PRETORIA (AFP) - South Africa's death rate jumped 57 percent between 1997 and 2003 with HIV/AIDS emerging as one of the main killers in the 15 to 49 age bracket, the official statistics agency said.

Chief statistician Pali Lehohla said that data from about three million death certificates issued between 1997 and 2003 "provide indirect evidence that the HIV epidemic in South Africa is raising the mortality levels of prime aged adults in that associated diseases are on the increase."

"Within the 15 to 49 age group, HIV does in fact emerge as one of the leading natural causes of death," added Liz Gavin, acting deputy director general for population statistics.

The official Statistics SA agency released a new report on the causes of death showing that tuberculosis accounted for the highest number of mortalities although officials admitted that these deaths could be linked to AIDS.

According to the Stats SA study, tuberculosis killed 37,917 people aged between 15 and 49 in 2001 while HIV/AIDS claimed 7,564.

South Africa has the highest HIV/AIDS caseload in the world, with 5.3 million people, or one in five adults, living with HIV and AIDS, according to UN figures.

Stats SA chief Lehohla has criticised international organisations such as the United Nations) for inflating AIDS figures, saying that his agency had come up with estimates "approximately 6.5 percent lower than some international agencies as the World Health Organisation and the UN."

The release of the report was repeatedly delayed, fueling speculation that Statistics SA was seeking to conceal the number of of HIV/AIDS deaths.

Gavin denied that Pretoria had turned up the heat on the agency to downplay the HIV/AIDS-related fatalities, saying: "There has certainly been no pressure on us to change any of the results."

The British medical journal The Lancet this month cited estimates from the South African Medical Research Council showing that the number of deaths linked to HIV/AIDS was likely to be thrice as much as the one in the government statistical report.

"Social stigma associated with HIV/AIDS, tacitly perpetuated by the government's reluctance to bring the crisis out in the open and face it head on, prevents many from speaking out about the causes of illness ... and leads doctors to record uncontroversial diagnoses in death certificates," The Lancet's report said.

The South African Medical Research Council said last month that there had been a steep rise in AIDS deaths in South Africa, but a large number still go unreported because they are attributed to AIDS-related conditions, without the disease mentioned as the cause of death.

Some 20 percent of deaths are "empirically" caused by HIV/AIDS, according to the council.

The release of the latest statistics on the causes of death came a week after President Thabo Mbeki declared in his state of the nation address that his government's plan to fight AIDS was "the best in the world."

The South African president last year said some 53,000 people would be receiving free anti-retroviral drugs from 113 state-accredited health centres by March this year.

However, that target has not been met and AIDS activists estimate that only 20,000 people are receiving free ARVs.

Mandela, who has lent his "46664" prison number to the campaign, will lead the star lineup at the concert to be held in the southern coastal town of George on March 19.

International artists such as Usher, Queen, Katie Melua and Annie Lennox are to perform along with local talent like Johnny Clegg, Danny K and Mandoza, some of whom are offering a repeat performance from the first 46664 concert held in Cape Town in November 2003.

While the Cape Town concert focussed on AIDS awareness in general, the music bash this time will look specifically at women and girls.

"We know that young women are six times more likely to be infected by the virus in comparison to men," Mandela said.

"I am calling on all South Africans, no more than ever before, to protect our young women and girls," Mandela pleaded.

Speaking a month after the death of his then only surviving son Makgatho from AIDS, Mandela complained of public apathy about AIDS, which has killed some 2.2 million people in sub-Saharan Africa, according to UN figures.

"I am concerned that not enough has been done by the public in general since the last four double six, six (46664) concert in Cape Town," he said.

"We called on the public to act and although people responded from all over the world, we know that more can be done in South Africa," Mandela said, sporting a black golf shirt bearing his prison number.

AIDS affects more than one in five adults in South Africa, with some 5.3 million people living with HIV and AIDS, according to UN AIDS, the highest caseload in the world.

Mandela also enlisted the help of actor Will Smith as master of ceremonies, the latest in a line of celebrity "ambassadors" for the 46664 campaign.

Some 40,000 people turned up for the first 46664 concert, where Mandela was introduced to the crowd by Irish rock band frontman Bono.

Mandela then said he wanted to lend the 46664 prison number that was assigned to him during the 18 years he spent on Robben Island to publicise the fight against AIDS because victims of the disease often just became numbers.

New York City health officials said last week that the strain, known as 3-DCR HIV, was unresponsive to three types of anti-retroviral medications and greatly accelerated the transition from infection to full-blown AIDS.

The virus was diagnosed in a man in his late 40s who reported having unprotected sex with multiple male partners, often while using the highly potent narcotic crystal methamphetamine.

Some gay activists and AIDS specialists believe the New York Health Department jumped the gun with its announcement, arguing that a lot more research was required to determine the precise nature of the virus strain in question.

"Those who practice good science would have waited," said Martin Delaney, founder director of Project Inform, one of the oldest US non-profit AIDS organisations.

"They would have shared and discussed the date with scientific peers and then -- most importantly -- they would have gone back to the labs and followed up on the patient for another six months before drawing any hard conclusions," he said.

The onset of AIDS usually occurs more than 10 years after initial infection with the human immunodeficiency virus (HIV). But in the case diagnosed last week, the time lag appeared to be just two to three months.

However, several AIDS researchers said it remained unclear whether the swift progression of the disease was attributable to the virulence of the HIV strain or the particular physiology of the patient.

They also noted that the existence of resistant HIV strains was not new.

Calling on the city authorities to clarify the facts, the New York-based Community HIV/AIDS Mobilisation Project (CHAMP) warned of the risk of stigmatising gay men as "crazed drug addicts, carelessly or wantonly spreading a killer bug."

New York Health Commissioner Thomas Frieden had described the case was "a wake-up call" to the gay community, particularly those who may use crystal methamphetamine.

"What would be dangerous," responded CHAMP executive director Julie Davids, "is for this to be a wake up call to the gay community to feel more shame and self-hatred."

In an interview with the New York Times on Tuesday, Frieden defended the decision to go public with the 3-DCR HIV case, saying that his intention was to announce not a scientific discovery but a public health phenomenon that required intervention.

"Our thought process was, first, were we convinced enough that this was a real phenomenon? Over time, yes, we were convinced," Frieden said.

"The next question was, were we convinced that we had to alert the medical community to issue a health alert? Again, over time we were convinced.

"Having decided that, it was unavoidable to do media notification as well," he said.

There is consensus, however, on the need to combat a resurgence in HIV transmission, including addressing the impact of crystal meth use on HIV risk behaviour.

"But let's not freak people out with stories of a superbug," said Delaney. "We're all freaked out enough, thank you, by HIV itself."

More than 88,000 New Yorkers are known to be living with HIV/AIDS, and an estimated 20,000 are believed to be infected without knowing it.

Gay activists, while recognising the responsibility of their own community to promote safe sex, argue that the federal government has hampered progress by favouring a message of abstinence over condom use.

Crystal meth, also known as "ice," puts users -- both gay and heterosexual -- into a highly sexualised state that lowers inhibitions. Studies have shown that people using the drug are more likely to have multiple partners and less likely to use condoms.

"In the last few years, crsytal use has really exploded," said Jason Riggs, communications director of the Califonia-based Stop Aids Project.

"It is a real cause for concern," Riggs said. "In San Francisco, if you're a gay or bisexual man using crystal you're 300 to 400 percent more likely to get HIV."

LONDON (AFP) - Britain's main opposition Conservative party promised to test immigrants from outside the European Union (EU) for HIV, tuberculosis and other diseases if it wins elections expected in May.

Under the plan, modelled on schemes in Australia, New Zealand and Canada, potential migrants from outside the EU, except asylum seekers, would be subject to the medical checks.

The ruling Labour Party immediately dismissed the plan as an attempt to catch up with the government's own immigration policy, while groups fighting HIV/AIDS condemned it as both ineffective and prejudicial.

Conservative leader Michael Howard told BBC radio that the "simple" aim of the plan was to "minimize the public health risks of diseases such as TB" and thus avoid an extra burden on the state-funded National Health Service.

Government figures showed tuberculosis (TB) had increased 25 percent over the past 10 years and nearly two-thirds of sufferers were born abroad, he added.

Visas would be turned down automatically only for those testing positive for tuberculosis, but reviewed on a case-by-case basis for those testing positive for HIV/AIDS, hepatitis or other diseases.

Britain's political parties are competing hard to address public concerns about immigration as the campaign heats up for general elections widely expected on May 5.

Home Office figures show 139,675 people were granted settlement in 2003, 20 percent more than 2002. There were no immediate figures for the number of people leaving the country.

The Conservatives lag well behind the government of Prime Minister Tony Blair in opinion polls, and have identified immigration as a means to make up ground.

"At the next election people will face a clear choice: limited and controlled immigration under the Conservatives or unlimited immigration under Mr Blair," Howard was quoted as saying in Tuesday's Guardian newspaper.

In January, Howard said he would impose an annual quota on people claiming political asylum if his party took power.

Blair's Labour Party fought back last week by unveiling a raft of tough measures to make it harder for unskilled foreigners to seek work or shelter in Britain.

According to the latest Conservative proposals, people coming to Britain from outside the EU temporarily for between six and 12 months from a "high incidence TB country" will have to undergo a chest X-ray.

All those intending to stay for longer than a year would be required to have a full medical examination. In addition to X-rays to test for TB, tests for hepatitis and HIV for over-16s would be required.

Exempt from chest X-rays would be pregnant women and children.

Medical tests would also be imposed on those coming for a shorter period to work in healthcare, childcare or teaching.

HIV/AIDS charity the Terrence Higgins Trust condemned the measures as "a prejudice-based policy not an evidence-based one".

The Trust's head of policy Lisa Power said the policy would more likely drive people with health problems to fake their tests to gain admission, while anyone from an EU country could easily enter.

Rival parties also condemned the planned policy, with Mark Oaten, home affairs spokesman for the opposition Liberal Democrats saying that "decent people" in the Conservative leadership "must be feeling very queasy" at their election campaign.

Labour immigration minister Des Browne, meanwhile, said his party's five year plan for immigration and asylum unveiled last week already targeted health screening for tuberculosis, calling the Conservative scheme "a desperate attempt to catch up".

More than 7,000 new cases of HIV were diagnosed in Britain in 2003 -- the highest ever and a 20 percent rise from the previous year, according to the Times newspaper, which also carried the story in a front page article.

India's one million eunuchs, transexuals some of whom have been emasculated, are now being asked to guard against the spread of HIV, the virus that leads to fatal Acquired Immune Deficiency Syndrome (AIDS).

The eunuchs, known as hijras in Hindi, are among the highest risk groups of people for HIV infection in a country with the second highest rate worldwide at five million people.

They have told Ashok Alexander, head of the Bill and Melinda Gates Foundation's India AIDS initiative called Avahan, that if he wanted them to use condoms to stem the spread of HIV, they in turn wanted to be treated with respect.

At a meeting in Tamil Nadu state to promote condom use, 20 eunuchs asked for loans for emasculation operations, help in getting identity cards -- many officials will not issue them because of confusion over the applicant's sex -- and a decision on whether they should use public toilets for men or women.

"People don't treat us properly," a eunuch with a degree in Tamil literature at the meeting said. "We are proud of being who we are and we deserve jobs instead of seeking sex work."

Of particular concern is the practice of unprotected anal sex by "kothis", or receivers, considered the highest-risk eunuch group because HIV infection is 10 times more likely in anal sex especially if lubrication is not used, according to Avahan.

The "kothis" dress in bright-print nylon saris with bangles on their wrists and ankles and have a deep feminine identity including using cosmetics and padded bras.

The reliance on sex work combined with their outcast status in much of public life, makes them a difficult group to reach out to.

Avahan funds a drop-in center in Dharmapuri in Tamil Nadu for a group of mostly "kothi" men to meet and discuss issues and get information on condom use and sexually-transmitted infections like anal warts.

"They have unique problems. But we're clear the program does not exist to solve all of them," Alexander said. "In cities like Bombay they have widespread acceptance and can manage, but in the rural areas it is very difficult even to hold a meeting."

The eunuchs say they are women -- a cause of much of the friction with the public and officialdom as they sit in the women's section of segregated buses and insist on applications for work or government programs to be called female.

"We know how to use condoms, it's the men who don't know," one eunuch at the meeting said.

There are sharp divisions among eunuchs -- "double deckers" who have sex both ways, "panthis" who are givers and "number nines" who are mainly cross dressers.

Many of them ply truck stops or work at hamams (bath houses) leading to concern that HIV infection can spread rapidly among their highly mobile clients.

Entering the eunuch world is part of an elaborate ritual of acceptance into small communities. Not all of the men are emasculated, though many just cite the cost of the operation as the prime barrier.

Kothi eunuchs, like women sex workers, earn about 300 rupees (seven dollars) on a good day of several clients.

Because of the low wages, many emasculated eunuchs choose a crude tribal ceremony that can lead to infection -- tieing their testicles for 24 hours and then cutting them off and cauterizing the bleeding. This costs 3,000 to 5,000 rupees (70 to 115 dollars), Alexander said.

At the higher end are operations performed by a local medical practitioner who may use antibiotics at around 10,000 rupees (230 dollars) and then sculpting by a professional doctor which can cost 60,000 rupees (1,400 dollars).

Eunuchs are regulars at Indian festivities: They barge into homes uninvited to bless the birth of a child and regularly gatecrash weddings.

They have also been used as debt collectors by credit card companies.

The eunuchs demand money in order to spare embarrassment at celebrations for childbirth or wedding and debtors would rather not have them turning up at work or home.

DAR ES SALAAM (AFP) - Sweden has agreed to grant Tanzania 22 million dollars (16.8 million euros) to support the country's plan to treat HIV/AIDS patients, a health ministry official said.

Only about 3,000 of the two million people in Tanzania estimated to be HIV positive are receiving life-prolonging drugs, he said.

Mgonja said the health authorities plan to put about 400,000 HIV-infected people on anti-retroviral treatment by 2008.