (U) Current disability statistics are difficult to 
ascertain.  Almost 400,000 elderly report having at least one 
disability, such as vision, hearing, communication, physical, 
 
PRETORIA 00001385  002 OF 002 
 
 
intellectual or emotional.  The stratification of 
disabilities for males and females is similar.  Some 17.6 
percent of the elderly report multiple disabilities. 
 
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HIV Prevalence 
-------------- 
 
¶6.  (U) According to the HSRC November 30, 2005 fact sheet on 
HIV prevalence by age, HIV prevalence in persons over 60 
years of age is 4.0 per cent of males and 3.7 per cent of 
females among the 5.4 million people in South Africa living 
with HIV and AIDS.  HIV prevalence in persons over 50 years 
of age is estimated to be 5.7 percent.  However, the study 
cohort for these older age groups is small, so these figures 
should be viewed with some caution.  (Note: See 
www.hsrc.ac.za/factsheet-40.phtml for a more detailed 
breakdown.  End Note.) 
 
¶7.  (U) Goal 9 of the HIV and AIDS and STI Strategic Plan for 
South Africa, 2007 (NSP) refers to the mitigation of the 
impact of HIV and AIDS in order to create an enabling and 
social environment for care, treatment and support.  The 
death rate among females over the age of 50 in 2005 was more 
than 2.5 times the 1997 rate.  This is due largely to 
communicable disease, parasitic opportunistic infection, and 
disorders of the immune system.  The death rate among males 
had the same dramatic increase in the mortality rate and was 
due to the same conditions, with the addition of infectious 
causes. 
 
¶8.  (U) NSP Objective 9.3 is "to strengthen the 
implementation of policies and services for older people 
affected by HIV and AIDS."  This includes activities to 
create awareness about the impact of HIV and AIDS and the 
promotion of the integration and equitable representation of 
older persons in home and community-based care programs. 
These activities are good ways to involve the elderly and 
ensure that they are part of the system of available 
services.  NSP Objective 9.4 is "to mainstream the provision 
of appropriate care and support services to HIV-positive 
people with disabilities and their families."  This will also 
provide resources to the elderly who are heads of household 
and who often take care of several generations and provide 
care and support to persons living with AIDS within the 
household. 
 
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Comment 
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¶9.  (U) South Africa's aging challenges are compounded by its 
growing HIV and AIDS problem.  HIV and AIDS has had a 
disproportionate impact on the parents of young children.  As 
a result, the elderly (grandparents) often find themselves 
taking care of children at a time when it is they who need to 
be taken care of.  There are now an estimated three million 
orphans and many of these orphans are being supported and 
cared for by their grandparents.  The South African 
Government is addressing this problem by providing subsidies 
for those who care for orphaned children.  This money often 
provides economic support for both the grandparents and the 
children.  This program is undermined when the elderly 
themselves fall victim to chronic disease and HIV and AIDS. 
End Comment. 
BOST