12/06/2010 Latest data on worldwide mortality: emerging success of ARVs however South Africa picture still grim
Bonnie Skinner
Latest data on worldwide mortality: emerging success of ARVs however South Africa picture still grim
A study funded by The Bill and Melinda Gates Foundation and recently published in The Lancet has examined worldwide mortality in men and women aged 15-59 years from 1970 to 2010.
The study examined 187 countries and used various data sources to generate yearly estimates of the probability of premature death, defined as those dying between then ages of 15 and 60 years of age, per thousand of population.
The study showed rapid and substantial increases in adult mortality in sub-Saharan Africa due to the HIV epidemic. The study revealed that South Africa was among the top 11 countries with the highest adult mortality in 2010, along with eight other sub-Saharan African countries (Botswana, Central African Republic, Lesotho, Malawi, Mozambique, Namibia, Swaziland, Zambia and Zimbabwe) and the Caribbean island of Haiti. This correlates with findings from UNAIDS AIDS Epidemic Update which states that sub-Saharan Africa is home to 22.4 million, or 67% of all people living with HIV worldwide, and accounted for three-quarters of the AIDS-related deaths in 2008.
The study produced male and female adult mortality graphs for each country over the period 1970 to 2010. Male adult mortality in South Africa began quite elevated at 417 per thousand in 1970, and dropped to 384 in 1990, yet in 2010 has soared to 532 per thousand. The reversal of decline in adult mortality is even more dramatic in the female population; female adult mortality in South Africa followed the worldwide trend and fell from 228 in 1970 to 160 in 1990. However, from then the trend drastically reversed, with female adult mortality climbing to 439 in 2010.
Figure 1: Male adult mortality South Africa, 1970-2010
Source: ‘Worldwide mortality in men and women aged 15–59 years from 1970 to 2010: a systematic analysis’
Figure 2: Female adult mortality South Africa, 1970-2010
Source: ‘Worldwide mortality in men and women aged 15–59 years from 1970 to 2010: a systematic analysis’
The data curve for worldwide adult mortality depicts a quite different story, with worldwide adult mortality remaining on an almost continuous downward trend from 1970 to 2010. The reversal of the decline in adult mortality evident in the 1990s is attributed to the HIV pandemic, and until this point the worldwide trend in adult mortality had been relatively homogeneous. The study also attributes the return to declining adult mortality from 2000, and most notably from 2005, to the increased access to anti-retroviral medication seen around the world.
Figure 3: Worldwide adult mortality (45q15) in men and women from 1970 to 2010
Source: ‘Worldwide mortality in men and women aged 15–59 years from 1970 to 2010: a systematic analysis’
In 2010, the country with the lowest risk of adult mortality for men was in Iceland, where male adult mortality 65, and for women was Cyprus, where female adult mortality is 38. Highest risk of adult mortality in men was seen in Swaziland, at 765, and for women in Zambia, with at 606 per thousand.
Sources:
UNAIDS, AIDS Epidemic Update, November 2009
Julie Knoll Rajaratnam, Jake R Marcus, Alison Levin-Rector, Andrew N Chalupka, Haidong Wang, Laura Dwyer, Megan Costa, Alan D Lopez, Christopher J L Murray, ‘Worldwide mortality in men and women aged 15–59 years from 1970 to 2010: a systematic analysis’, The Lancet, online edition, 30 April 2010
