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Analysts sceptical about Zim Aids figures
Michelle Faul, Associated Press
November 02, 2007

http://www.iol.co.za/index.php?art_id=nw20071102090337263C146616

Zimbabwe has registered a 2,5 percent decline in HIV infection rates, and the number of Aids deaths also is dropping, but analysts are skeptical 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 on 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 spokesperson Sophie Barton-Knott. A researcher at London's Imperial College who helped work on the report said the trends presented were as accurate as possible given the available data, according to college spokesperson Laura Gallagher. 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 skeptical about statistics, which could also be caused by an undercount, by mass migration...," said Dr David Bourne, an epidemiologist at the University of Cape Town.

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." 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 co-ordinator 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. An independent Zimbabwean Aids researcher, who spoke on condition of anonymity because of the sensitivity of the subject, said the declines could be credited partly to changes in people's behaviour. She said it had been documented that many Zimbabweans are postponing their sexual debut, waiting until they are 18 or 19 years old, and that the use of condoms has increased exponentially.

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. 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 abandoned the country. A five-minute consultation with a private doctor this week cost Z$4-million, more than half the take-home salary of a police officer. 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 were "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.

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