In South Africa, the WHO World Health Report (2004) indicates an adult mortality¹⁰¹ rate per 1000 population of 598 for males and 482 for females. Life expectancy for males is 48.8; for females 52.6. Healthy life expectancy is 43.3 for males; 45.3 for females.¹⁰²

HIV/AIDS is a huge burden for sub-Saharan Africa. Throughout the region in 2003, an estimated 23-27 million people were thought to be living with the disease which also caused up to 2.5 million deaths. This represents a huge loss and impacts significantly on health systems and social and family structures.

South Africa has the largest number of individuals affected by AIDS in the world. Estimates suggest that in between 4.5 million and 6.2 million people were living with HIV/AIDS at the end of 2003. In the same year, up to 520,000 adults and children are thought to have died from the disease (Table 19).

Table 19 Country HIV and AIDS estimates, end 2003

 Source: 2004 Report of the global AIDS epidemic

UNAIDS reports:

South Africa has a population of 44.8 million people and the largest economy in the Southern African Development Community. The national HIV infection rate among pregnant women attending antenatal services in 2003 was 27.9%, with variation among the country's nine provinces from as high as 37.5% in KwaZulu-Natal to as low as 13.1% in the Province of Western Cape. Over the past four consecutive years, the rate of HIV infection among young people below the age of 20 has remained stable.

South Africa has a national strategic framework for 2000–2005. In 2003, the government approved a Comprehensive National Plan on HIV and AIDS Care, Management and Treatment, which aims among other things to provide access to antiretroviral treatment to more than 1.4 million South Africans by 2008.

The degree of commitment to tackle the epidemic in South Africa is high. The South African government fulfils the 2001 Abuja commitment to allocate 15% of government expenditure to health. In 2003, South Africa allocated US $1.7 billion from its national treasury to fight HIV/AIDS over a three-year period.

On the policy front, South Africa has a national strategic framework for 2000–2005. In 2003, the government approved a Comprehensive National Plan on HIV and AIDS Care, Management and Treatment, which aims among other things to provide access to antiretroviral treatment to more than 1.4 million South Africans by 2008.

South Africa has a multisectoral National AIDS Council (NAC) chaired by the deputy president. Civil society and private sector engagement in shaping, influencing and implementing policies and programme interventions is dynamic and robust, facilitated largely by South Africa's open and progressive constitutional democracy.

There is a plethora of international bilateral organizations, foundations and NGOs working in HIV/AIDS. Most of these organizations bring additional resources to the national response against HIV/AIDS. Among the lead HIV/AIDS funding contributors in South Africa are the Global Fund to fight AIDS, Tuberculosis and Malaria and the American Government Emergency Plan for AIDS Relief. Bilateral donors bring additional resources to complement government and civil society efforts.¹⁰³