VZCZCXRO9838
RR RUEHBZ RUEHDU RUEHJO RUEHMR RUEHRN
DE RUEHSA #0998/01 1301511
ZNR UUUUU ZZH
R 091511Z MAY 08
FM AMEMBASSY PRETORIA
TO RUEHC/SECSTATE WASHDC 4427
INFO RUEHTN/AMCONSUL CAPE TOWN 5586
RUEHJO/AMCONSUL JOHANNESBURG 8029
RUEHDU/AMCONSUL DURBAN 9803
RUEAUSA/DEPT OF HHS WASHDC
RUEHPH/CDC ATLANTA GA 2339
RUCNSAD/SOUTHERN AF DEVELOPMENT COMMUNITY COLLECTIVE

UNCLAS SECTION 01 OF 02 PRETORIA 000998 
 
SIPDIS 
SENSITIVE 
 
DEPT. FOR AF/S; OES/IHB 
STATE PLEASE PASS OGAC:BPATEL; ALatour, MSherlock, CMarconi, PBouie 
STATE PLEASE PASS TO USAID/W for GH and AFR/SA 
HHS/PHS FOR OFFICE OF GLOBAL HEALTH AFFAIRS WSTEIGER 
CDC FOR GLOBAL HEALTH OFFICE SBLOUNT 
 
E.O. 12958: N/A 
TAGS: SOCI TBIO SENV EAID PGOV KHIV KSCA ZU SF
SUBJECT:  Alarming AIDS Statistics, But Are They Valid? 
 
PRETORIA 00000998  001.2 OF 002 
 
 
¶1.  (U) Summary:  South African media reported on Sunday May 4 that 
new HIV statistics attributed to the Development Bank of South 
Africa (DBSA) revealed that 2 million more South Africans are 
HIV-infected than present estimates show.  The report also claimed 
that these statistics are more reliable than current data.  The 
report was disputed by South Africa's National Department of Health, 
the Treatment Action Campaign (TAC) AIDS advocacy group, and others. 
 DBSA stated On May 6 that it had not authorized the release of the 
reported statistics, which had not been validated. End Summary. 
 
------------------- 
Alarming Statistics 
------------------- 
 
¶2.  (U) The Sunday Independent newspaper reported on Sunday May 4: 
"Shocking new Aids statistics reveal that 2 million more South 
Africans are infected with HIV than the most recent government 
estimates show."  According to the report, the 2007/2008 statistics, 
attributed to the Development Bank of South Africa (DBSA) show that: 
 
 
--7.6 million South Africans are HIV-positive -- Of these, about 6.1 
million are economically active people between the ages of 20 and 
64, who could contribute to the country's economy; 
--More than 27 percent of men and women aged between 20 and 64 are 
HIV positive; 
--More than 92,000 babies have been infected, either perinatally or 
through mother's milk in the past year; 
--The total number of Aids sick by mid-2007 was 1,287,844; 
--Nearly 722,000 people have died of Aids-related diseases in the 
past year, bringing the total number of such deaths since 2003 to 
more than 3.7 million; 
--1.2 million of the country's 1.49 million orphans have lost their 
parents to Aids and this number is expected to increase by more than 
336,000 this year alone. 
 
The Independent's report further stated, "What makes these 
statistics more alarming is the fact that the data on which they are 
based are probably more reliable than the Department of Health's 
because they were collected at grassroots level and not based on 
estimates." 
 
------------------------- 
Versus Current Statistics 
------------------------- 
 
¶3.  (U) The reported statistics are in stark contrast to those 
currently accepted.  The 2006 Department of Health statistics showed 
that there were 5.4 million HIV-positive people in South Africa. 
The Actuarial Society of South Africa (ASSA) estimated in its 
statistical summary for 2000 to 2015 that there would be 5.6 million 
HIV-positive people and 370,000 Aids deaths in 2008.  UNAIDS stated 
in its 2006 Global Report that 18.8 percent of the adult population 
of South Africa was infected, and that 320,000 people died of 
Aids-related deaths in the country during 2005.  Following the 
report, the opposition Democratic Alliance (DA) party on Monday 
accused Health Minister Manto Tshabalala-Msimang of keeping Aids 
statistics low. 
 
------------------- 
NGO and Government 
------------------- 
 
¶4.  (U) The Treatment Action Campaign (TAC) AIDS advocacy group 
issued a statement on May 5 challenging the DBSA figures, saying, 
"They are extremely suspicious and cannot be characterized as having 
been collected at grassroots level and not based on estimates.  They 
Qbeen collected at grassroots level and not based on estimates.  They 
are certainly not more accurate than the Department of Health's 
statistics."  TAC has also asked why a scientific report was 
released to the media before it was published or without other 
evidence that it was subjected successfully to peer-review and why 
no other leading HIV demographers are aware of the grassroots work 
conducted by DBSA researcher Calitz. 
 
¶5.  (U) The Department of Health (DOH) spokesperson dismissed the 
report on May 6, noting that it seemed to be far off from the 
estimates of many other surveys conducted by government and 
independent research institutions.  The department said it would 
study the DBSA report before responding to it in detail and 
encouraged other researchers involved in HIV prevalence studies to 
 
PRETORIA 00000998  002.2 OF 002 
 
 
engage with the report and ensure that there was a peer review of 
its findings.  The spokesperson noted that, "The Department of 
Health uses the survey of HIV prevalence among women attending 
antenatal clinics and follows the model suggested by United Nations 
AIDS Agency to estimate the level of HIV prevalence in the country." 
 He reported that as of February 2008, DOH figures show that at 
least 456,000 people had been initiated on antiretroviral treatment, 
including 39,759 children.  (Comment: This is a cumulative number of 
people ever started on treatment, not the actual number currently on 
treatment in the public health sector, which the USG PEPFAR 
(President's Emergency Plan for AIDS Relief) team estimates is 20% 
less than the government number.  Nevertheless, the figure is much 
higher than the previously released DOH figure of approximately 
329,000, indicating substantial progress in expanding antiretroviral 
treatment over the past six months.  End Comment) 
 
----------------------------- 
Retraction - Sorry About That 
----------------------------- 
 
¶6.  (U) Finally, the Citizen newspaper published a report on May 6 
stating that DBSA had released a statement clarifying that the 
statistics were working data that had not yet been "validated as per 
normal practice or put through stakeholder consultations.  This is 
why the data had not been published or reported by the Bank, as was 
normally done when it released research results."  The DBSA said 
that the information was published "without the Bank's knowledge or 
its explicit and formal authority."  The DA has nonetheless refused 
to apologize to the Department of Health after calling for an 
explanation of why the official HIV statistics are low compared to 
figures released by the Development Bank of South Africa (DBSA).  DA 
spokeswoman Sandy Kalyan said on May 7 that she based her 
information on the Sunday Independent article and that DBSA should 
apologize to South Africans. 
 
¶7.  (U) Comment:  The recently released statistics attributed to 
DBSA have not been validated and should not be relied on at this 
time.  Warren Parker, at CADRE, a PEPFAR supported partner working 
under Johns Hopkins University, confirmed to us that the statistics 
"were a total red herring - and not even formally in a report."  He 
commented that it seems that the DBSA researcher sent some 
projections from an old ASSA model.  Parker advised that the third 
round of the Human Sciences Research Council (HSRC) national HIV 
household survey that collects HIV prevalence data is currently 
underway and its findings are expected to be presented in December. 
This survey is funded primarily with PEPFAR funds through the U.S. 
Centers for Disease Control and Prevention (CDC). This will provide 
the latest population-based HIV prevalence data, and also allow for 
comparison of the 2008 data with prior HSRC surveys in 2002 and 2005 
- which should reveal robust trends over time.  The USG PEPFAR Team 
in South Africa generally relies on the HSRC survey and the ASSA 
data, both of which are considered to be reliable and are referenced 
in South Africa's HIV & AIDS National Strategic Plan 2007-2011.  End 
Qin South Africa's HIV & AIDS National Strategic Plan 2007-2011.  End 
Comment. 
 
Ball