Health Minister Aaron Motsoaledi on Tuesday unveiled what he himself described as shocking figures showing a huge Aids-related leap in South Africa's death rate.
"In 11 years [from 1997 to 2008], the rate of death has doubled in South Africa. That is obviously something that cannot but worry a person," he told a media briefing at Parliament.
Motsoaledi pinned the blame for the current scale of the pandemic squarely on the denialist health policies pursued by former president Thabo Mbeki's government.
The health minister called for urgent implementation of a campaign to create a "massive change in behaviour and attitude" towards Aids among citizens.
He said that in 2007, the total number of deaths - from all causes - registered in South Africa was 573,408; in 2008, this figure had leapt to 756,062.
"If this trend goes on - I don't have 2009 figures, [but] we might easily have reached 900,000 [deaths] by now - I'm worried because... in 1997 the death rate was about 300,000.
"If in 2008 it's 756,062 it means the rate of deaths increased by more than 100 percent%... 11 years," he said.
Researchers attribute the sharp rise in the total number of registered deaths to the Aids pandemic. They believe such a change in the death rate to be a better indicator of the spread of the pandemic than absolute HIV figures, because the majority of deaths due to HIV are misclassified.
Motsoaledi said the worst-affected provinces were KwaZulu-Natal (where the HIV prevalence rate in 2008, measured among ante-natal women, was 38.7%), followed by Mpumalanga (35.5%) and Free State (32.9%).
The least-affected provinces were the Northern and Western Cape (16.2% and 16.1% respectively).
Asked to what extent "denials" by the previous administration and an "abdication of the fight against Aids" had led to the current scale of the pandemic, Motsoaledi said the fact that it had was obvious.
"On [the figures], it's shocking. As to whether it has been affected by what we did in the past 10 years, to me that's obvious... I don't think we'd have been here if we'd approached the problem in a different way.
"It's a really obvious question. Yes, our attitude toward HIV/Aids put us here where we are," he said.
No comment from Mbeki
Contacted for comment later on Tuesday, former president Mbeki's spokesman, Mukoni Ratshitanga told Sapa: "No, he [Mbeki] would not like to comment."
Motsoaledi cited the current relatively low incidence of Aids in the Western Cape as an example of how providing antiretrovirals to HIV positive people could reduce incidence of the disease.
"I have shown you figures of how the Western Cape reversed [the trend]. Infant mortality in the province dropped... within three years [between 2003 and 2006] because of extensive dual [antiretroviral] therapy. So you can reverse it... if you develop good strategies."
Majority of deaths among women
The majority of the Aids deaths were among young people, particularly young women.
According to figures published in The Lancet medical journal, South Africa was carrying a huge part of the global Aids burden. "We are 0.7% of the world population, but we are carrying 17% of its HIV/Aids burden... When you take the global average of HIV/Aids, the country is 23 times the global average,"
TB deaths rising
Other figures presented by Motsoaledi include a massive increase in the number of people dying from tuberculosis, the main cause of death of HIV-infected people.
A total of 22,071 people died of TB in 1997; in 2005, 73,903 people died of this disease, a 334.8% increase, and seven times the global average.
Further, a total of 57% of children who died during 2007, died as a result of HIV.
Life expectancy in South Africa was an estimated 13 years below what it would be without HIV - in 2006, 56 years for women, and 51 years for men.
Motsoaledi said strategic leadership was needed in the campaign to check the pandemic.
SAMA gravely concerned
The SA Medical Association is "gravely concerned" about HIV/Aids statistics which show a huge Aids-related leap in South Africa's death rate.
"We have always been concerned on whether it is correct to wait with treatment until a person's CD4 count has dropped to 200 [cells per microlitre]. We believe it might contribute to a higher mortality rate by delaying treatment," Sama's chairman Norman Mabasa said in a statement on Wednesday.
The CD4 count is used to measure the strength of a person's immune system.
Mabasa said the treatment threshold of 200 should be lifted to a CD4 count of between 300 and 350, which would be in line with global trends.
"This must apply to both public and private sector, as HIV/Aids does not discriminate. We are cognisant that this step will result in more people requiring treatment and thus there would be financial implications, and government must be committed to it." - (Sapa, November 2009)