Although more than 250 000 South Africans died of AIDS-related illnesses in 2013, the country is making significant progress in combating HIV.

This is according to a huge global study looking at trends in HIV, TB and malaria between 1990 and 2013 published in The Lancet medical journal yesterday.

In 2003, 56 000 children under five contracted HIV, mostly getting HIV from their mothers as newborns. This number plummeted to 7 611 in 2013 – a tenfold reduction. Fewer South Africans are also dying of TB and malaria than in 2000.

“South Africa’s HIV/AIDS prevalence is one of the largest burdens on our country’s health,” said Andre Pascal Kengne of the South African Medical Research Council. “We are encouraged to see progress with the prevention of mother-to-child transmission and other childhood interventions, but this data demonstrates the need to be diligent in prevention and treatment efforts to decrease incidence and mortality rates for all age groups.”

South Africa has shown the greatest gains against malaria, recording a 13 percent decline in malaria mortality rates from 2000 to 2013. By contrast, the global rate of decline was 3 percent during this time. The country aims to eliminate malaria by 2018.

“Global investment in HIV treatment is saving lives at a rapid clip”

The global study was conducted by an international consortium of researchers led by the Institute for Health Metrics and Evaluation (IHME) at the University of Washington.

The consortium analysed and triangulated HIV, TB and malaria incidence, prevalence and deaths over time. Special emphasis was also given to incorporating new data, more rigorously identifying sources of uncertainty, and accounting for biases that may be present in various data sources.

[quote float=”right”]”The quality of antiretroviral programs varies widely. In order to reduce HIV-related deaths even further, we need to learn from the best programs and do away with the worst ones.”

Although more people died from AIDS-related illnesses in South Africa than any other country, other countries in southern sub-Saharan Africa – Botswana, Lesotho, and Swaziland – showed higher prevalence rates of the disease. Swaziland recorded an HIV prevalence rate of nearly 17 000 cases per 100 000 people in comparison to South Africa’s prevalence rate of 12 133 cases per 100 000.

Researchers found that the scale-up of interventions for HIV – including antiretroviral therapy (ART), programs to prevent mother-to-child transmission (PMTCT), and the promotion of condom use – have helped drive reductions in years of life lost to the disease, particularly in more recent years.

HIV is increasingly a condition people live with rather than die from, and the world has added nearly 20 million life years as a result of these programmes.

“The global investment in HIV treatment is saving lives at a rapid clip,” said Dr. Christopher Murray, IHME Director and an author of the study. “But the quality of antiretroviral programmes varies widely. In order to reduce HIV-related deaths even further, we need to learn from the best programs and do away with the worst ones.”

TB prevalence rates remain very high in South Africa at about 965 cases per 100,000 in 2013. This far exceeds the global prevalence rate of 160 cases per 100,000. But there has been a 6.1 percent decline in TB death rates between 2000 and 2013.

Globally, TB mortality rates fell 3.7 percent, and southern sub-Saharan Africa had declines of 4.1 percent during this period.

Like most of the world, South Africa experienced increased rates of malaria mortality and cases between 1990 and 2000. The country’s malaria death rate peaked in 2000, at 4.1 deaths per 100 000, and then steadily declined, dropping to less than 1 death per 100 000 in 2011.