Goodnight to Aids

Golly, that was a close shave! Just as we should have watched a holocaust of death from Aids, South Africans seem to nonchalantly pull off another of their famous miracles, this time slaying a health dragon that was to wipe the floor with us.

The problem of looming threats in a humanity that likes to put the frighteners on about the world coming to an end is getting people to separate real dangers from fad. Never more so than when that danger is unseeable, as in a virus. So it has been with HIV/Aids, where not only redirection of state health resources was needed, but also behavioural change in the most intimate of things by ordinary folk.

After having been first properly identified in the 1980s in the US, proper alarm escalated about the global carnage Aids could visit on us all, with early predictions of up to one in five American adults succumbing. It was quickly clear that this wasn’t happening, indeed didn’t wherever societies had reliable mortality and general health statistics. For the Dark Continent, computer-generated models predicted population clearance of vast areas.

Aids moved from epidemic to pandemic, even acquiring capitalised letters (“AIDS”), unlike other scourges (another big Aids term). Then controversy arose when President Thabo Mbeki got himself wrapped up in dodgy medical theories and obstinately refused to order the automatic treatment of infected people. For the disease is real, even if never at the feared initial estimated prevalence. In SA we keep proper stats of the born and the dying, and we really have turned the corner against Aids.

Much of this may have to do with state provision of anti-retroviral treatment. A lot could come from better provision of broader healthcare. Thus from 2001 to 2008, cases of malnutrition fell 70%, malaria came to close to utter defeat through the reintroduction of DDT use. Vaccination and immunisation of children under one year old rocketed from 64% to 89% this century; while 1 800 new state clinics were built, bringing these to within 5km of 95% of our people. As of last year,  hospitals are getting subject of a major recapitalisation, and 250 have been “revitalised”.

Meanwhile private healthcare has come into its own, taking a massive burden off the Exchequer, and is subscribed to by 16% of South Africans. This often maligned industry now attracts 44% of all healthcare expenditure, producing more than double the state’s number of nurses every year.

Where estimates from computer-generated models had our life expectancy dropping now to the lower fifties, the actual death count of 502 000 in 2002 had only risen to 573 000 by 2009 while population numbers increased by much higher proportions. The number of orphan-headed households fell a third this last decade; infant mortality to lower than 1994 levels; maternal deaths falling 16% year-on-year the last three years.

And we’ve reversed how we act. More people received state-provided anti-retroviral treatment than needed it last year, to be sure, and two thirds of men now use condoms, against only 18% in 1992. New HIV infections have fallen every year since 2000. We’re over the worst.

(First published in The Citizen, December 2012)

– By Paul Pereira