Life expectancy boom in SA

2014-04-02 00:00

KWAZULU-NATAL is breaking world records for increases in the length of people’s lives — and South Africans overall are living an astonishing seven years longer than they were in 2005.

In what one Harvard researcher told The Witness was “basically a world record”, life expectancy for women in rural KwaZulu-Natal has jumped 13,3 years in only eight years — and smaller funeral parlours are going out of business.

Meanwhile, a mortality survey released by the Medical Research Council last week showed “a staggering increase of seven years since 2005” with average South African lifespans jumping from 53 years to 61,3 years, and still rising.

Vast socio-economic differences in South Africa mean middle-class men and women are still living some 20 years longer than the poorest citizens, at around 79 and 83, respectively.

But experts said the massive change, which could continue surging to 65 years this decade, if TB campaigns are successful, would impact the whole of society.

Despite having a larger population, 120 000 fewer people died in South Africa last year, compared to 2005.

Researchers at both the MRC and the Harvard School of Public Health told The Witness the historic boom in the country’s overall longevity could ultimately be traced to a single courtroom decision in June 2002.

Dr Debbie Bradshaw, director of disease research at the MRC, said the sharp growth in the lower-middle-class and middle-class could not account for the change, “as there are new risks from lifestyle changes like fatty meats and less exercise”. Instead, Bradshaw said the country’s belated HIV drug treatment campaign had driven the turn-around “particularly in terms of lower child mortality”, along with successful immunisation campaigns against other diseases.

“This is excellent news; we had not projected increases this sharp,” said Bradshaw.

“We have made a huge dent in mother-to-child transmission: 10 years ago, 24% of babies [to HIV moms] were born infected; now the figure is two percent. And there has been a huge effort to roll out ARVs, which have proved very effective.”

She said improved nutrition from the expansion of social grants to over 16 million recipients could also have played a role.

South Africa’s huge HIV drug programme was launched after the Treatment Action Campaign (TAC) won a Constitutional Court ruling in 2002 that forced then health minister Manto Tshabalala-Msimang to issue drugs to prevent mother-to-child transmission of the disease. A general roll-out began in 2004, and accelerated in 2007.

Spokesperson for the TAC, Marcus Low, warned that celebration of the record jump should be tempered by the fact that South Africa also saw a record-breaking slump in life expectancy in the late 1990s — largely due to “inaction” by government on the Aids epidemic.

“My sense is that we have just very rapidly got back to where we were, though that’s obviously a very good thing,” he said.

“We are very concerned about TB, which is a disease that can be cured — especially how prisons appear to be driving the epidemic.”

The MRC found that average 15-year-olds now have a 62% chance of surviving through all of their work years to the age of 60, where they had only a 54% chance of living these years in 2005.

Shockingly, Bradshaw revealed that MRC projections in 1998 suggested that by 2014 15-year-olds would have only a 20% chance of surviving to 60 if nothing was done to tackle the Aids epidemic.

“What’s worrying is that HIV prevalence remains very high, at around 12% of the population, and we have a long way to go in terms of prevention,” she said. “But it is absolutely remarkable, what treatment of this disease has done.”

Last year, Harvard researchers, working with the Africa Centre for Health and Population Studies at UKZN, announced “one of the most rapid life expectancy gains observed in the history of public health” after a survey in KZN. They found that lifespans across all of rural KZN had leapt from 49,2 years in 2003 to 60,5 years in 2011. Women in 2011 could expect to live over 13 years longer.

Harvard researcher Jacob Bor, the head author of the research, told The Witness the ARV roll-out had not only prevented thousands of deaths, but had done so surprisingly cheaply, at a cost to the state of just R15 000 per extra year gained for each patient. He said he found no evidence that the HIV treatment programme had negatively affected patients needing care for problems other than HIV.

Last month, Health Minister Aaron Motsoaledi said, “I was told that the most lucrative business is a funeral home. I’m told that they are now being closed.”

Deputy director of the UKZN study centre, Dr Kobus Herbst, said he’d seen the same thing, “In Mtubatuba where we are based, I have seen several funeral parlours go out of business. With further improvements in dealing with infectious disease there is no reason why we would not see further increases in life expectancy even beyond the 65-year mark. But there is another scourge waiting in the wings: lifestyle diseases; already we see hypertension being highly prevalent in South Africa as well as obesity.”

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