Statistics South Africa (Stats SA) has recently listed Covid-19 as the leading cause of death for the year 2020 in their latest mortality report. The question of what causes the most deaths in South Africa isn’t straightforward and largely depends on the source of the data. Health Minister Dr Aaron Motsoaledi says HIV/AIDS remains the biggest killer.
According to Stats SA’s Mortality and Causes of Death report, published earlier this year, Covid-19 emerged as the leading cause of death in 2020. This contrasts with earlier years when tuberculosis (TB) topped the list from 2012 to 2018, and diabetes claimed the number one spot in 2019.
Zanele Taylor Mtsweni, principal statistician at Stats SA, explained that the mortality reports are based on death notification forms from the Department of Home Affairs. These forms, collected manually, undergo extensive sorting and coding processes. As a result, there’s often a delay in publishing reports, which may contribute to discrepancies in the data.
HIV/AIDS: The Silent Epidemic
While Stats SA’s latest report cites COVID-19 as the top cause of death in 2020, the South African Medical Research Council (SAMRC) continues to report that HIV/AIDS is the leading cause of death. SAMRC researchers argue that misclassification of deaths in Stats SA’s reporting skews the data, making it unreliable for health resource allocation decisions.
Dr Nadine Nannan from SAMRC’s Burden of Disease Research Unit supports Motsoaledi’s statement, emphasising that HIV-related deaths remain a massive issue in South Africa. She explains that while doctors certify immediate causes of death, such as pneumonia or tuberculosis, they often omit HIV as the underlying cause.
According to the World Health Organization (WHO), the underlying cause is the most critical factor for understanding mortality patterns.
The Issue of Misclassification
The SAMRC’s concerns regarding misclassification extend beyond just HIV/AIDS. Nannan points out that the overall quality of South Africa’s cause-of-death data is poor, which was especially highlighted during the Covid-19 pandemic. The current civil registration system couldn’t provide timely cause-of-death information, limiting the government’s ability to respond effectively to public health emergencies. Researchers from the SAMRC’s Burden of Disease Research Unit recently conducted a rapid assessment of South Africa’s death registration and reporting system. Their findings indicate that while the country has a well-established system for registering deaths, the quality of the cause-of-death data is questionable.
The Importance of Accurate Death Reporting
Accurate reporting of causes of death is essential for shaping public health policy. Dr. Nannan notes that this data informs preventative measures and helps plan health services to address major public health concerns. The government relies on this information to allocate resources and prevent avoidable deaths.
In the long run, improving the accuracy of mortality statistics is critical to developing more effective public health strategies. Proper classification of deaths, whether from HIV/AIDS, COVID-19, or other diseases, enables the government and health professionals to allocate resources better, reduce mortality rates, and improve the overall health system.