OPINION> Brendan John Worrell
African judge assists AIDS challenge in China
By Brendan J. Worrell (Chinadaily.com.cn)
Updated: 2008-10-31 15:11

Visiting China at the invitation of the Minister of Health and UNAIDS, South African Supreme Court Judge Edwin Cameron revealed how prior to entry into the country he needed to make a special visa application. He is one of the world's most esteemed AIDS awareness campaigners and is openly HIV positive. In his country about 11% of the population has the virus with an estimated 1,000 dying daily.


One of the world's preeminent AIDS awareness campaigners, Justice Cameron, addresses reporters at Beijing's UNAIDS headquarters yesterday.  Chinadaily.com.cn/Brendan John Worrell

For over two decades China, as well as many other nations have pursued travel restrictions in regards to HIV positive people though according to Justice Cameron this discrimination and the ensuing stigmatization is at the very heart of prevention and management strategies that require our reevaluation.

This year in August at the 17th International AIDS Conference held in Mexico, Hao Yang, deputy director of the ministry's disease control and prevention bureau mentioned that in 2009 this discriminatory law would be dropped from China's statutes. It follows earlier repeals made by the US and other governments and is in appreciation, verified by the World Health Organization, that the virus has now reached all points of the globe and that total exclusion of travelers at borders who are HIV positive is in effect counter-productive to containment and prevention strategies.

To date more than 700,000 people live with HIV in China though worryingly most have not been tested and are unaware they are infected. Last year alone it is estimated that 50,000 people contracted the disease. Stigmatization and misinformation leading to a "fear and a denial climate" are contributing factors to this and according to a report released last month by Beijing's Renmin University, the Global Business Coalition on AIDS, TB and Malaria, UNAIDS and Ogilvy, the situation demands greater action.

The cities placed under the microscope were Kunming, Shenzhen, Shanghai, Wuhan, Zhengzhou and Beijing. According to the survey 30% of the 6,000 interviewees questioned think HIV positive children should not be allowed to study at the same schools as uninfected children; over 60% would be unwilling to live in the same household with an HIV infected person and almost 50% would be unwilling to have a meal with a HIV infected person.

As it stands such thinking constrains many who may be infected from seeking life-saving treatment, let alone the necessary counseling required to minimize harm and ensuing at-risk behavior. Furthermore in regards to quality of life outcomes for infected individuals, their family and friends and the wider community, unnecessary walls are erected that do not contribute to the better management and prevention of HIV. Report in hand, Cameron beseeches more equitable outcomes and practice from both the public and private sector where ignorance and prejudice is still widespread.

Highlighting this need for greater awareness is the fact that more than 48% of respondents thought they could contract HIV from a mosquito bite, and over 18% by having an HIV positive person sneeze or cough on them.

In terms of at risk behavior almost 30% did not know how to use a condom correctly and only 19 % said they would use a condom if they had sex with a new partner.

Further afield over a quarter did not know where to go to get a HIV test and over half had never talked about HIV related issues with their families.

Sadly over 30% also felt those with HIV deserved the disease.

Though as Justice Cameron reiterated being diagnosed with HIV today doesn't necessarily mean a death sentence, "I fell ill 11 years ago with AIDS and I've been living a very vigorous and active life since then because of antiretroviral therapy." What needs to be stressed is that in the last 12 years AIDS mortality in richer nations has declined 6-fold as a result of such medicines and today a huge international effort is taking place to bring such life-saving treatment to millions in the developing world. Those in China can also benefit if they are aware and not made to feel shamed.

According to Cameron the legal framework that exists to protect people with HIV in China is commendable though he believes there is still a lot that can be done, particularly in regards to "second line treatment" where such drugs are unfortunately less readily available. During a press conference at UNAIDS headquarters on Thursday Cameron revealed a sense of faith that HIV would not blow out here in Asia the way it has in Africa, though members from the audience queried this optimism citing the peculiar demographic and cultural context of China that posed its own unique set of challenges.

At issue was the growing number of males to females 120:100; the growing movement of large numbers of migrant workers to cities who are usually men that may be seeking services of sex industry workers; cultural taboos that do not encourage open discussion of such topics in traditional Asian society and the proliferation of a sex industry that is quietly acknowledged though not officially sanctioned and as such not targeted effectively by outreach workers.

In 2007 there were an estimated 20,000 AIDS related deaths in China. The survey Justice Cameron referred to was the first of its kind conducted on a large scale in China. Unquestionably, tackling ignorance, prejudice and stigmatization, while at times discomforting and provocative, is unavoidable in the search for solutions.

Contact the author: brendanjohnworrell@hotmail.com