Child Mortality, Including Deaths from AIDS, Falls in South Africa

A new study reveals that AIDS is killing fewer children in South Africa than it has in the past.

South Africa had the highest population of people infected with AIDS in the world. In 2011, an estimated 5.6 million people were living with AIDS in the nation. Over the past decade, improvements in HIV and AIDS care has led to a reversal of child mortality rates in South Africa, according to new research published in AIDS, the official journal of the International AIDS Society.

"After years of rising mortality rates, the mortality picture for South Africa's children has shifted drastically," said Kate Kerber, of the University of the Western Cape in Belleville, South Africa. "Opaque and conflicting messages have been replaced by data that can be used for action and accountability."

For the past two decades, researchers have been engaged in a concerted effort to determine the causes of neonatal and child deaths in South Africa, where HIV control measures have not always been well in place. In the past, attempts to control the spread of HIV and AIDS were "hampered by denial of the HIV epidemic and weak political leadership," the study authors said in a statement.

Kerber said that in 2005, South Africa was one of only four countries in the world where where the under-5 mortality rate was higher than the baseline established by the 1990 Millennium Development Goal. At that time as many as 39 percent of deaths in children under 5 years old were due to AIDS.

A sea change in South African health care administration and social attitudes has led to a scenario in which the trend of under-5 mortality has reversed, the researchers said, citing "major political and program changes."

Overall, mortality rates for children under 5 years old have fallen between 6 and 10 percent per year since 2006, according to the researchers, who add that the proportion of AIDS deaths for that age group has fallen between 11 percent and 24 percent.

The rate of improvement has been impressive. The researchers report that South Africa's childhood mortality rates have improved the fourth fastest globally, and second only to Rwanda in Africa.

"The recent rate of decline is similar to improvement in other middle-income countries lauded for progress in reducing child mortality, such as Brazil and China," the researchers wrote.

Kerber said that if current rates continue, South Africa could meet the United Nations Millennium Development Goal for under-5 mortality by the end of the current decade.