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Cablegate: South Africas National Policy On Aging

VZCZCXRO2233
RR RUEHDU RUEHJO
DE RUEHSA #1385/01 1101537
ZNR UUUUU ZZH
R 201537Z APR 07 ZFF4
FM AMEMBASSY PRETORIA
TO RUEAUSA/DEPT OF HHS WASHDC
RUEHPH/CDC ATLANTA GA 1757
RUEHC/SECSTATE WASHDC 9278
INFO RUEHTN/AMCONSUL CAPE TOWN 4207
RUEHDU/AMCONSUL DURBAN 8759
RUEHJO/AMCONSUL JOHANNESBURG 6548

UNCLAS SECTION 01 OF 02 PRETORIA 001385

SIPDIS

SIPDIS

CDC ATLANTA FOR STEVE BLOUNT
DHHS FOR OGHA

E.O. 12958: N/A
TAGS: ECON SOCI SF
SUBJECT: SOUTH AFRICAS NATIONAL POLICY ON AGING

REF: STATE 29783

-------
Summary
-------

1. (U) South Africa shares mortality risks and aging
challenges similar to many developing countries. According
to South Africa's 2001 census, South Africa had 2.2 million
people aged 65 years or older, representing 4.9 percent of
the total population. There is a significant
non-communicable or chronic disease problem among the
elderly. Current disability statistics are difficult to
ascertain. HIV prevalence in persons over 60 years of age is
4.0 per cent of males and 3.7 per cent of females among the
5.4 million people in South Africa living with HIV and AIDS.
South Africa's aging challenges are compounded by its growing
HIV and AIDS problem. The South African Government's program
to provide subsidies for those who care for orphaned children
is undermined when the elderly themselves fall victim to
chronic disease and HIV and AIDS. End Summary.

---------------------------------
South Africa's Elderly Population
---------------------------------

2. (U) South Africa shares mortality risks and aging
challenges similar to many developing countries. According
to South Africa's 2001 census, South Africa had 2.2 million
people aged 65 years or older, representing 4.9 percent of
the total population. This elderly population was 68.9
percent Black, 21.6 percent White, 7.2 percent Colored and
2.3 percent Indian. The elderly population dropped from
788,000 aged 65-69 years to only 157,000 aged 85 years or
more (of which one-third was male and two-thirds was female).
According to the same census, the majority of the elderly
population live in the more rural provinces and, if there,
live in more traditional housing situations. Sixty-eight
percent of the elderly report being regarded as head of
household. Those in the more populated provinces are more
often institutionalized or living in homes for the elderly.

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Causes of Death
---------------

3. (U) There is a significant chronic disease problem among
the elderly. The most recent study of disease among the
elderly is the Medical Research Council's (MRC) Revised
Burden of Disease Report, which contained 2000 data that was
published in 2003. According to this report, the leading
specific causes of death among older persons are ischaemic
heart disease, stroke, hypertensive heart disease, chronic
obstructive pulmonary disease and diabetes mellitus.
Ischaemic heart disease and stroke together account for
almost one-third of deaths. The South African health website
confirms this information, with the major cause of death
being non-communicable or chronic diseases. When lumping the
individual causes of death together into disease categories,
cardiovascular disease is the primary cause of death,
accounting for 43 percent of individuals over 60, followed by
malignant neoplasms (16 percent), respiratory disease (10
percent), infectious/parasitic disease excluding HIV/AIDS (8
percent), and diabetes mellitus (6 percent).

4. (U) These figures are reinforced by earlier studies. The
Human Science Research Council (HSRC)/University of Cape Town
Centre for Gerontology Multidimensional Survey of Elderly
South Africans in 1990-91 found that the most prevalent
self-reported condition affecting Blacks, Asians and Coloreds
was high blood pressure (hypertension). This condition went
untreated for 11 percent of both urban and rural Blacks. A
subsequent national household survey by Hirschowitz and Orkin
in 1995 confirmed the importance of hypertension and also
found that 70 percent of the elderly (age 65 and over) had a
chronic illness or ongoing health problem. More than half of
survey respondents reported having a disability, the most
common being difficulty with vision.

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Disability Prevalence
---------------------

5. (U) Current disability statistics are difficult to
ascertain. Almost 400,000 elderly report having at least one
disability, such as vision, hearing, communication, physical,

PRETORIA 00001385 002 OF 002


intellectual or emotional. The stratification of
disabilities for males and females is similar. Some 17.6
percent of the elderly report multiple disabilities.

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HIV Prevalence
--------------

6. (U) According to the HSRC November 30, 2005 fact sheet on
HIV prevalence by age, HIV prevalence in persons over 60
years of age is 4.0 per cent of males and 3.7 per cent of
females among the 5.4 million people in South Africa living
with HIV and AIDS. HIV prevalence in persons over 50 years
of age is estimated to be 5.7 percent. However, the study
cohort for these older age groups is small, so these figures
should be viewed with some caution. (Note: See
www.hsrc.ac.za/factsheet-40.phtml for a more detailed
breakdown. End Note.)

7. (U) Goal 9 of the HIV and AIDS and STI Strategic Plan for
South Africa, 2007 (NSP) refers to the mitigation of the
impact of HIV and AIDS in order to create an enabling and
social environment for care, treatment and support. The
death rate among females over the age of 50 in 2005 was more
than 2.5 times the 1997 rate. This is due largely to
communicable disease, parasitic opportunistic infection, and
disorders of the immune system. The death rate among males
had the same dramatic increase in the mortality rate and was
due to the same conditions, with the addition of infectious
causes.

8. (U) NSP Objective 9.3 is "to strengthen the
implementation of policies and services for older people
affected by HIV and AIDS." This includes activities to
create awareness about the impact of HIV and AIDS and the
promotion of the integration and equitable representation of
older persons in home and community-based care programs.
These activities are good ways to involve the elderly and
ensure that they are part of the system of available
services. NSP Objective 9.4 is "to mainstream the provision
of appropriate care and support services to HIV-positive
people with disabilities and their families." This will also
provide resources to the elderly who are heads of household
and who often take care of several generations and provide
care and support to persons living with AIDS within the
household.

-------
Comment
-------

9. (U) South Africa's aging challenges are compounded by its
growing HIV and AIDS problem. HIV and AIDS has had a
disproportionate impact on the parents of young children. As
a result, the elderly (grandparents) often find themselves
taking care of children at a time when it is they who need to
be taken care of. There are now an estimated three million
orphans and many of these orphans are being supported and
cared for by their grandparents. The South African
Government is addressing this problem by providing subsidies
for those who care for orphaned children. This money often
provides economic support for both the grandparents and the
children. This program is undermined when the elderly
themselves fall victim to chronic disease and HIV and AIDS.
End Comment.
BOST

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