Source: Médecins Sans Frontières

HIV/AIDS [ID 18861]

"Link collection for information on HIV/AIDS health care in China"

Document(s): Open document

Source:

Report on HIV/AIDS medicines registered in China [ID 22340]

07.2008 - Source: World Health Organization

Epidemiological Fact Sheet on HIV/AIDS and Sexually Transmitted Infections, 2008 update ("Epidemiological Fact Sheet on HIV/AIDS and Sexually Transmitted Infections") [ID 24110]

Data on HIV/AIDS and STIs prevalence, health service and care indicators, prevention indicators

Document(s): Open document

07.2008 - Source: World Health Organization

Epidemiological fact sheet on HIV/AIDS and sexually transmitted infections (data on HIV/AIDS and STIs prevalence, health service and care indicators, prevention indicators) ("Epidemiological Fact Sheet on HIV/AIDS and Sexually Transmitted Infections") [ID 24668]

Document(s): Open document

06.2008 - Source: Congressional-Executive Commission on China

Authorities continue to harass HIV/AIDS advocates ("China Human Rights and Rule of Law Update (June 2008)") [ID 23951]

"Chinese authorities have made significant progress in their efforts to combat the spread of HIV/AIDS since 2003, but at the same time continue to harass HIV/AIDS advocates. Authorities reportedly ordered the closure of the "AIDS Museum" Web site, www.aidsmuseum.cn, according its founder, Chang Kun, in a May 7 Radio Free Asia interview. Chang, an HIV/AIDS activist, said he received a phone call on May 6 from the site's Internet Service Provider (ISP) saying that the local public security bureau's Internet surveillance division reportedly ordered the site closed because it contained information about "firearms and ammunition."
Shaanxi province officials reportedly shut down another Web site, AIDS Wikipedia, also founded by Chang from February 20 to March 12, according to a Radio Free Asia interview on February 22 reported in The Epoch Times and Chang's personal Web page. In the interview, Chang said the closure by the local public security bureau's Internet surveillance division was due to his article about farmland confiscation in Anhui province.
The closure of Chang's Web sites follows other instances over the past year where officials harassed HIV/AIDS activists and curbed their online activities."

Document(s): Open document

01.2008 - Source: Center for Strategic and International Studies

Report on HIV/AIDS and drug addiction (drug treatment and HIV prevention, opioid addiction and treatment, availability of treatment, policies) ("Combating the Twin Epidemics of HIV/AIDS and Drug Addiction") [ID 24147]

"The most recent and reliable estimates from UNAIDS place the number of adult HIV infections at 650,000 cases nationwide (a range of 390,000 to 1.1 million).7 This prevalence rate represents 0.1 percent of the population, one of the lowest rates among the countries in this report. The first indigenous cases of HIV were identified in 1989 in the southwestern province of Yunnan among IDUs.8 A second major outbreak was detected in the east-central provinces in the mid-1990s as a result of contaminated blood collection instruments.9 Soon after these findings there were dire predictions of an epidemic with 10 million HIV cases by 2010.10 Fortunately these predictions have proved unfounded, but the estimate of 840,000 infections remained higher than previous estimates by the Chinese government, as the epidemic among IDUs has continued to grow.11 Active testing of the population began in 2004 to provide the basis for better estimation of the scope of the HIV epidemic in China.

HIV infections in China remain concentrated among heroin injectors. According to 2005 government figures, injectors comprise 43.2 percent of reported HIV/AIDS cases.13 Not only is the epidemic being driven by transmission among injectors, but the prevalence within injectors has, in many locations, reached levels on par with the highest seen elsewhere in the world. In the provinces first affected, Yunnan and Xinjiang, more than four out of five injectors are already infected.14 At the China Center for Disease Control and Prevention surveillance sites in Guizhou, Guangxi, and Sichuan, prevalence rates of 34 percent, 43 percent, and 50 percent, respectively, were reported in 2004.15 In 2003, HIV incidence rates among injectors were more than 8 percent per year at study sites in Guangxi and Xinjiang."

Document(s): Open document

10.10.2007 - Source: Congressional-Executive Commission on China

Fear of the disease has led some local officials to harass persons with HIV/AIDS and their advocates ("Annual Report 2007") [ID 21413]

"Nonetheless, while national officials have emphasized the importance of combating HIV/AIDS, it is local implementation that determines whether national-level commitment and policy action produce outcomes of consequence on the ground. Implementation remains highly problematic. Fear of the disease has led some local officials to harass persons with HIV/AIDS and their advocates.16 Henan province, where a large number of villagers contracted HIV through unsanitary blood collection practices in the late 1980s and early 1990s, provides a particularly stark example [...]
The depth of the crisis is only magnified by official corruption. In July 2007, the Ministry of Health (MOH) announced the removal of a director of a Guangdong province blood center as a result of his involvement in illegal blood sales and noted that six other people had received sentences of between 6 and 18 months for helping individuals repeatedly sell their blood using fake identity cards.24 In the hopes of reducing illegal blood trade activity, the MOH has announced that blood collection centers are required by the end of October 2007 to set up equipment to videotape plasma collections."

Document(s): Open document

10.10.2007 - Source: Center for Strategic and International Studies

Report on the government's response on HIV/AIDS and U.S.-China bilateral initiatives ("China's Response to HIV/AIDS and U.S.-China Collaboration") [ID 24148]

Document(s): Open document

24.07.2007 - Source: Center for Strategic and International Studies

Demographic information on HIV/AIDS ("Demography of HIV/AIDS in China") [ID 24149]

See report for further details

"HIV-positive persons are present in all 31 provinces and municipalities of China. As of the end of 2005, the Ministry of Health estimated that approximately 650,000 (range: 540,000 to 760,000) persons could be infected in China, with about three-quarters of these persons living in five Chinese provinces: Yunnan, Henan, Xinjiang, Guangxi, and Guangdong.
More troubling is data regarding certain at-risk groups. Data as of the end of 2005 shows that prevalence among IDUs has tripled from 1.95 percent in 1998 to 6.48 percent in 2004, and from 0.02 percent in 1996 to almost 1.00 percent in 2004 among CSWs, a remarkable jump of nearly 50-fold. Among pregnant women in high-risk areas, HIV prevalence has also grown dramatically, from nil in 1997 to 0.26 percent in 2004.
As of the end of 2005, in some provinces, such as Yunnan, Henan, and Xinjiang, HIV prevalence rates exceed 1 percent among pregnant women and among persons who receive premarital and clinical HIV testing. This meets the criteria of the UN Joint Program on HIV/AIDS (UNAIDS) for a “generalized epidemic.”
The source of HIV infection is another indicator of how the disease may be moving toward a more generalized epidemic in China. Data for those who were infected in 2005 shows that while IDU infection accounts for 48.6 percent of HIV infection, sexual transmission for the first time accounts for more infections, at 49.8 percent. Mother-to-child transmission also appears to be increasing as part of the overall epidemic, another indicator that the epidemic is emerging in the general population."

Document(s): Open document

18.07.2007 - Source: International Treatment Preparedness Coalition

There is still a high degree of stigma against injecting drug users (IDUs), sex workers, and migrant workers, and policy and institutional barriers prevent them from accessing antiretroviral (ARV) treatment and care ("Missing the Target 4: Time is Running Out to End AIDS –Treatment and Prevention for All!") [ID 21754]

"IDUs: IDUs are viewed with particular suspicion by treatment providers because they are seen as unreliable and at high risk of being nonadherent to ARV therapy. They are at times refused entry to treatment programs. IDUs also face the constant risk of arrest and detention, and it is extremely difficult to provide a continuum of care once they have been sent to a mandatory drug detox centre or detention facility. In addition, many IDUs are extremely reluctant to register using their real names because they fear their identities will be passed on to police and other authorities, and thus are not willing to participate in the national treatment system.

Migrant workers: PLWHA are only allowed to access ARV therapy in their area of residency (China has a national residency system), and this is a major barrier for PLWHA who are not residing where they are registered. In some cases, doctors or patient groups will negotiate to send ARVs across the country, but in most cases, people living outside of their area of residency simply do not have access to treatment.
Sex workers: As the majority of sex workers are also migrants, they confront the same restrictions on access to free ARVs that migrant workers do. Facing the choice between an income and medical treatment, most choose the former.

Women and MSM, as minority populations, face few barriers to accessing treatment, other than those encountered by any individual (i.e., residence requirements, financial burdens)."

Document(s): Open document

18.07.2007 - Source: International Treatment Preparedness Coalition

Diagnosis and counselling is inadequate both in the case of tuberculosis (TB) patients being screened for HIV and HIV-positive people being screened for TB ("Missing the Target 4: Time is Running Out to End AIDS –Treatment and Prevention for All!") [ID 21756]

"Diagnosis is inadequate both in the case of TB patients being screened for HIV and HIV-positive people being screened for TB. Since the TB program requires sputum-positive tests, and AIDS patients tend to be sputum-negative, an estimated 50% of TB cases among AIDS patients may be missed.
Counselling is extremely limited, and in most places is provided by health care workers who have not had formal training in counselling or psychological support.
Efavirenz, which is recommended for use in HIV/TB co-infection, is available and on the list of “free ARVs” in China, but the high fee paid by the government means that doctors are under pressure not to prescribe it. In some areas, such as in one city in Yunnan where 60% of AIDS patients are TB co-infected, efavirenz is not available at all."

Document(s): Open document

14.03.2007 - Source: World Organisation Against Torture

Activists involved in the fight against HIV/AIDS were often the victims of acts of harassment ("Steadfast in Protest; Annual Report 2006") [ID 19513]

"In addition, activists involved in the fight against HIV/AIDS were often the victims of acts of harassment, because they raised the question of the responsibility of the authorities in the development of the epidemic, in particular through contaminated blood transfusions. For example, Mr. Hu Jia, an HIV/AIDS activist in Shanghai and cofounder and former director of the Aizhixing Institute for Health Education, was detained from February 16 to March 28, 2006. In addition, on October 18, 2006, authorities from the autonomous region of Xinjiang ordered the closing down of Snow Lotus, an unregistered NGO fighting AIDS."

Document(s): Open document
Open document

06.03.2007 - Source: US Department of State

Discrimination against persons with HIV/AIDS remains widespread in many areas ("Country Report on Human Rights Practices 2006") [ID 19167]

"Under the new contagious disease law and adopted regulations, employment discrimination against persons with HIV/AIDS and hepatitis B is forbidden, and provisions allow such persons to work as civil servants. However, discrimination against the estimated 650,000 persons with HIV/AIDS and approximately 10 million hepatitis B carriers remained widespread in many areas. Hospitals and physicians sometimes refused to treat HIV-positive patients. During the year a number of hepatitis B carriers sued local government institutions to enforce their rights to work and study. While they won judgments in some cases, widespread discrimination remains. In October the Ministry of Health criticized local officials in Urumqi, Xinjiang for expelling 19 hepatitis B carriers from public schools. The criticism was carried in the national press, but no remedies were reported. Persons with HIV/AIDS likewise suffered discrimination and local governments sometimes tried to suppress their activities. In April Jilin Province authorities blocked a group of HIV-positive persons from accepting free travel to visit the Great Wall. At the same time, international involvement in HIV/AIDS prevention, care, and treatment, as well as central government pressure on local governments to respond appropriately, brought improvements in some localities. Some hospitals that previously refused to treat HIV/AIDS patients now have active care and treatment programs, because domestic and international training programs improved the understanding of local healthcare workers and their managers. In Beijing, dozens of local community centers encourage and facilitate HIV/AIDS support groups.

Some NGOs working with HIV/AIDS patients and their family members continued to report difficulties with local government, particularly in Henan Province where thousands were infected in government-run blood selling stations during the 1990s. Henan authorities were successful in providing free treatment to persons with HIV/AIDS. However, foreign and local observers noted that local governments were reluctant or even hostile towards coordinating efforts with NGOs and preferred to work independently."

Document(s): Open document

01.2007 - Source: Human Rights Watch

HIV/AIDS ("World Report 2007") [ID 18575]

"Central government officials have announced new steps to reverse the country’s HIV/AIDS crisis, but serious challenges remain. HIV/AIDS is expected to cost China's economy nearly US$40 billion over the next five years.

Local officials and security forces continue to obstruct efforts by activists and grassroots organizations to contribute to prevention and education efforts and to organize care-giving. Although there are hundreds of nongovernmental HIV/AIDS organizations in China, only a few are recognized by the government. In 2006, security officers in several provinces detained and beat activists lobbying for improved compensation for AIDS sufferers who contracted the disease through blood transfusions.

In October 2006, local authorities in Xinjiang shut down the Snow Lotus HIV/AIDS Education Institute, an HIV/AIDS advocacy group with funding from the Global Fund for HIV/AIDS, Tuberculosis and Malaria. The group was closed after it exposed the exclusion of 19 junior high school students from their school because they were suffering from Hepatitis B."

Document(s): Open document

12.2006 - Source: Congressional-Executive Commission on China

Government's recognition of the need to address the threat of HIV/AIDS is often outweighed by its desire to maintain control over civil society groups ("China Human Rights and Rule of Law Update (December 2006)") [ID 19567]

"Repeated government custody of AIDS activists such as Wan, Li, and Hu Jia demonstrate that the government's recognition of the need to address the threat of HIV/AIDS is often outweighed by its desire to maintain control over civil society groups and halt the emergence of independent organizations. This is also not the first time the Chinese government has interfered with, and harassed participants of, international conferences. In May 2005, Chinese government authorities abruptly canceled a planned international academic conference on constitutionalism and democracy that was jointly organized by Fordham University and the China University of Politics and Law. In June 2005, security officers in Beijing detained the executive director of a respected U.S. human rights NGO after she attended a seminar associated with the EU-China bilateral human rights dialogue."

Document(s): Open document

12.2006 - Source: World Health Organization

Epidemiological fact sheet on HIV/AIDS and sexually transmitted infections (data on HIV/AIDS and STIs prevalence, health service and care indicators, prevention indicators) ("Epidemiological Fact Sheet on HIV/AIDS and Sexually Transmitted Infections") [ID 21743]

Document(s): Open document

20.09.2006 - Source: Congressional-Executive Commission on China

HIV/AIDS ("Annual Report 2006") [ID 17391]

see report for further details - Chapter V(g)

"• The central government continued to take steps over the past year to prevent and control the spread of HIV/AIDS. Although the estimated number of HIV/AIDS cases nationwide has decreased, health officials still consider the disease to be a grave problem. Government efforts to prevent and control the transmission of HIV/AIDS continue to face serious challenges, as local implementation of national policy lags far behind central government attention to the problem. Victims of HIV/AIDS and other infectious diseases also continue to face harassment and discrimination, despite legal protections."

Document(s): Open document

10.08.2006 - Source: Amnesty International

Beijing: HIV/ AIDS activist Xige detained by police in July while trying to lobby the national Ministry of Health for compensation for those who have contracted HIV/ AIDS from blood transfusions; she could be at risk of torture or ill-treatment and is reportedly being denied access to regular medical care that she needs ("Urgent Action 217/06 [ASA 17/043/2006]") [ID 17864]

Document(s): Open document

06.2006 - Source: Center for Strategic and International Studies

Assessment of HIV/AIDS initiatives (HIV/AIDS situation in country, HIV/AIDS response, persistent challenges and gaps, major Chinese and international initiatives, practices and strategies) ("Assessing HIV/AIDS Initiatives in China") [ID 17128]

Document(s): Open document

30.03.2006 - Source: Tageszeitung

Missed Aids-activist was in detention; reported about ordeal lasting 6 weeks, probably will suffer lasting harm ("Vermisster war in Haft") [#47846],  [ID 17175]

Document(s): Open document

11.03.2006 - Source: Human Rights Watch

Henan province: Hundreds of people infected with HIV through unsafe practices at government clinics denied medical treatment and compensation ("China: House Arrests Stifle HIV/AIDS Petitions") [#46317],  [ID 17129]

Document(s): Open document

13.02.2006 - Source: Guardian

Patients with HIV-Aids will be legally protected from discrimination under new law ("Legal rights for Aids patients") [#43929],  [ID 17164]

Document(s): Open document

12.02.2006 - Source: BBC News

Government announced new law to control and prevent spread of AIDS as well as to ban discrimination against AIDS sufferers ("China issues new rules on Aids") [#43960],  [ID 17165]

Document(s): Open document

01.2006 - Source: Human Rights Watch

HIV/AIDS ("World Report 2006") [#42330],  [ID 17338]

"Although Chinese authorities have announced new steps to address the country’s burgeoning HIV/AIDS crisis, they continue to obstruct the efforts of activists and grassroots organizations to contribute to prevention and education among vulnerable groups and to organize care-giving for those infected. Regulations have thwarted activists’ attempts to register their organizations and to raise funds, while Internet censorship has restricted the kind of information available to individuals at high-risk. Activists who attempt to bring problems related to the crisis to media attention have been particularly vulnerable to harassment."

Document(s): Open document

11.10.2005 - Source: Congressional-Executive Commission on China

-Central government expands efforts against HIV/AIDS epidemic, but local authorities often harass HIV-activists ("Annual Report 2005") [#37506],  [ID 4472]

see report for further details - chapter III(h)

"Central government efforts to address China’s HIV/AIDS epidemic continue to expand and deepen, but local governments often harass Chinese activists who work on HIV/AIDS issues."

Document(s): Open document

04.2005 - Source: UK Home Office

Country Report April 2005 - HIV/AIDS ("Country Report - April 2005") [#31975],  [ID 4473]

"5.113 According to the UNAIDS website:

“HIV/AIDS was first diagnosed in China in 1985. In 2003, the number of people living with HIV/AIDS (PLWHA) was estimated to be 840 000, among which 80 000 had developed AIDS. The epidemic has spread to 31 provinces, and the country is witnessing a rapid increase in HIV infections and AIDS deaths, particularly in central provinces, where many people became infected through unsafe blood and blood plasma in the 1990s. Huge income disparities, large scale labour migration and gender imbalances are some of the factors increasing the population's vulnerability to HIV. Since 2002, when China first publicly acknowledged the scale of the HIV/AIDS problem, it has been mobilizing a multisectoral response to HIV/AIDS. A coordinating body was set up which is today reporting directly to the State Council.” [8b]

5.114 As reported by the official People’s Daily newspaper on 30 November 2004, “Official figures show that China has an estimated 840,000 AIDS/HIV cases.” [12ac]

5.115 As reported by the China AIDS Survey (a site that lists chronologically policy and regulations relating to HIV/AIDS control in China):

“The Chinese government currently estimates up to one million Chinese citizens may be infected with the AIDS virus. However, experts agree that these figures do not accurately reflect the actual number because China lacks the resources to carry out extensive surveillance in the countryside. Additionally, current surveillance protocols primarily cover only specific high risk groups. Because of these limitations, it is estimated that only five percent of HIV cases in China are reported. UN and World Heath experts believe the real figure lies between 1.5 and two million, and the United Nations Program on AIDS (UNAIDS) projects China could have between 10 and 15 million HIV cases by the year 2010. Although this number represents only a small percentage of China’s vast 1.2 billion population, the sheer numbers of people at risk is staggering.” [8oa]

5.116 As reported by the same source, “[On] 1 December 2003 Chinese Premier Wen Jiabao visited and shook hands with AIDS patients in Beijing's Ditan Hospital. Wen's visit marks a milestone in China [sic] top-level commitment to fight AIDS in China.” [8ob]

5.117 As reported by the BBC on 12 July 2004, Premier Wen reiterated earlier demands for local officials to do more to help people living with AIDS on the eve of the global AIDS conference in Bangkok in July 2004. [9bb] As reported by the Guardian newspaper on 12 July 2004, “Whether Mr Wen’s words herald a new openness and the end of the persecution of Aids activists in China remains to be seen. Drug users, who are at the heart of the Asian epidemic, are a shunned group.” [16aj]

5.118 On the eve of World AIDS day (2004) President Hu visited AIDS patients in Beijing; his visit was reported by the official People’s Daily newspaper on 30 November 2004. [12ac]

Availability of Anti-retrovirals

5.119 As reported by Human Rights Watch (HRW) on 11 November 2003, the Chinese government has begun making anti-retroviral drugs available free of charge to all rural residents and to those in urban areas unable to pay for the treatment themselves. [7g]

5.120 As reported by the official China Daily newspaper on 14 April 2004, to qualify for free medical treatment, patients must be rural residents or urban citizens who have economic difficulties and are not covered by any basic medical insurance. [14j]

5.121 On 15 April 2004, the official People’s Daily newspaper reported that the government had announced the introduction of free AIDS tests and consultations for all citizens. The report stated, “According to the regulation, the central government pay for the tests in the AIDS-stricken areas while the local governments in other areas pay themselves.” [12q]

5.122 As reported in the Guardian newspaper on the same date, “In theory yesterday’s announcement threw the clinic doors open to everyone, though it remains to be seen whether China’s underfunded health system will be able to cope with a surge in the demand for tests or treatment.” [16af]

5.123 According to a report dated 1 December 2004 by the official news agency Xinhua, “More than 10,000 AIDS patients have been given free anti-retroviral therapy, a kind of anti-virus treatment, this year. The total central government investment on HIV/AIDS amounted to about 390 million yuan (US$47 million) in 2003. The budget for 2004 was 810 million yuan (US$98 million), while budgeted international support reached to 421 million (US$51 million) in 2004.” [13q]

Intravenous Drug Users (IDUs)

5.124 The same source continued, “According to Ministry of Health surveillance, the prevalence of HIV among IDUs is from 5 to 8 per cent.” It also stated that, “China has built 34 clinics and 50 [treatment] spots to provide Methadone and clean syringes for drug users.” [13q]

5.125 On 4 October 2004, the official People’s Daily newspaper reported that China has approximately 500,000 registered IDUs (this constitutes 60% of the people estimated to be infected with HIV/AIDS). [12y]

5.126 As reported by the BBC on 30 November 2004, “In Yunnan's provincial capital, Kunming, that [sic] increase [in government spending] is symbolised by a new needle exchange project. The centre also includes games rooms and a library about HIV/Aids. It only opened in March, but more than 1,000 heroin addicts now use its services.” [9bp]

Discrimination

5.127 In September 2003, HRW published a report, “Locked Doors: The Human Rights of People living with HIV/AIDS in China”, detailing the many obstacles that people faced when diagnosed as HIV positive in China. This report highlighted both the high level of ignorance about the disease, particularly in rural areas and the continued reluctance of local officials to fully implement central government initiatives. [7f]

5.28 According to a report in TIME Asia dated 2 August 2004, the authorities in Henan province were particularly reticent when it came to accepting outside assistance in caring for those infected with HIV/AIDS. In July 2004, they closed an AIDS orphanage on the pretext that the NGO running it had not applied for a license. The report also alleged that dozens of villagers contacted by reporters had not yet received the medication promised by central government. [15dc]

5.129 As reported by CNN on 29 August 2004, new legislation was enacted on the 28 August 2004 banning the sale of blood products and prohibiting discrimination against people infected with contagious diseases. [10d] In response to this HRW stated, “This law is long overdue. Now the Chinese government needs to ensure that violations are effectively monitored and that the law is enforced, said Joanne Csete, director of the HIV/AIDS Program of Human Rights Watch [on 30 August 2004].” [7l]

5.130 According to the results of a survey reported by the official China Daily newsper on 14 December 2004:

“At least 80 percent of China's estimated 5 to 10 million gays mistakenly believe they are safe from HIV/AIDS, according to the country's first ever survey on the homosexual group. The survey, conducted by the center of AIDS control and prevention under the Chinese Center for Disease Control and Prevention in collaboration with its branch office in northeast China's Heilongjiang Province, found 80.6 percent of the gay men are totally ignorant of their exposure to the virus or underestimate the risk.” [14o]"

Document(s): Open document

06.12.2004 - Source: Médecins Sans Frontières

1.5 million people are living with HIV/AIDS; MSF has begun working with local medical staff to provide care and treatment ("Providing AIDS care and helping street children") [ID 22339]

Document(s): Open document

31.08.2004 - Source: Human Rights Watch

The new law was passed, that bans discrimination against people living with infectious diseases ("China: Law Bans HIV-Related Discrimination") [#26659],  [ID 4474]

Document(s): Open document

10.08.2004 - Source: Amnesty International

An AIDS/HIV activist attacked and beaten by two young men/ the attack is believed to be an attempt to intimidate him on account of his activism ("China - Further Information on UA 221/04") [#24619],  [ID 4475]

Document(s): Open document

09.08.2004 - Source: Amnesty International

Release of couple who had been detained for sending children to the school established by their fellow HIV/AIDS activist for children whose parents were HIV-positive or who had died of AIDS ("China - Further Information on UA 221/04") [#24616],  [ID 4476]

Document(s): Open document
Open document

14.07.2004 - Source: Amnesty International

Shangqiu city, Henan province: 4 people, all HIV positive, detained after they tried to protest at inadequate healthcare and other services for those infected with HIV/AIDS in the city/ they may be at risk of torture or ill-treatment ("China - UA 221/04") [#24007],  [ID 4477]

Document(s): Open document

10.2003 - Source: UK Home Office

Country Assessment - October 2003 - AIDS/HIV ("Country Report - October 2003") [#49232],  [ID 4480]

"5.72. The exact number of people infected with HIV / AIDS in China is unknown, The World Health Organisation (WHO) estimates the figure to be around 850,000 (figures for 2001). The true extent of the problem could be much worse as WHO estimate that up to 95 per cent of cases go unreported. There is also concern that with such a heavy emphasis on fighting SARS, HIV / AIDS will now be seen as less important for health officials.

5.73. The official estimate of HIV-positive cases (as opposed to confirmed cases) was over 600,000 people by the end of year 2000. Intravenous drug use was held to be responsible for 69.8 percent of HIV infection cases.

5.74. In September 2002, the PRC authorities admitted that there may be over one million HIV cases in China, and that a projection towards 2010 might see the development of over 10 million cases of people with HIV.
[...]

5.123. The Chinese authorities have, reportedly, been under increasing pressure to tackle the country's AIDS / HIV problems. By March 2001, for example, the authorities of Guangdong Province acknowledged that prejudicial practices occurred in provincial institutions, such as the throwing out of HIV positive people from prisons and re-education-through-labour camps to fend for themselves. AIDS treatment, it was held to be, was prohibitively expensive at about 10,000 Yuan (about Ł750) per patient per year in Guangdong Province. (see below at treatments) Such figures were released as part of a regional bid for central funding of a series of treatment centres: a previous proposal in year 2000 for a treatment centre in Jiangmen , Guangdong Province had failed on grounds of cost. The building of the centre was set at 30 million Yuan (Ł2.1 million), with on-going costs of 10 million Yuan (Ł715,000) a year for 1,000 patients.
[...]

Wenlou Village Scandal

5.75. In the early 1990s, the provincial health authority in Henan province set up collection station, buying blood from local people many of who subsequently became infected with the HIV virus as a result of contaminated needles. The situation was particularly bad in the village of Wenlou where many poor farmers went repeatedly to the collection centres and made a living from “donating” their blood; commercially sellable proteins were removed from the blood and what was left was “pooled” and injected back into the donors. Today 65 per cent of the villages in Wenlou are HIV-positive.

5.76. There are credible reports of AIDS sufferers being shunned and abused by fellow villagers, nearby townsfolk and local officials when the scandal first broke. [4rg] Reports of harassment of HIV / AIDS suffers by government officials continue to surface. Many of the officials “accused” of colluding with pharmaceutical companies at the time are now suspected of blocking media access to the affected villages. Some have even been promoted to more senior positions within the CCP.
[...]
5.125. Official practices regarding people with HIV / AID has since been held up to some scrutiny. A hospital was successfully sued after releasing false AIDS information about a patient in July 2001, in Shanxi Province, prompting the central Ministry of Health to call for more attention in the protection of the right to privacy of HIV/AIDS cases. Senior health officials have echoed the call for respect and dignity to be given back to people with AIDS / HIV.

5.126. Further, the government arranged the first national HIV/AIDS conference for 13-16 November 2001, which has adopted and passed a number of key messages and measures, as well as opening up debate. (see below)
[...]

Treatment and Strategies

5.75. The typical cost of patent-protected retrovirals - AZT being the generic name - in PRC has been given as 870 Yuan (Ł62) for Videx and 3,110 Yuan (Ł225) for Zerit (both made by Bristol-Myers Squibb) for courses lasting fourteen days. The authorities are also committed to developing a programme of Methadone treatment in order to combat the sharing of needles by intravenous drug users.

5.76. There have been calls from within the PRC for the government to look at ways of overcoming the obstacles to producing generic versions of successful anti-viral drugs as a way of lowering the price. [4rt][4rv][9cx][20z.] Better education on issues such as 'safe sex', are frequently stressed by foreign observers many of who point out that the mass of the Chinese populous remain in the dark over the scale of the disease.

5.77. State media has given wide coverage developments in South Africa: landmark judgement breaking pharmaceutical companies' restrictions. The authorities have noted that India is now able to produce drug treatments at a cost of 300 US dollars per patient per year, as opposed to the imported drug regimes of up to 10,000 US dollars per patient per year.
[...]
5.138. Two PRC pharmaceutical companies have announced they have plans to manufacture de-regulated "cocktail" therapies. One firm, Shanghai Desano Co, has put forward two proposals that would reduce drug therapy down to 3,000 Yuan (US$360 - Ł220) a year per patient. It admits that no international company could pitch so low, and only expects to break even. In August 2002, the North East Pharmaceutical Group announced that it hopes to make AZT treatments for a tenth of the price of imported AZT as soon as September 2002. Chinese doctors are concerned that even the locally made, cheaper products will still be beyond the pocket of most Chinese HIV patients.

5.139. The State Council's AIDS prevention plan for years 2001 to 2005 was published in September 2001. It focused on the strengthening of the administration of blood collection stations and the development of the treatment of AIDS as a major Chinese research goal. The plan also hopes to address ignorance about AIDS/HIV by improving the quality of media reporting of the issue. There are the beginnings of a social turnaround, with state media beginning to show a sympathetic approach towards people with AIDS / HIV. In September 2002, it was reported that middle schools are starting to experiment with sex education programmes for students.
[...]
Experts outside PRC

5.127. A leading US AIDS expert, Helene Gayle, has warned that PRC must address HIV infection through sexual transmission rather than just reacting to blood transfusion scandals. A two fold emphasis was suggested, with increased public awareness about AIDS in conjunction with sex education, and increased official surveillance with improved statistics and more open debate. Another US expert has cautioned that China needs to develop better public awareness, accurate statistics and greater participation of the non-governmental sector in strategies to combat AIDS.

Internal debate

5.128. Has culminated in the first national conference, but prior to the conference, a number of regional officials and PRC experts have been able to air the issues around AIDS. One instance however has been of embarrassment to local and then central officials, with the case of a retired doctor, Dr Gao Yaoji, who spent her pension funding her work with the Henan villagers, to international acclaim. As she performed this assistance without any cooperation from local officials, and took on an advocacy role, she was denied a passport in June 2001 to attend the Global health Council awards ceremony.

5.129. The 23rd Congress of Pediatrics, meeting in Beijing on 12 September, flagged up AIDS/HIV infection as a serious forthcoming risk to the birth rate in future years. (The birth rate of natal and neo-natal deaths to live births was given as 33 per 1,000 births, a decrease in infant mortality.)

5.130. People with AIDS / HIV are starting to speak out openly for the first time, such as in the request to speak to the first national conference and the launch on 6 November 2001 of Xiao Cai's personal website, as unofficial support website.

First National Conference

5.131. Key reforms came out of the conference held in Beijing, on 13 - 16 November 2001. It was held to a remarkably open international conference [4rq][4ru][4ry] though it was marred by the decision to bar representatives (with AIDS) of the Henan villages affected by the blood transfusion scandals from speaking to conference
Statistics

5.132. Most sources outside PRC opine that there has been considerable under-reporting of AIDS/HIV cases. The Ministry of Health's1996 official estimates are of 200,000 plus cases as opposed to 9,970 recorded cases. In 1997, Guangdong Province Province (in Southern coastal China) had the fastest infection rate, but recent reports indicate Yunnan Province (in South China) and XinJiang Province (in West China) had dramatic rises in 1998. Hong Kong has better epidemiological data, with an estimate of 12,000 cases for year 2000.

5.133. Figures were released by the Ministry of Health in late August 2001, based on data for the period up to the end of June 2001. Yin Dakui, vice minister of Health, announced there had been 584 deaths of people with AIDS since the first case was reported in China in 1985. That the accumulated number of confirmed AIDS / HIV cases now stood at 26,058 cases, with 1,111 cases of fully blown AIDS. The official estimate of HIV-positive cases (as opposed to confirmed cases) was now over 600,000 people by the end of year 2000. Intravenous drug use was held to be responsible for 69.8 percent of HIV infection cases.

5.134. In September 2002, the PRC authorities admitted that there may be over one million HIV cases in China, and that a projection towards 2010 might see the development of over 10 million cases of people with HIV."

Document(s): Open document

09.2003 - Source: Human Rights Watch

Report focused on human rights and AIDS (discrimination, violations of freedom of expression, violations of confidentality) ("Locked Doors: The Human Rights of People Living with HIV/AIDS in China") [#17497],  [ID 4478]

"Already, the virus has cut a devastating swath across the country, affecting at least 1.5 million men, women, and children. In fact, the numbers are probably much higher3-- actual infection rates remain unclear in China, because local authorities have minimized the epidemic in order to protect external investment in local economies. During the 1990s, local authorities were also complicit in the transmission of HIV to hundreds of thousands or even millions of villagers through an unsanitary but highly profitable blood collection industry. Faced with such multiple local failures on the part of provincial and county governments, Beijing’s reluctance to act decisively in the AIDS epidemic continues to cost lives and cause incalculable suffering to those living with the virus.

As AIDS activist Zhang points out, persons living with HIV in China have urgent needs for health care, legal aid, and community support. Instead, widespread discrimination by state and private actors, and the lack of redress, are forcing many people with HIV/AIDS4 to live like fugitives. Their voices in this report, some of teenagers, tell of not only the horror of facing a painful and certain death, but also of facing that death alone, in squalor, with no one to bring them food or change their sheets, fearful to even show their faces to neighbors because of the risk of eviction. Having been fired from jobs, evicted by landlords, or worst of all, refused care by hospitals because of their HIV status, some try to mask their pain and despair with drugs--which in turn can hasten the spread of the virus to others. Stigma and discrimination are clearly fuelling the epidemic in China. [...]

China has the capacity to combat AIDS. Despite a severely damaged national public health system and discriminatory hospital practices, some individual doctors and nurses have made extraordinary efforts to care for people with HIV. Behind the scenes, some senior policy makers are pressing Beijing to issue increasingly progressive-sounding statements on the epidemic and to undertake serious legal reform. A handful of small-scale pilot projects on the borders, the products of collaboration between some concerned Chinese officials and international nongovernmental organizations (NGOs), show what could be done. Yet in practice, Beijing has thus far done remarkably little. [...]

Thus many people living with HIV/AIDS in China live in a health care vacuum without hospital care, antiretroviral drugs, or counseling. [...]

On revealing their status (or having it revealed for them), persons living with HIV/AIDS may find themselves rejected by their families and friends, cast out of their homes, and unable to find or keep employment. If they turn to hospitals to seek assistance, some find they are refused care, and many are unable to afford care even when it is accessible. There are few NGOs that offer care or other services to people living with HIV/AIDS in China. Those individuals who dare to identify themselves to others as HIVpositive and who try to band together to form their own support groups face repression and censorship. Unable to afford medicines and lacking access to basic information about what works, some people with HIV even band together in secret to hold their own drug trials, experimenting with unregulated remedies sold by street peddlers in back alleys, in a desperate attempt to stave off the virus."

Document(s): Open document

11.07.2003 - Source: Amnesty International

AI: HIV-positive people detained for protesting for better health care services ("China - UA 210/03") [#14272],  [ID 4481]

"Sixteen unnamed people have been detained by police in Xiongqiao village in Shangcai county, Henan Province. All are thought to be HIV-positive and some may be suffering from AIDS. There are unconfirmed reports that at least some of them have been beaten in police custody and Amnesty International is concerned for their safety.
[...]
The raid on Xiongqiao village may have been provoked by an earlier incident which took place between 19-22 June, when up to 100 HIV-positive villagers visited the provincial capital Zhengzhou to protest about the lack of adequate health care in Xiongqiao. Five of them were reportedly detained by the policeand taken back to Xiongqiao. Two have since been released, but three are believed to remain in detention. One of those released has claimed that the detainees were beaten to force them to confess to crimes of "robbery" and "attacking government offices".
[...]
BACKGROUND INFORMATION
An estimated one third to one half of the 500-600 residents of Xiongqiao are reported to be HIV positive after becoming infected through selling their blood to government-sanctioned blood-collecting stations in the 1990s. The blood-collection schemes became a useful source of income for villagers, but were often poorly managed and unsafe. It is estimated that up to one million people may have been infected with the HIV virus in this way in Henan and other provinces.
The extent of the spread of HIV/AIDS in Henan became better known last year after the most prominent HIV/AIDS activist in China, Dr Wan Yanhai, head of the Beijing-based Aizhi Institute, published on his website (www.aizhi.org) lists of people who died in Henan province of HIV/AIDS related illnesses. He was arrested in August 2002 on suspicion of "leaking state secrets", but released around one month later after widespread international protests at his detention (See UA 273/02, ASA 17/043/2002, 2 September 2002, and follow-ups).
On 11 July, the Aizhi Institute reportedly wrote to the Health Minister of the Chinese government, calling for greater transparency and urging the government to release statistics detailing the number of people infected with the HIV virus through use of government-sanctioned blood collection centres and in which provinces.
The cost of medical treatment in China has increased sharply over recent years due to economic restructuring. Few villagers in Henan and other infected provinces have been given antiretroviral drugs or other specialist care."

Document(s): Open document
Open document

09.07.2003 - Source: Human Rights Watch

HRW: Police in Henan province increasingly using arbitrary arrests and violence against HIV-positive protestors seeking access to treatment ("China: Police Violence Against HIV-Positive Protestors Escalates") [#14193],  [ID 4482]

"In the 1990s, millions of villagers in Henan and other central provinces were infected with HIV through government-managed blood collection centers. Officials were motivated by the high profits available from the international blood products industry; for villagers, the sale of their blood was a much-needed source of income.

Demonstrators have called for access to antiretroviral treatment and care for people with HIV/AIDS, and decried the misappropriation of state AIDS funding. Government health officials responded to earlier protests by HIV-positive villagers with promises of aid. But violence and arbitrary arrest have been the response in more recent incidents"

Document(s): Open document

15.11.2002 - Source: Human Rights Watch

HRW: Jiangsu province, Suzhou city: new law protecting the rights of people living with HIV/AIDS - an important first step toward combating widespread discrimination ("China: Suzhou HIV/AIDS Law Praised/ New Party Leaders Should Push for National Legislation") [#9528],  [ID 4484]

"Chinese laws attempt to control and supervise people living with HIV/AIDS, and to punish people in high-risk groups, said Csete, but the Suzhou city ordinance is the first one in China that protects their rights."

Document(s): Open document

20.09.2002 - Source: BBC News

Prominent Aids activist freed after confessing to breaking the law and leaking state secrets ("China releases Aids activist") [#8661],  [ID 4486]

Document(s): Open document