Update: AIDS in Rural China

A long, in-depth article in the NY Times notes that China’s approach to AIDS in the countryside, while “better than nothing,” is simplistic and inadequate.

The main reason, the article says, is that China is haphazardly handing out retroviral drugs with no patient care or counsel. (The reporter likens it to a food drop.) A few are improving, but without adequate supervision, many are becoming sick from the pills and even discontinuing treatment. Patients who can’t deal with the side effects are totally on their own.

Reading the article, one is hardly inspired with hope:

Bates Gill, a China expert at the Center for Strategic and International Studies in Washington, said that while anti-retroviral pills need to be taken under a precise regimen, waiting for China’s health system to improve was an imperfect answer.

“Do you begin the treatment now, learn as you do it and make mistakes?” he asked. “Or do you wait? It’s a tough choice.”

The social costs and stigma of AIDS, meanwhile, are scarcely being addressed. Villagers here in Dongguan estimate that as many as 100 children have lost one or both parents to AIDS or live with a parent dying of the disease. While villagers say the government gives the families two sacks of flour a year and a small discount on school fees, children of H.I.V.-positive parents are often segregated at school.

Mr. Zhao’s wife earns about $1.60 a day mixing cement and does not dare tell anyone her husband has AIDS. “They wouldn’t employ me at all,” she said, asking not to be identified by name.

The underlying theme throughout is the role of the government, which will determine whether the people live or die.

Mrs. Zhao, the mother who sold blood to buy her son toys, now considers herself one of the lucky ones because she has suffered no side effects. Her worry is that the government will decide that the medicine is too expensive.

“We don’t know how long we’ll be able to take the medicine,” she said, adding that local health officials also were not certain. “They tell us they don’t know either. They hear from the people on top. It all depends on the people on top.”

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