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MSF in China, 2006
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According to UNAIDS, up to 650,000 people in China are infected with HIV. Although the healthcare system generally operates on a market-oriented, fee-forservice approach, the Chinese government has launched a comprehensive AIDS response and has begun providing free antiretroviral treatment to AIDS patients using a combination of Chinese and imported antiretroviral medicines. MSF continues to operate a model for HIV/AIDS programs within the country.
Since December 2003, MSF has been treating AIDS patients in a small clinic located on the premises of the Guangxi center for Disease Control in Nanning City. Here, an average of 315 consultations are performed monthly and 276 patients receive free antiretroviral (ARV) treatment. MSF was initially the only provider of free ARVs in the province of Guanxi; now, several government-run sites have also opened. The MSF project has been distinctive because of its strong emphasis on confidentiality and counselling.
In central China, the spread of HIV/AIDS is atypical. Most people here contracted HIV from unhygienic blood collection and transfusion practices when selling their blood plasma, a common practice undertaken by villagers to supplement their incomes. In Xiangfan, Hubei province, MSF manages a treatment clinic in collaboration with the Xiangfan center for Disease Control. More than 360 patients are registered in the clinic and 140 patients receive free ARVs. Care includes home visits and a strong educational component. All MSF projects in China are highly community-oriented, with MSF facilitating patient support groups and providing information to patients’ families, health workers and the wider community.
Blocked from Henan
MSF has been trying since 2002 to work in Xiangfan’s neighbouring province of Henan, where an estimated 300,000 or more people are in need of HIV/AIDS treatment, many infected with HIV from selling their blood. One-fifth of the patients in the Xiangfan project come from Henan, and the demand from people in that province to be enrolled in treatment increased significantly in 2006. Despite repeated attempts to establish a Henan program, provincial authorities continue to refuse MSF access to the province.
Advocating for drug access
MSF is advocating at the national level for China to facilitate access to AIDS medicines, particularly for fixed dose combination pills (FDCs) that can simplify treatment. Intellectual property protection and other factors currently block the use of FDCs, resulting in restrictions in drug choice, lack of availability of needed drugs, and high prices for some medicines. Production capacity exists for many drugs that are either not available or too expensive in China, but patent barriers often block generic manufacturing. A team of a pharmacist, campaigner and lawyer work full-time to document, raise awareness of and overcome various barriers to accessing medicines.
Handover of children’s shelter
Since 2000, MSF had been running a project for street children in Baoji, Shaanxi province. This crisis center and shelter was established to provide medical, psychological and social care for street children. In 2005, 109 children were taken into the shelter. After helping create a local NGO to take over the management of this project, MSF withdrew from Baoji in March 2006.
MSF has worked in China since 1988.