Recent mortality changes in South Africa are interesting because it has the most plentiful and the highest
quality mortality and cause of death data of any country with a major HIV epidemic. Also, South Africa
exhibits a combination of first world and third world mortality patterns as predicted by Gwatkin (1980).
Gwatkin saw developing countries as trapped in a situation in which death rates from non-communicable
diseases associated with development, such as diabetes, would increase, while mortality from infectious
diseases, such as tuberculosis, would still be substantial. Although HIV was unknown in 1980, Gwatkin
also predicted that such countries would be vulnerable to new epidemics that might appear. We
investigate adult mortality 1997-2005, paying special attention to sex differentials in mortality and the
changing role of the three Global Burden of Disease categories.