South African scientists and researchers have opted to refrain for the time being from commenting on a letter President Thabo Mbeki wrote to the health Minster questioning the country’€™s spending on AIDS.

Mbeki used 1995 data from the World Health Organisation to bolster his earlier claims that HIV/AIDS was not the leading killer in South Africa.

He ordered Dr Manto Tshabalala-Msimang to re-examine the country’€™s spending priorities in the light of statistics, which most researchers quietly claim are outdated.

More recent data, including Government’€™s antenatal survey carried out among pregnant women attending government clinics, reveal that one in five South Africans are likely to be infected.

A government source said the letter had not been distributed to the departments, but rather some of the information and requests contained in the letter.

‘€œWithout the spin in the letter, the requests seem fair and quite simple to explain, but once you read the letter within context the whole affair takes on another dimension,’€ the source said.

As was the case with Mbeki’€™s earlier questioning of the link between HIV and AIDS, the president once again admitted in the letter that he had sourced his information from the Internet.

According to Mbeki’€™s Internet list, most deaths were caused by external causes (such as murders), diseases of the circulatory system, TB, bronchitis and pneumonia.

But statistics from various sources, including the SA Police Services and StatsSA, show that a significantly higher number of South Africans were likely to succumb to AIDS-related diseases than crime. Adding up all the murders reported to the SAPS from 1996 to 2000, it comes to about 120 000.

However, comparing the population estimates from StatsSA in 2000, their model for causes of death due to HIV/AIDS was 400 000 more than their model for causes of death without HIV/AIDS in 2000.

The StatsSA model that was slightly revised in their recently published mid-year estimates for 2001 showed that the estimated number of deaths due to HIV/AIDS was lower than in the 2000 estimate (down from 390 000 to 230 000) due to more data being available.

Using the officials models from StatsSA ‘€“ that is based on data they have on fertility and mortality ‘€“ it is obvious that deaths due to HIV/AIDS already far outstrips deaths due to crime.

More importantly, the deaths due to HIV/AIDS are climbing whereas the number of murders according to the SAPS figures is declining. Insurance industry sources allege that there were more than 200 000 deaths due to HIV/AIDS last year alone.

In his letter, the president said that these figures would provoke a ‘€œhowl of displeasure and a concerted propaganda campaign among those who have convinced themselves that HIV/AIDS is the single biggest cause of death in our country’€.

‘€œThese are the people whose prejudices led them to discover the false reality, among other things, that we are running out of space in our cemeteries as a result of unprecedented deaths caused by HIV/AIDS.’€

A government source said it was important not to have a knee-jerk reaction to statistics and to withdraw funds simply because figures showed that a particular disease had almost been eradicated.

‘€œIf you had to pull funds from the polio or measles immunisation campaign, it would in turn lead to an increase in cases.’€

In a media statement, after the letter was leaked to the media, Tshabalala-Msimang said she did not view this as an exercise to reduce the resources and energy devoted to the HIV/AIDS programme, but as a critical appraisal of whether ‘€œwe are sufficiently focused in other areas of health care and social service. The significance of HIV/AIDS and the challenges it poses to our services are not in question’€.

She said a Medical Research Council report, containing updated information on deaths related to AIDS, would be released once it has been presented to Cabinet.

* The international investment community is dumbstruck by the inadequate response of the South African government to the HIV/AIDS pandemic ravaging the economy, according to Jeffrey Sachs, director of the Center for International Development at Harvard University. The Financial Times (London) quoted Sachs as saying that the government’s handling of the crisis had undermined business confidence in South Africa by causing bewilderment among investors over the policy judgement of the ruling African National Congress. ‘€About a quarter of the labour force is infected with HIV. The government has somehow not come to grips with this in the way it has to. The result of this is quite tragic,” Sachs told an investment conference in Johannesburg.