A group of drug users gather at the Center of Disease Control
(CDC) in Jiele, a small township in Ruili City, southwest China's
Yunnan
Province. A doctor is teaching them how to do artificial
respiration.
The class offered by the local CDC to intravenous drug users
(IDUs), in Mandarin and in languages of several ethnic minorities
inhabiting the area, is part of a program to promote condom use and
other methods to prevent the spreading of HIV/AIDS and reduce the
hazard of drug using.
Jiele Township is an epitome of areas in southwest China
bordering with the notorious "Golden Triangle" in international
drug trafficking, where local residents could easily get drugs at
low costs from Myanmar and other countries across the border. For
an average addict, 30 yuan would be enough to cover his daily
consumption, says a middle-aged trainee of the class.
"Our aim for the time being is not to have them quit the drug,
but to prevent them from contracting HIV/AIDS," says Duan Yijuan, a
doctor at the CDC branch.
She says that in the past, the local government was not so keen
on providing such training for fear it might encourage people to
use drugs. "But now, we have full support from the provincial
government, " she says.
"The government even supports our programs of clean needle
exchange and methadone replacement," says Wang Yunsheng,
deputy-director of the HIV/AIDS prevention office of the province's
Health Bureau, "which is a big progress from the past."
The local governments' conception change actually reflects a
major turn of the central government's attitudes toward the control
and prevention of the infectious disease. That is to confront the
reality more positively and open.
The recognized turning point came in December 2003, when Premier
Wen Jiabao
and Vice Premier Wu Yi
shook hands with AIDS patients in a Beijing hospital, signaling
that the central government has put the combat with the disease on
top of the agenda.
Meanwhile, the central government's gesture, as a climax among
all government and non-government organizations' efforts to
eliminate fear and discrimination against HIV-infected people, has
made a great impact on the public's thoughts about HIV/AIDS.
Just from May to August this year, Beijing alone witnessed a
training workshop for patients of HIV/AIDS on their rights to
information and treatment, and a camp for children orphaned by
AIDS.
"Today, what the government is doing is probably more than 500
percent what it was doing a year ago," says epidemiologist Ray Yip,
director for the Global AIDS Program of the US Centers for Disease
Control and Prevention (CDC) in China.
He says that the outbreak of SARS in the Spring of 2003, as a
fatal infectious disease, sounded an alarm that any infectious
disease should be treated with serious attention.
In China, there are about 500,000 registered IDUs, who
constitute 60 percent of the estimated 840,000 people infected with
HIV throughout the country, where the first AIDS case was detected
in 1985.
In Yunnan Province alone, where the largest number of
HIV-infected people was reported, the reported HIV-infected cases
are 15,000, while experts estimate 75,000 people have been
infected. Another high-risk group are sex workers.
But due to the social stigma and pressure that the two groups
are facing, it is not easy to trace all of them and provide
knowledge and medical care, says Wang Yunsheng.
Alarming to experts, about 95 percent of the estimated 840,000
people living with HIV do not know about their infection, according
to Prof. Jing Jun, director of the HIV/AIDS Policy Research Center
at Qinghua
University. Their ignorance can be disastrous, as they can pass
the virus to their sexual partners and children.
The HIV/AIDS epidemic in China also features the highest
prevalence in some remote areas of minority-inhabited areas. The
population of ethnic minorities barely accounts for 10 percent of
the nation's total, but among the HIV-infected people, 36 percent
are from ethnic minorities, according to Jing.
The underdevelopment of these areas and their geographical
inaccessibility handicap the communication of information about
prevention and control of HIV/AIDS.
Realizing that most patients of HIV/AIDS are poor, the Ministry
of Health announced last April that the government would give free,
anonymous testing and counseling to HIV carriers who have financial
difficulties.
Hubei and Henan provinces in central China have pledged to offer
free AIDS-related medication to all HIV-carriers in addition to
dispatching officials to areas most seriously hit by the
epidemic.
In 2001, the central government increased its budget for
HIV/AIDS prevention and control from 15 million yuan (US$1.8
million) to 100 million yuan (US$12 million) annually, and the
figure reached 390 million yuan (US$47 million) last year.
Another 2.5 billion yuan (US$300 million) has been earmarked to
improve the construction of public blood banks in central and
western China to prevent transmission through sub-standard blood
collection and transfusion.
Actually, Yunnan is a pioneer in China to start the free
anti-virus treatment. The provincial government is now preparing a
standard anti-virus treatment program.
Chen Juemin, director of Yunnan's Health Bureau, says they have
invited foreign experts to work out a treatment program in
accordance with international standards.
In Central China's Henan
Province, which has a large number of rural residents infected
with HIV from tainted plasma donation, the anti-virus treatment was
provided on a large scale, says Wang Zhe, deputy-director of Henan
CDC, in order "to save more lives."
But experts say this anti-virus treatment still has its own
flaws due to the limitation of anti-HIV drugs currently available
in China. The four AIDS drugs in the program--ddI, d4T, AZT, and
nevirapine, not only have serious toxicity, but could easily
develop resistance among HIV patients if they fail to adhere.
A survey conducted by the Chinese CDC in Beijing shows among 500
former blood donors receiving treatment: after about nine months,
nearly 20 percent of them dropped out, and 20 to 30 percent had
become resistant to nevirapine.
"This means that we need to introduce new anti-HIV drugs to our
treatment plan while trying to train more qualified doctors to
monitor the whole process of treatment," says Zhang Fujie, a
clinician at China's Center for Disease Control and Prevention
(CDC) who heads the national effort. "We still have a long way to
go."
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(Xinhua News Agency October 4, 2004)