Inter Press Service - November 12, 2003
Antoaneta Bezlova

A common worry though, expressed by rights groups, AIDS activists and China experts is that the measures unveiled in recent weeks remain half-hearted and driven by worries about health disasters' adverse effects on China's economic performance and social order -- rather than care for the welfare needs of individuals.

SARS, which spread out of southern China around the world last fall and killed 774 people, challenged the new generation of Chinese leaders to confront the realisation that underinvestment in health care causes social instability and reduces economic growth.

This summer, in a sign that it is taking health concerns more seriously, the government began offering free anti-retroviral drugs to those living with HIV/AIDS in several poor areas hit hard by the epidemic.

Last week, Chinese executive deputy health minister Gao Qiang said 5,000 poor patients would receive free treatment this year. By 2008, the number is expected to rise to 40,000, according to Zhang Fujian, director of the National HIV/AIDS Clinical Task Force.

However commendable this new effort is for a country that refused to acknowledge that is had an HIV/AIDS epidemic a couple of years ago, the number of people scheduled to benefit from free treatment remain a drop in the sea.

Based on a national surveillance system, the government extrapolates that the number of HIV infections is rising by 30 percent a year. Using the same accumulative method, it estimates there are 840,000 HIV carriers, including 80,000 AIDS cases in this country.

Though the numbers appear small for a country with population of 1.3 billion, the disease is spreading rapidly from groups such as intravenous drug users to the general population.

The number of AIDS patients in the first half of 2003 jumped by 140 percent from the year-earlier period, the state media reported in October. The 'Beijing Youth Daily' quoted Wang Xinlun, director of the Health Education Office of the China Epidemic Prevention Centre, as citing the increase without putting a figure to the rise.

Without speedy government efforts, by 2010 China could have 15 to 20 million people with HIV, warns the United Nations.

China's Ministry of Health claims that only 45,000 HIV/AIDS cases have been registered with the authorities, and thus its plans envisage free treatment to 40,000 people by 2008.

"It means there would be nearly 800,000 unidentified HIV carriers and AIDS patients in China, continuing their high-risk activities without awareness," Jing Jun, a professor from Qinghua University, said at a recent AIDS and SARS symposium in Beijing.

Rights groups express concern that social stigma attached to AIDS patients in China prevents many of them to come forward and receive the treatment.

"Draconian crackdowns against people at high risk of HIV will only drive them underground and make it less likely that they will come forward for testing and treatment," said Brian Adams, executive director of the Human Rights Watch in a statement from New York this week.

There have been numerous media reports about hospitals in China reluctant to admit HIV-positive people. "China urgently needs a national law barring discrimination against people with HIV/AIDS, and should establish a mechanism through which victims of discrimination can file complaints," said Adams.

"How will the Chinese government give out medicine if the patients can't even get in the hospital?" he added.

Another area of concern is that authorities continue to harass grassroots AIDS activists, making work for disease awareness and education about the pandemic difficult.

The government is still reluctant to endorse the activities of non-governmental organisations working in the AIDS field or of individuals like Wan Yanhai or Gao Yaojie, whose clandestine work has done much to expose the problem and get help for the victims.

Instead of receiving public support, such AIDS activists have been harassed and even detained. Wan, founder of China's first AIDS hotline, was detained last year on accusations of divulging state secrets.

Gao Yaojie - a retired doctor from Henan province who this summer received the Magsaysay award, Asia's version of the Nobel prize -- was prevented from travelling abroad to receive her award in September. She complains of continuous harassment by local health authorities because of her campaign against AIDS.

Detractors also charge that the money Beijing is spending on providing peasants with free treatment come almost entirely from foreign donor agencies.

The Global Fund to Fight AIDS, Tuberculosis and Malaria awarded China 98 million dollars last month for a programme of free treatment over the next five years. The programme is to focus on impoverished farmers who contracted HIV by selling blood at state clinics that used unsanitary collection methods.

In his speech announcing the launch of free treatment for AIDS patients, Deputy Minister Gao Qiang said 24 million U.S. dollars would be spent yearly on a special fund for HIV/AIDS prevention, care and treatment.

Almost the entire amount comes from the Global Fund donation. Experts estimate that Beijing spends only 2 million dollars a year to address the pandemic.

The government's spending priorities come in unfavourable light because of its commitment to pay for high-cost projects like manned space flights and a moon-landing mission, as evidenced by China's successful launch of a man in space last month. The cost of China's space programme is estimated at 2 billion dollars a year.

Then there is the ambiguity about who is 'poor enough' to qualify for the drug cocktails distributed by the government. A year's supply of imported AIDS costs about 10,000 dollars, an unfathomable sum for farmers who typically earn as little as 200 dollars a year. The combination of domestic drugs, available at around 600 dollars a year, is still beyond the budgets of many peasants.

AIDS activists estimate that 1 million peasants in central Henan province were infected by selling blood to government collection stations in the early 1990s.

Beijing should stop neglecting health and welfare in favour of economic growth, said Hu Angang, director of Qinghua University's Centre of China Studies. "The government has to transform from a developmental government to a public service government," he remarked.

With the SARS outbreak wreaking havoc and shaving about 0.7 percentage points of China's Gross Domestic Product this year, the government seems to have learned its lesson well.

031112
IP031107

Always watch for outdated information. This article first appeared in 2003. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2003. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .