A recent study attempting to quantify misclassification of HIV/AIDS deaths concluded that for the year 2000–01, the number of deaths related to HIV/AIDS was likely to be almost three times as high as that published in the Government's statistical report compiled from death certificates. The study suggests that 80% of the excess deaths in men and 70% in women attributable to HIV were classified as tuberculosis or lower respiratory tract infections.
Social stigma associated with HIV/AIDS prevents many from speaking out about the true cause of illness and death among friends and family and leads doctors to record uncontroversial diagnoses on death certificates. The South African Government needs to face the truth about HIV mortality states the editorial.
The Lancet comments: "Earlier this year, Nelson Mandela stepped into the limelight and was widely praised and admired for openly attributing the death of his son Makgatho aged 54 years to AIDS just hours after he had died. To change attitudes, many more such disclosures from respected public figures are needed in a country that has more than 5 million people who are HIV positive.
"The South African Government needs to stop being defensive and show backbone and courage to acknowledge and seriously tackle the HIV/AIDS crisis of its people. The progress in provision of antiretroviral treatment to all people with advanced HIV has been painfully slow since the Government's first report of a planned programme in August, 2003. When Thabo Mbeki opens the 2005 parliamentary session this week, he introduces it under the motto "Parliament: The Voice of the People: Realising a Better Life for All". Without making HIV/AIDS his highest and most urgent priority, this motto will be nothing more than empty words."
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The Lancet