Controversial Aids statistics claiming that infection figures are underestimated by two million are outdated and may have been plagiarised, experts say.
The statistics released to the media over the weekend by the Development Bank of Southern Africa (DBSA) claimed that more than 7.6 million people in South Africa are infected with HIV. Official government estimates have the number at 5.4 million.
The credibility of the DBSA figures has, however, come in for some severe criticism.
The figures are "completely unreasonable," says Professor Rob Dorrington of the University of Cape Town and director of the Centre for Actuarial Research, who also serves on the Actuarial Society of South Africa (ASSA) Aids committee.
"The figures presented in the article on the weekend were all from the ASSA2000 Aids and Demographic model, produced by the Actuarial Society of South Africa," Dorrington said. "This model is very out of date and has been superseded not once but twice by better models (ASSA2002 and ASSA2003, and we are working on the next version this year)."
"With hindsight, the ASSA2000 model overestimated the number infected significantly, mainly because the data we had up to that point underestimated the bias in antenatal prevalence being experienced in South Africa," Dorrington said.
These concerns were echoed by Nathan Geffen of the Treatment Action Campaign (TAC) who accused Johan Calitz, and the other authors of the DBSA study, of plagiarising the ASSA research.
Geffen also claimed that the DBSA numbers are "hopelessly wrong."
"It's shoddy incompetent work lifted from the ASSA2000 model which is out-of-date, and does not account for prevention of mother-to-child transmission of HIV, or the antiretroviral roll-out", he said.
Manto refuses to be drawn
Health Minister Manto Tshabalala-Msimang on Monday declined to be drawn into a discussion on the DBSA statistics. Briefing the media in Cape Town, Tshabalala-Msimang said the statistics was a matter that should be left to researchers to study.
"There is a need for engagement amongst researchers so that they can guide us on this matter," she said.
Tshabalala-Msimang said although the department had noted the significant difference in infection figures, the discrepancy did not mean that government had to revisit its HIV/Aids programmes.
Asked about progress in the implementation of the department's dual therapy programme meant to improve prevention of mother-to child-transmission of HIV, Tshabalala-Msimang said provinces were busy training health practitioners and that some regions were already providing the treatment.
Puzzled by the media
However, she said she was puzzled by the fact that the media, which not long ago, had been busy "toyi toying" against the implementation of dual therapy, were now suddenly embracing it.
It is unclear what the minister was referring to, since most voices in the media had been urging the department to implement dual therapy for some time in accordance with World Health Organization recommendations.
Speaking at the same briefing, the department's Director General, Thami Mseleku, dismissed suggestions that health professionals were leaving the country in droves.
"We are not seeing a situation where nurses and doctors are leaving the department - what we are seeing is a situation where more nurses are coming back to the country," he said.
Manto hiding stats: DA
However, the Democratic Alliance on Monday took the minister to task on the basis of the DBSA figures, accusing Tshabala-Msimang of keeping Aids statistics low.
"The minister of health must explain why official statistics are so low," said DA spokeswoman and Member of Parliament, Sandy Kalyan.
Referring to the DBSA report, Kalyan said 2.2 million more people were becoming sick and dying of Aids than government figures showed.
"The Minister of Health needs to be interrogated about how her department collects the data that it bases its treatment programmes on.
"While the minister's claims, on the basis of departmental information, that the epidemic is now stabilising, this report indicates otherwise - in fact, it suggests that almost one in six South Africans is HIV positive."
Kalyan explained that if the department of health was using incorrect figures, then it meant that all the calculations on the number of people who needed treatment, the number of staff and the quantity of drugs required would be wrong.
"It is ironic that last month the minister slammed a UN report - which showed South Africa falling drastically behind [in the Millennium development goals] - for information collated from small samples."
DA backs DBSA report
"Yet this is exactly how her department compiles its own statistics, with snap samples from a handful of clinics, in contrast to the DBSA report, which was based on information from many grass-roots sources in addition to clinics, local municipalities, development planners, mortuaries and funeral homes."
Kalyan said her party would ask parliament whether the DBSA report could spark a review of the reliability of government statistics and, if necessary, call the minister to brief the health portfolio committee.
The health department said on Monday that the DBSA figures appeared to be "far off" from other government and independent surveys.
Dept stands by earlier estimates
In a statement, the department stood behind its earlier estimate, which it said was supported by the findings of other research institutions such as the Human Research Council, Actuarial Society of South Africa and Global AIDS report released by UNAIDS during the last World Aids Day.
"The Department will study the DBSA report before responding to it in detail. We are also encouraging other researchers involved in HIV prevalence studies to engage with the report and ensure that there is peer review of its findings."
The department rejected the allegations made by Kalyan, saying it had conducted studies in the particular field for 15 years.
"The outcomes of these studies released annually, have reflected both the increases experienced in the early 1990s and the stabilisation that has been experienced over the past three to four years."
The findings of independent studies conducted by several organisations with credibility in HIV prevalence studies confirmed the trends reflected in the Health Department's survey over the past years, it said.
- (Sapa/Marcus Low, Health24)
Manto lying about Aids stats: DA