China will further expand testing and intervention efforts, including education and drug coverage, said the country’s 12th Five-Year Plan (2011-15) for HIV/AIDS prevention and control.

[...]China’s infection rate overall is 0.06 percent. The WHO defines high prevalence as 1 percent or more.

[...]Chinese scientists have succeeded in the first phase of a clinical trial of an HIV vaccine and will launch the second stage in a few months.

However, today is not simply a day to celebrate the progress made in the battle against AIDS, but also a day for raising awareness of the AIDS pandemic and the way HIV infection effects people’s health and political status. From the official World AIDS Day website:

World AIDS Day is held on 1 December each year and is an opportunity for people worldwide to unite in the fight against HIV, show their support for people living with HIV and to commemorate people who have died. World AIDS Day was the first ever global health day and the first one was held in 1988.

[...]Today, many scientific advances have been made in HIV treatment, there are laws to protect people living with HIV and we understand so much more about the condition. But despite this, people do not know the facts about how to protect themselves and others from HIV, and stigma and discrimination remain a reality for many people living with HIV. World AIDS Day is important as it reminds the public and Government that HIV has not gone away – there is still a vital need to raise money, increase awareness, fight prejudice and improve education.

An opinion piece in the Wall Street Journal acknowledges China’s progress in this on-going battle, but also brings attention to the realities of life for victims of HIV/AIDS:

Although the new five-year Action AIDS Plan and the 2006 Regulations on AIDS say that people with HIV should have rights, there are no national laws prohibiting discrimination. Indeed, in some provinces it is illegal to hire people with HIV/AIDS for work that involves handling food, or to allow them to use a public swimming pool. Schools are free to openly refuse children whose parents are living with HIV/AIDS.

[...]Institutionalized discrimination drives people living with HIV/AIDS underground, spreads the virus more quickly, and makes many people fearful to even take an HIV test. This makes educating the public and tackling discrimination not only a matter of human rights, but also a public health imperative.

[...]Every country in the world faced the same challenges in the early stages of the epidemic. China has taken great steps forward in acknowledging and beginning to fight HIV/AIDS. But until people living with HIV/AIDS can come out from underground, the epidemic will take many more lives.

And it is not only foreign media focusing on China’s need to create a non-discriminatory environment for HIV/AIDS victims. In contrast to the China Daily page mentioned above, see this article from the Global Times:

Although there is still a long way to go in the medical fight against HIV/AIDS, it is this social discrimination that is most pressing, particularly in countries such as China where stigmas associated with HIV/AIDS are still rife.

It is even more distressing to see these prejudices within the medical profession. There have been reports even in recent years of hospitals and doctors refusing to treat or operate on patients with HIV/AIDS, sometimes leading to prolonged suffering and deaths. Hospitals that are supposedly “designated” for HIV/AIDS patients very rarely have the ability to treat anything other than HIV-related illnesses, while other mainstream hospitals seem to fear infection. It is ludicrous for anyone who is medically trained to have an attitude like this regarding HIV/AIDS. The risk of infection is minimal if proper procedures are followed.

[...]The right treatment is there, but people need to feel comfortable seeking treatment, afforded the respect they deserve, and given treatment that works. Despite some of Beijing’s efforts to make the necessary changes, HIV/AIDS-related deaths will continue to remain at an unacceptable level unless attitudes change.

And though China seems to recognize just how far there is left to go in this difficult battle, there is still little willingness to acknowledge the government’s role in spreading the disease during blood drives in the 1990′s. 79-year-old former health official Chen Bingzhong has penned a third open letter to Hu Jintao describing the state’s role in covering up the Henan blood scandal. NTD Television provides video coverage and a brief interview with Chen:

[Chen Bingzhong, AIDS Activist]:
“As a health worker I have a responsibility to be the voice for these victims, otherwise I would be incompetent. Regardless of how much I’m threatened I won’t stand down. A few days ago, Beijing police called me and tried to pressure me. I said ‘I won’t back down.’ I’m near my days anyway, and I want my death to be meaningful.”

The Chinese regime has stepped up the campaign against HIV and AIDS in recent years, as reported cases continue to grow. Authorities have never publicly addressed the Henan blood scandal though, instead, they blame unprotected sex as the major contributor for the outbreak.

A letter from US Ambassador to China Gary Locke was published today in China Daily, stating that the US and China stand together in the fight against AIDS. Also see this NBC Photoblog post for photojournalistic coverage.

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“Discriminatory rules against AIDS patients in the public servants’ physical examination fly in the face of Chinese law,” Yu Fangqiang, a lawyer and activist with the pressure group Tianxia Gong told AFP.

Yu said the education departments and a court that refused to hear the case of one of the men had violated the Prevention and Treatment of Infectious Diseases and Employment Promotion laws and the Regulation on the Prevention and Treatment of HIV/AIDS.

UNAIDS China country coordinator Mark Stirling said the organisation was watching China’s reaction to the appeal closely.

“There should be no discrimination. Employment should be based solely on qualifications, not on a teacher’s HIV status,” Stirling told AFP. “The risk of HIV-AIDS transmission in a classroom setting is virtually nil.”

According to the Chinese Center for Disease Control (CDC), there are 434,000 registered HIV and AIDS patients in China, but there are estimates that predict 787,000 carriers by the end of 2011. Xinhua adds:

China has been boosting distribution of HIV/AIDS tests among spouses of carriers and others who have close contact with them, the statement said, adding that a total of 67.45 million HIV tests were conducted across the country between January and October, up 16.5 percent year-on-year.

These tests found 61,000 HIV carriers and AIDS patients.

The latest figures from the CDC showed that China has registered 434,000 HIV carriers and AIDS patients, as well as 88,000 deaths due to the disease, since 1985, when the first case was found in the country.

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Although the high profile Chinese artist Ai Weiwei finally resurfaced after more than 11 weeks in detention on 21 June, many lesser known figures are still languishing in Chinese jails following a round up of activists earlier this year. Wang Lihong is a case in point — and an example of how injustice begets injustice in China’s dysfunctional legal system.

Wang Lihong has a long history of activism, including work on behalf of petitioners who have suffered violence at the hands of the authorities and campaigns for Chinese lawyers targeted because of their advocacy work. Like Ai Weiwei, Wang was rounded up in the weeks following anonymous online posts calling for a “Jasmine Revolution” in China earlier this year. She has now been in detention for 17 weeks. On 21 March she was charged with “inciting social unrest,” but on 22 April this charge was reduced to “disturbing public transportation in a crowd.”

Oiwan Lam recently posted details of Wang’s career and the campaign to release her at Global Voices Online, including a partial list of the causes with which she has been involved since 2008:

1. The police murder case of Yang Jia on July 1 2008. She visited Yang Jia’s mother and interviewed her and blogged about Yang Jia’s case.

2. Together with another blogger, Temple Tiger, she helped the homeless people around Tienanmen square.

3. The Deng Yujiao self defense murder case in May 2009. Wang Lihong travelled to Hubei to join the “surrounding gaze” flash mob in order to pressure the court for an open and fair ruling on Deng’s case.

4. On May 2009, Wang campaigned for a visit to petitioner, Yao Jing, who was seriously injured by local government officials from Linyi who tried to intercept her petition in Beijing. Together with a group of bloggers, Wang raised donation for Yao Jing’s hospital and lawyer expenses.

5. Campaigned for human rights lawyer Ni Yulan, who was prosecuted by Beijing authority soon after she was released from jail.

6. Participated in the “surrounding gaze” flash mob action in support of the three Fujian netizens who was accused by local authorities for defamation in their citizen reports about a suspected rape case in March and April 2010.

7. Celebrated the Nobel Prize award to Liu Xiaobo in October 2010. She was detained for two weeks and was under house arrest for several months.

8. In March 2011, she visited two activists in a Henan detention center, Wang Yi who was sentenced to one year labour education for writing a tweet and Tian Xi, an AIDS activist.

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At stake are hundreds of millions of dollars for programs to reduce the incidence of tuberculosis, prevent and treat H.I.V. infections and wipe out malaria. China has received $539 million from the Global Fund since 2003, according to the fund’s Web site. An additional $295 million is in the pipeline, making China the fund’s fourth largest recipient behind Ethiopia, India and Tanzania, one global health expert said.

A decision by the Global Fund to pull out of China would be hugely embarrassing for the Chinese government because it would suggest that China was unable to meet the standards of an international organization that dispersed funds to far less sophisticated governments. The fund can terminate grants that have been mismanaged or short of that,  formally suspend them. Suspension is a harsher step than halting payments and sets up a series of major obstacles to the release of additional funds.

Those more punitive measures seemed to have been averted Friday after two days of tense meetings between officials from the fund and the government. Jon Liden , a spokesman for the Global Fund, said China agreed Friday to a number of stipulations on how money would be used and monitored. “We came to a point where we needed to make clear signals to China,” he said. “We seem to share an understanding of the way forward.” This week, sources familiar with the negotiations said China pledged to the Global Fund that it would repay any funds that were misspent. But some fear that the inclusion of civil society groups in the health effort may still be an issue.

he Hebei Province director of an AIDS support group, Shen Zhiqi, said that he supported the fund’s decision to withhold funds, because “I really don’t want to see something as well-intentioned as the Global Fund be sucked into the black hole of corruption.” But he said he did not endorse totally withdrawing financing because it would hurt grass-roots groups.

The Chinese government has been wary of such groups for years. One prominent official gave a taste of the government’s thinking earlier this week. In Qiushi, a Communist Party journal, Zhou Benshun, the secretary general of the party’s political and legislative affairs commission, wrote that China must “guard against being misled to the point of falling into the trap of so-called ‘civil society’ devised by certain Western countries.”

The Chinese government has often been suspicious of charities and many charities in China are struggling financially. From BBC:

Charities were marginalised – a situation that still exists today. Meng Weina, the woman who set up Huiling, blames the government for the difficult financial position faced by charities like hers.

“The Chinese government doesn’t like – and even obstructs – charities. It doesn’t want to give them money because that will give them strength and power,” she said. ”That makes the Chinese government nervous because it could threaten its ability to rule,” added Ms Meng, who oversees centres in 10 cities across China.

She said this attitude had also helped shape many people’s poor opinion of charities.

“The notion of what is the role of government verses philanthropy is still being developed.”

That change is not coming fast enough for Huiling’s Meng Weina, who constantly has to move her Beijing centre to smaller and smaller locations because of rising rents. She said the key to change was the forcing the government to admit that charities have a role in providing services. She does not think that will happen soon.

Here is more detailed information on The Global Fund’s Grant Portfolio on China.

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About 63 percent of all those needing AIDS drugs are getting them, up from virtually zero in 2002. That has caused a 64 percent drop in mortality in “person-years,” as China measures it, an estimate of how long someone would have lived without the disease.

AIDS mortality dropped to 14.2 per 100 person-years in 2009, from 39.3 in 2002.

The study, led by China’s national center for control and prevention of AIDS and other sexually transmitted diseases, was published online on Wednesday by Lancet Infectious Diseases.

China’s success in such a short time “is a testimony to the young midlevel scientists who convinced the leadership that this was the right thing to do,” said Dr. Myron Cohen, an AIDS specialist from the University of North Carolina who has lived in China and helped it battle the epidemic.

Meanwhile, another report found that people with AIDS in China are routinely denied hospital care due to ignorance about the disease even within the medical profession. From Reuters:

Based on interviews with 103 people living with HIV and 23 healthcare workers, the ILO and China’s National Center for STD and AIDS Prevention and Control found that people have been refused medical care and have been discriminated against by healthcare workers.

One HIV-positive man, talking at a news conference to unveil the report, recounted how he was denied medical treatment for his back problem because of his HIV status in hospitals in Tianjin and Beijing.

“The doctor said at our hospital, many patients need surgery, and if other patients get infected, it will be a very bad thing,” said the man, who declined to be identified.

“At the second hospital … the doctor told me: ‘I sympathize with your suffering but because of your status, I dare not operate on you’,” said the man, who is a farmer from Tianjin and added he was forced to leave his job in a steel firm after his boss discovered he had HIV.

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The municipal information office informed the website’s founder, Wan Yanhai, by e-mail that it had been closed for publishing forbidden news, according to international news reports. Wan, an AIDS activist now based in Washington, published the notice on the organization’s Google profile. Wan did not immediately respond to CPJ’s e-mail request for comment.

Propaganda officials had asked the website to remove an open letter from a former senior health official, Chen Bingzhong, which was first published in late 2010, according to a statement on the Google profile page. Chen accused Chinese Communist Party propaganda chief Li Changchun and Vice Premier Li Keqiang, both former party leaders of central Henan province, of covering up the link between the government-supported sale of blood for transfusions and an epidemic of HIV, the virus that causes AIDS, according to The Associated Press. Aizhi administrators refused to comply with the requests because they were made without required legal documentation, their statement says ….

Commercial blood banks that sprang up in rural areas in China in the 1980s and 1990s, paid peasants for contributing blood, extracted the plasma, and then re-infused donors from the pooled blood samples. The scale of the epidemic is still unknown, although international news reports say more than 100,000 people contracted the virus through the process. Further infections occurred through hospital transfusions. Reporting on the epidemic was censored in the local press, foreign journalists were harassed for investigating, and Wan Yanhai and other activists were detained, according to CPJ research. The blood drive in Henan was organized and encouraged by the provincial health department, according to the UK Guardian newspaper.

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State-run news agency Xinhua reported Tuesday that China’s State Council decided to repeal the ban after realizing it did little to prevent the spread of disease and caused problems when the country was hosting international events.

The revision came days before the opening of the six-month Shanghai World Expo, which organizers expect will draw 70 million people. The government had previously lifted the ban temporarily for other large-scale events, including the 2008 Olympics in Beijing.

Xinhua said the health ministry estimates the number of people living with HIV in China had reached 740,000 by October 2009, with deaths caused by AIDS totaling 49,845 since the first case was reported in 1985.

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China could lift a longstanding ban on HIV-positive foreigners entering the country as early as this month, state media reported Wednesday.

Citing “insiders,” the China Daily newspaper said the State Council, or Cabinet, decided on Monday it would make changes to laws barring foreign HIV carriers.

Under current regulations, those suffering from infectious diseases such as leprosy or HIV/AIDS or from mental disorders are not allowed in, the report said.

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On any given night, in 14 cities around the country, hundreds of people flock to makeshift blood collection centers in bars, bathhouses and apartments where workers test for syphilis and H.I.V., the virus that causes AIDS. The ambitious testing initiative, started in 2007, is financed by the Bill & Melinda Gates Foundation, which will spend $50 million over five years in an effort to slow the spread of AIDS in China. So far, more than 110,000 people have been tested.

But the Gates H.I.V. prevention program in China is unusual because it offers a financial incentive to those drawing the blood — about $9 per sample and an additional $44 for those that come back positive — which is shared with donors. The program has provoked a flurry of criticism from some established AIDS organizations that say the money has given rise to a network of fly-by-night groups whose only interest is collecting money.

Here in Tianjin, a northern city of 11 million people, two dozen organizations have sprung up in the past year, many of them run by bar owners or bureaucrats affiliated with the government. Some of the groups do not provide counseling to those giving blood and make little effort to help those who test positive get medical treatment.

“Gates has created a huge blood-buying operation that only cares about money, not about people,” said Ma Tiecheng, who runs a seven-year-old AIDS organization in the northwest city of Shenyang. “I’ve seen people getting four H.I.V. tests a day.”

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The bar in Dali, a tourist town in the southwestern province of Yunnan, aimed to provide a place where homosexuals could meet in a relaxed atmosphere and get information about HIV/AIDS prevention, he told AFP by phone.

China’s health ministry warned on Tuesday that homosexual transmission of HIV/AIDS was gaining pace. Zhang, a doctor at a hospital in Dali, said raising awareness of the disease among the gay community was “extremely important.”

The bar was due to open on December 1 — World AIDS Day — with the support of the local government, which had invested 120,000 yuan (17,600 dollars) in the NGO, he said.

“Our government leader asked me whether we could open it today, but I said the volunteers did not want to,” Zhang said, pointing out that journalists and photographers had descended en masse on Dali following news of the bar’s opening.

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