Abstract
Following an overview of the data and approaches for mortality estimation in African countries, we compare trends in estimates of 45q15 produced by the UN agencies with those derived from reports of sibling survival in the Demographic and Health Surveys. A short discussion of the distribution of causes of death is based on verbal autopsy data coming from a handful of Demographic Surveillance Sites. Despite the sometimes intriguing differences between estimates from different sources, a few general patterns of adult mortality trends are common to most sources. With the exception of northern Africa, declines in adult mortality during the last few decades have been modest, and in some populations drastic mortality reversals have been recorded. These are primarily driven by the HIV/AIDS epidemic, but the extremely high adult mortality rates in some southeastern African countries are due to the triple burden of infectious and chronic diseases and the relatively high level of deaths due to external injuries. In some countries severely affected by the HIV/AIDS epidemic, adult mortality started to decline again, and that occurred well before the large scale availability of antiretroviral therapy.