How to Stop HIV/AIDS from becoming a National Disaster [Southern Weekend, 5 December 2003]

Every year Dec 1 is World AIDS Day, this year is the 16th annual one. What’s different this year? In fact, in the face of this global human disaster, in the face of the countless people suffering from this virus (including people with HIV and people with AIDS), perhaps this sort of question lacks sympathy, lacks humanity. What we should really be asking is: We, I myself, what am I doing for them? But this year there are truly some differences.

The first difference is that the Chinese government has decided to invest more money, and to implement the “four free” policy: Free antiretroviral medicine , Free anonymous testing, Free mother-to-child prevention treatment, and Free schooling for AIDS orphans. This is a bold policy that directly attacks the problem. Of course, it [the policy] will at the same time be a test of the strength of enforcement and the [central government’s] ability to resolve related problems. Also, the 34 department representatives on the State Council’s AIDS prevention coordinating body will provide a structure. It will prevent and control AIDS in a coordinated way, in the same determined way that SARS was controlled.

However, this writer believes that the biggest difference this year is that public opinion is gaining an increasingly clear understanding towards discrimination against people with AIDS, and the protection of the rights of people with HIV/AIDS is a common concern for all of society. It may appear simple, but this
difference was not easy to achieve. Because of people’s [lack of] understanding of AIDS, along with the increasing number of people infected with HIV, the lack of a cure and the fear of the moral burden, this fear evolved into a sort of vicious cycle: the more one is scared, the less able one is to understand HIV/AIDS; the more one doesn’t understand HIV/AIDS, the more scared one becomes. However, with this fear, we will never be able to comprehend this disease that is terrorizing humanity, how it runs rampant
and uses human indifference and other hidden emotions to create chaos in our minds, how it uses stigma and distrust to prevent comprehensive and scientific understanding of AIDS.

But let us not forget that all sorts of stigma still exist: HIV/AIDS patients cannot get into a hospital for even a minor operation, because doctors are scared of becoming infected with this “unclean” disease, would “rather be infected with SARS, but not AIDS”. One person with HIV said, “doctors’ ability to refuse AIDS patients has already developed into an art”. Mother to Child transmission can be greatly reduced through definitive intervention before and after the birth, but in the news we see a story about a pregnant HIV+ woman’s child who does not get routine vaccinations because hospital staff are not willing to give them. (see report in Xin Jing Bao, 1 Dec 2003)

Excuse me, doctors who protect our health, is this sort of panic reasonable? Should you panic? Dr. Cai Weiping, who has been an AIDS doctor for over 10 years, believes that there is some risk performing an operation on an HIV+ person, but if you protect yourself carefully you will not be infected. Also, the HIV virus is very weak outside the body, and ordinary disinfection will usually kill it. Dr. Zhang Dan of the Infectious Disease department of Beijing’s You’An hospital has a similar opinion: “Medical staff fear and
therefore keep a distance from HIV patients because they have limited understanding,” Zhang says, “and it is precisely because they do not understand enough about HIV/AIDS that they lack the relevant information about protection.” The real problem is that China has no protection standards for performing operations on HIV+ people.

Excuse me, if you say that even doctors are scared, who dares NOT be scared?

Another related issue is that recently some medical quacks have actually been taking advantage of the weak position of people with HIV/AIDS, using advertisements, the internet, and mailings to trick them and their families. Dr. Gao Yaojie has all these years been taking care of people with HIV, and says “this sort of victim is not limited to one person or one family, it is already a serious social problem.”

What is more, some people with HIV do not understand their own interests, In a ‘self-polluting’ manner, they “live with their backs turned against society”. And some media and public security personnel irresponsibly call them “AIDS pickpockets” or “AIDS criminal suspects”. (see Xin Jing Bao “Controlling AIDS” requires countless more ‘Todays’”)

As all these prejudices are brought more clearly to the surface, this is also a great opportunity for the government and opinon-makers to spread scientific knowledge about HIV/AIDS to the wider public. Wen Jiabao made an example of his own conduct, by shaking hands with AIDS patients, by eliminating the abnormal fear of AIDS he made a strong statement. Also, experts have pointed out that the current Infectious Disease Control Law, with its stress on isolation the contagious elements, cannot effectively control HIV/AIDS, and the country will have to draft new laws, laws that protect the normal rights of people who are infected with HIV. And even more importantly, we need more people to become volunteers, we need more NGOs, we need to address the basic life needs of people with HIV/AIDS and to help them have confidence and self-respect.

According to Han Qide, a vice chairman of the standing committee of the National People’s Congress, if we do not implement effective measures, by 2010 there will be more than 10 million people with HIV in China. It will become a national disaster. This writer believes that the most important step to preventing this national disaster is eliminating stigma against HIV/AIDS, because such prejudice will never lead to proper reactions [to AIDS]. In the face of disaster, there are no ‘outsiders’, everyone is on the same ship together.

南方周末：如何避免艾滋病成为国家灾难
How to Stop HIV/AIDS from becoming a National Disaster [Southern Weekend]
http://news.sina.com.cn/c/2003-12-05/11152293067.shtml
南方周末

　　 作者：薛华

　　每年的12月1日是世界艾滋病日，今年已经是第16个年头了。今年有什么不同？其实，面对这样一种全人类共同的灾难，面对无数受到病毒折磨的艾滋病患者(包括艾滋病感染者和艾滋病病人)，这样的提问也许是缺乏同情心和不人道的。我们真正应当问的是，我们，我自己为他们做了些什么？但今年的确有些不同。

　　 首先的不同在于中国政府决定投入更多的钱，实行四大免费政策：免费实行抗艾滋病病毒治疗，免费匿名检测，免费实施母婴阻断，对艾滋孤儿实行上学免费。这是见魄力、一步到位的政策，当然也同时考验着执行的力度和配套问题的解决能力。其次，国务院联合34个部委成立的艾滋病防治联系会议制度，决心像防治SARS那样，统筹协调防治艾滋。

　　然而，笔者以为，最大的不同在于，舆论对于艾滋歧视有了越来越清晰的认识，艾滋维权成了全社会共同关注的主题。看来简单，这一不同却来之不易。因为人们对艾滋病的了解，往往伴随着对日益增加的患者数目、无法根治和道德负担的恐惧，这种恐惧不经意就形成了一种恶性循环：越是怕，就越是无法认知艾滋病；越是不了解艾滋病，就越是怕。但是，带着恐惧，我们永远无法清楚认识到这一折磨人类的恶魔，它是如何猖獗地利用人际的冷漠以及种种阴暗、见不得光的心理肆意捣乱，它又是如何用歧视和不信任蒙蔽了全面了解艾滋病科学知识的心性。

　　让我们不要忘了这种种的歧视依然存在：艾滋病患者为一个小手术求医无门，因为医生也怕被染上这“不干净”的病，“宁肯感染SARS，也不愿意感染AIDS”，一位艾滋患者感叹，“医院对艾滋病人的拒绝已经发展成为一门艺术”；母婴传播通过一定的产前产后干预，可以大大降低婴儿传染的几率，然而新闻中一位艾滋孕妇的孩子，却连正常新生婴儿都要打的预防针，医院都不愿意打。(见《新京报》2003年12月1日报道)

　　请问，保卫人类健康的医生，这样的恐慌有没有道理、应不应该？在艾滋病科当了十多年的医生蔡卫平认为，为艾滋病患者做手术有一定风险，但只要做好防护就不会被感染；而且艾滋病毒在空气中很脆弱，一般的消毒剂就可以将之杀灭。北京佑安医院感染科医师张彤也有类似看法，“医护人员之所以对艾滋病患者惧而远之，缘于对艾滋病的恐惧和认知不足”，并且“正是因为对艾滋病认知不足，医护人员缺乏相应的防护知识”。真正的问题是，目前国内尚缺乏一套针对艾滋病手术的防护规范。

　　请问，如果说连医生都怕了，谁还敢不怕？

　　接下来的问题是近年来竟有一些医疗骗子利用了艾滋病感染者和病人的弱势地位，利用广告、网络、信件欺骗艾滋病人及家属。近年来一直关心艾滋病群体的高耀洁医生疾呼“这样的受害者绝非一人一户，已经成为严重的社会问题”。

　　更有甚者，一些艾滋病人不完全知道自己的权利，用“自污”的方式，用“与一种生命认同完全背反社会的方式来生活”，而一些媒体和治安人员也不自觉地称其为“艾滋扒手”、“艾滋嫌犯”。(见《新京报》余世存文《“治艾”需要无数个“今天”》)

　　这种种的歧视行为愈加清晰地浮出水面，同时也是政府和舆论向公众普及科学常识、消除歧见的绝好机会。温家宝总理前日就以身作则，主动和艾滋患者握手，在消除对艾滋患者不正常的恐惧方面作出绝佳表率。另外，专家透露现行的《传染病防治法》着重于隔离传染源，不能适应艾滋病防治，国家将出台专门法律，侧重维护艾滋病患者的正当权益。而更重要的是，需要更多的人成为志愿者，需要更多的NGO，从艾滋病人的全部生活需要出发来帮助他们自信、自尊。

　　全国人大常委会副委员长韩启德警告说，若不采取有效措施，2010年中国全国艾滋病感染人数将超过1000万，将成为国家灾难。笔者认为，消除这一国难的最重要一步就是要消除艾滋歧视，因为正确的行为不可能由偏见所引导，并且面对灾难，没有局外人，大家都在同一条船上。