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Great health policies, poor outcomes

South Africa has achieved much in health since the era of Manto Tshabalala-Msimang, but South Africans are still getting a raw deal, a health conference in Durban heard on Friday.

"We have poor health outcomes despite good policies," Salim Abdool-Karim, director for the Centre for the Aids Programme of Research in South Africa, told an SA Medical Association conference in Durban.

"Health outcomes are disproportionately poor."

He said since Tshabalala-Msimang stepped down as health minister in 2008, the government's decision to implement the world's biggest antiretroviral programmes had a major impact on South Africa's mortality rate.

A quarter of all people in the world receiving antiretroviral treatment were in South Africa.

The rate of mother-to-child HIV transmission had fallen almost 10-fold, from 27 percent to 2.7 percent of newborn babies being infected.

There had been other improvements in health, such as a slight decline in tobacco consumption.

The country was unique in that it carried an exceptionally high health burden, he said.

Some 17 percent of all HIV infections globally occurred in South Africa while it had less than one percent of the world's population.

The country had five percent of the world's tuberculosis cases.

Injuries caused by violence were higher than the global average, with South Africa accounting for 1.3 percent of such injuries.

South Africa had one percent of the world's non-communicable diseases, such as hypertension and cardiovascular disease.

Abdool-Karim said there was a steady increase in these diseases.

South Africa was unique in that it was affected disproportionately by several health problems at the same time.

Bangladesh, which had a population of about 150 million, spent less money per person on health and yet all its health indicators, such as infant mortality, matched those of South Africa, with a population of about 53m.

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