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International Activity Report 2008

China

Last year, for the first time, HIV/AIDS became the top fatally infectious disease in China. According to the Ministry of Health, 44,839 new cases were reported between January and September 2008. The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that at the end of 2007 the amount of people living with the disease in China was 700,000, 190,000 of whom needed antiretroviral (ARV) therapy. Fewer than 20 percent of them are receiving the treatment they need.

Although the Chinese government provides ARV therapy through its national program, HIV testing and the management of opportunistic infections are not free, so people can die from HIV-related illness before being able to access the treatment. Stigma caused by association with the disease also prevents people from visiting national facilities for testing and receiving treatment at an earlier stage.

While some important second-line antiretrovirals were eventually registered in 2008, many essential medicines are still inaccessible. The cost of many anti-opportunistic infection drugs is still too high and pediatric formulations of drugs to treat HIV and tuberculosis (TB) are unavailable within the country.

In collaboration with the Guangxi Public Health Bureau and Guangxi Center for Disease Prevention and Control, Doctors Without Borders/Médecins Sans Frontières (MSF) has been providing free and confidential care and treatment for HIV/AIDS patients in Nanning since 2003. This comprehensive program provides voluntary counseling and testing (VCT), diagnosis, management of opportunistic infections, ARV therapy, and outreach activities in some communities. In 2008 more than 3,000 people received free VCT and around 300 patients were started on ARV therapy. At the end of 2008, 1,550 patients had been enrolled in this program, more than 900 of whom had been started on ARV therapy.

Emergency assistance

On May 12, a magnitude 8.0 earthquake hit Sichuan province, leaving more than 80,000 people dead and 10 million homeless. In collaboration with the Sichuan Red Cross, MSF donated 4,310 family-size winter tents and medical supplies to Mianzhu city. MSF also provided support to hospital patients suffering from crush syndrome in Chengdu, and assisted a triage center in Guanghan City, Deyang. However getting access to the area and population affected by the earthquake proved difficult due to government restrictions.

MSF provided psychological care to survivors of the earthquake in Hanwang, Mianzhu County and Long Men Shan, Pengzhou City. "In the aftermath of the earthquake, people were in shock and intensely afraid. They clearly needed psychological care," said Dr. Misa Sugawara, MSF field coordinator in Sichuan. MSF continues to provide psychological care in Mianzhu and Beichuan County, where 238 consultations were conducted between November and December 2008.

In response to the snowstorms that hit Maocao village in Guizhou province in February, MSF distributed 9,000 kg (19,482 lbs) of rice as well as cooking oil and water to villagers. In June, in response to floods in Guangxi, MSF provided 115,000 kg (352,531 lbs) of rice, 1,900 bottles of cooking oil and 140 sets of plastic sheets to victims in Zhongdu Township, Luzhai County in Guangxi.

Project handover

In May 2003 MSF began providing care and treatment in Xiangfan, targeting the estimated 45,000 people living with HIV/AIDS in Hubei and the neighboring Henan province. This program was handed over to Chinese authorities in March 2008.

Blocked from the Inner Mongolia region

MSF tried to open a multi-drug-resistant tuberculosis (MDR-TB) program in the Inner Mongolia region, where an estimated 6.5 percent of people who tested positive for TB and haven’t received treatment are infected with a drug-resistant strain. Repeated negotiations with Chinese authorities aimed at signing a memorandum of understanding were unsuccessful. In early 2009 MSF gave up trying to open the program.

MSF has worked in China since 1988.

MSF Projects 2008