02 November 2007

Zim HIV/Aids rates declining?

Zimbabwe has registered a decline in HIV infection rates and the number of Aids deaths, but analysts are sceptical given the lack of medical care in the country in crisis.

Zimbabwe has registered a 2.5 percent decline in HIV infection rates, and the number of Aids deaths also is dropping, but analysts were sceptical given the lack of medical care in the country in crisis.

The HIV rate dropped from 18.1 percent in people aged 15 to 49 years last year to 15.6 percent this year, Zimbabwe's Ministry of Health said Thursday.

Aids deaths also have decreased, down to 2 214 a week from around 2 500 a week, according to the new statistics.

The government said its figures had been verified by the United Nations. But UNAIDS said that was not the case.

"It looks like they've used the methodology that we recommended, however, as we haven't received this data officially, we cannot validate it," said spokeswoman Sophie Barton-Knott.

Decline hailed by Unicef
However, Unicef hailed the decline, calling it "one of the most significant and rapid declines of any country in the world."

But it added that "mortality also played a hand in the drop" and said two-thirds of Zimbabweans in need of Aids treatment were not receiving it.

It said about 98 000 HIV-positive pregnant women need medication to prevent transmission to their children - far more that the 8 500 who received it last year.

Unicef also attributed the decline to Zimbabwe's successes in persuading people to change their sexual behaviour.

"Young people are having fewer partners and using more condoms," said the Zimbabwe representative of the UN population agency UNFPA, Bruce Campbell.

"They have heard the messages, taken action, and are being safer."

Many still question figures
Others were doubtful of the figures and the assumptions, pointing to Zimbabwe's economic and infrastructural meltdown, lack of medical care and medication, and the difficulties of relying on statistics when as much as a third of the population has abandoned the country.

"I think with the current state of affairs in Zimbabwe, one would be kind of sceptical about statistics, which could also be caused by an undercount as a result of mass migration," said Dr David Bourne, an epidemiologist at the University of Cape Town in South Africa.

Aids figures for India dropped considerably this year after expanded surveys and an improved methodology allowed experts to fine-tune their estimates.

Bourne said experts expected to see a peak and decline in prevalence rates, which would occur naturally even without intervention, but the fact that the number of deaths was declining was "very surprising."

Many deaths uncounted
In Zimbabwe, as in much of Africa, many Aids deaths are attributed to secondary causes such as tuberculosis and many victims go to rural villages where they die, uncounted.

Nathan Geffen, policy coordinator for South Africa's Aids Treatment Action Campaign, said it was extremely difficult to measure Aids mortality in a country where the infrastructure has fallen apart.

"A drop in sero-prevalence rates can mean many things, including that people with HIV are dying," he said.

The new figures would mean that about one in seven Zimbabweans is believed to be HIV-positive, down from a peak of one in four at the height of the Aids pandemic in the 1990s.

Zimbabwean authorities said they have increased the number of people in a low-cost antiretroviral program in recent months, with the number accessing the life-prolonging drugs now standing at about 86 000.

Zim residents sell medication for cash
But a report on state radio last week said some beneficiaries were so desperate for money that they were selling their medication on the streets.

In an economic meltdown, Zimbabwe is suffering inflation between 7 000 and 25 000 percent according to official and unofficial estimate.

Its impoverished citizens are unable to afford what little medication is available on the black market.

Hospitals and clinics have been hit by power, water and staff shortages, as many trained staff have since abandoned the country.

A five-minute consultation with a private doctor this week cost four million Zimbabwe dollars, more than half the take-home salary of a police officer.

HIV rates still high
Sub-Saharan Africa has one of the world's highest Aids rates and Zimbabwe's neighbour, South Africa, has the highest number of people living with HIV, some 5.5 million.

In Zimbabwe, more than 1.3 million people are now estimated to be HIV-positive out of a population of about 11.6 million.

Thursday's announcement came from Health Minister David Parirenyatwa, who was quoted by the official Herald newspaper as saying that the country's HIV rates are "still very high."

"While we welcome it, we should still caution ourselves that this is still an alarming figure that we must address," the minister was quoted as saying. – (Sapa)

Read more:
HIV death rate doubles in SA
Shocking SA Aids stats released


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Dr Sindisiwe van Zyl qualified at the University of Pretoria in 2005. She is a patients' rights activist and loves using social media to teach about HIV. She is in private practice in Johannesburg.

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