China has cut AIDS mortality by almost two-thirds since it began distributing antiretroviral drugs nine years ago, according to a study released in May by China’s national centre for control and prevention of AIDS.
Roughly 63 percent of AIDS patients who require drugs now receive them, up from virtually none in 2002, resulting in a 64 percent drop in mortality in terms of "person-years" – an estimate of how long someone would have lived without the disease. AIDS mortality dropped to 14.2 per 100 person-years in 2009, down from 39.3 in 2002.
Despite the success story, the Global Fund to Fight AIDS, Tuberculosis and Malaria has frozen hundreds of millions of dollars worth of grants to China over disagreements about how China manages the money, in particular its hostility towards community-based organisations.
About 740,000 people are infected with HIV or AIDS in China, a number that is expected to grow to 1.2 million by 2015, and AIDS continues to be a major killer. The disease claimed 7,743 lives on the mainland in 2010, a 16.79 percent increase from the previous year, making it the country’s top killer among infectious diseases for the third year in a row, according to a Ministry of Health report in February.
The rise was attributed to patients infected with HIV in the late 1990s who are now developing full- blown AIDS. Hao Yang, the deputy director of the ministry’s disease prevention and control bureau, also noted that many AIDS-related deaths in previous years went unaccounted for.
Wu Zunyou, an AIDS expert and director of the National Centre for AIDS/STD Control and Prevention, told China News Agency that one of the main reasons for the increase in deaths was the large number of patients who refuse testing for fear of stigmatisation, leaving treatment until it is too late. He said that among the cases of AIDS-related deaths in the last five years, 80 percent had refused treatment.
"It’s common to see misunderstanding and discrimination against AIDS patients," Wan Yanhai, China’s most outspoken AIDS activists who left China for the United States Last year, tells IPS on email.
AIDS patients seeking surgical treatment for other diseases are often refused, and sent to hospitals that treat only HIV/AIDS patients, which often lack proper surgical facilities, Xinhua News Agency reported this month.
Stigmatisation is fuelled by misinformation, Wan says, pointing to a survey conducted by the Chinese Journal of Health Education, which found that 51 percent of respondents said they would not shake hands with HIV carriers and 80 percent would not buy products from infected people.
A study conducted this March by the United Nations Joint Programme on HIV/AIDS, the Global Business Coalition on HIV/AIDS, Tuberculosis and Malaria, and Renmin University found that 49 percent of 6,000 respondents in six Chinese cities believed AIDS was transmitted through mosquito bites.
Over 18 percent said they could be infected if they shared a bathroom with an AIDS patient, and another 18.3 percent thought they might be infected if an AIDS patient coughed or sneezed near them.
Meanwhile, HIV/AIDS patients continue to face hardship.
Liu Cuiqin, a 32-year-old AIDS patient in Fuyang city, Anhui province, was diagnosed nine years ago when she delivered her baby. After she tested positive for HIV, which she picked up through a blood transfusion, her husband abandoned her, and her parents severed ties, she tells IPS.
Tian Xi, a 24-year-old from Zhumadian city, Henan province, received blood transfusion in March 1996. In 2004, he was diagnosed with AIDS, hepatitis B and hepatitis C. He filed a lawsuit against the hospital in which he was infected, but local courts refused to hear the suit.
Tian is currently serving one year in prison for "intentional destruction of property." He damaged some office property in the hospital where he was infected after the hospital’s president refused to speak with him, according to Tian’s father.
Chinese law forbids discrimination against HIV/AIDS patients and ensures them the right to proper treatment. The government began addressing the issue seriously after an outbreak in the early 1990s, when contaminated blood was injected into tens of thousands of poor farmers.
In February, the State Council issued a notice requiring all relevant government departments to safeguard the rights of AIDS patients. The notice also asked government departments to strengthen medical services for AIDS patients, help alleviate economic burdens on patients and families, increase the production of medicine, and offer tax subsidies on drugs.
But the government has largely shunned grassroots groups in the fight to control AIDS, denying them funds it had promised under the Global Fund agreement. China has received 539 million dollars from the Global Fund since 2003, with an additional 295 million dollars in the pipeline.
Audits last year found that China had failed to give an agreed 35 percent of a 283 million dollar AIDS grant to community-based organisations. This prompted the Global Fund to freeze the money.
"I think the Ministry of Health was fooling the Global Fund," Wan says.