HIV/AIDS is the biggest killers in every South African province except the Western Cape

A new report by the Medical Research Council in South Africa has quantified the leading causes of death in each province for the first time, and has found that HIV/AIDS is the biggest killers in every province except the Western Cape.

The study shows that people living in KwaZulu-Natal are likely to die 11 years younger than people in the Western Cape, and HIV and Aids is the biggest killer in the province, but heart attacks and strokes claim the most lives in the Cape.

The life expectancy in the Western Cape is an average 67 years for women and 59,8 years for men.

Diseases related to poverty were found to be more prevalent in poorer, rural provinces, there are, for example, low mortality rates from diarrhoea in Gauteng but high rates in Limpopo and the Eastern Cape.

Professor Debbie Bradshaw, author of the report says it is an attempt to better understand regional health challenges.

Bradshaw says there is quite a big difference in health status in different provinces, and national policy makers need to have a sense of the inequalities between provinces. Provincial leaders also need to better understand their major problems.

Mortality levels, says Bradshaw, differed significantly from province to province, with a life expectancy of just 52 years for KwaZulu-Natal, compared with 63 years in the Western Cape.

The study which used data collected in 2000, will hopefully be repeated with data from 2005.

Bradshaw found the task of turning the data into a report, was compounded by the difficulty of gathering reliable death statistics, as they are an essential component in planning and monitoring health services.

Not all deaths in rural areas are registered, and often, even when deaths were recorded, what was entered on the death certificate was not necessarily complete and accurate information.

Interim President of the Medical Research Council, Anthony Mbewu, says the Western Cape serves as an example for the rest of the country in waking up to the "heart disease crisis". A developing country, such as South Africa suffered from a "triple burden" of disease caused by poverty, violence and unhealthy lifestyles, and it is unhealthy lifestyles - including heart disease, diabetes and cancer - that is rapidly increasing.

Research programmes looking at how to encourage healthy living were growing because of these diseases.

MBewu says that just as HIV and Aids deaths might be underestimated because of the stigma associated with that disease, deaths from heart disease might also be underestimated because "there can be an assumption by health care practitioners that heart disease and strokes are uncommon".