Specialist warns that regulations must be improved and clarified

An increasing number of foreigners are receiving free treatment for HIV/AIDS on the Chinese mainland, a health specialist said, as he warned about a lack of "clear policies" on the issue.

The mainland reported 8,366 foreign HIV/AIDS sufferers at the end of August, according to the National Center for AIDS and Sexually Transmitted Diseases Control and Prevention. More than 200 foreigners were receiving free antiviral therapy.

Growing international exchanges are seeing more foreign sufferers arrive, and stay longer, in China, Wu Zunyou, director of the center, told China Daily in an exclusive interview.

But "we have no clear polices and Chinese nationals should always be the top priority, particularly with limited funding", he said.

Most foreign sufferers were living in Yunnan, Guangdong, Shandong and Fujian provinces, as well as in Beijing, Wu said.

Most are in the 20 to 44 age bracket and more than 50 percent were infected through heterosexual sex. Intravenous drug use is the second leading transmission route.

The vast majority were diagnosed in hospital, said Zhao Yan, deputy director of the national center's AIDS treatment and care division.

Free treatment is only for Chinese citizens with case-by-case exceptions for foreigners, she said.

More than 60 percent of foreigners receiving free treatment were female, often "mail order brides” from neighboring Southeast Asian countries.

Yunnan has most cases, about 120, according to Jia Manhong, director of the AIDS division under the province’s center for disease control and prevention.

"A great majority were women who had been living here for a long time and some even married locals and had children,” she said, adding that many foreign women were trafficked over the border as brides.

Some came already infected with HIV while some were infected by their Chinese husbands, Jia said.

"Even without a legal permit to stay and a marriage certificate we still have to provide these people free treatment otherwise they could die and their families would be alone,” she said.

Yunnan began free treatment for foreigners in 2009.

Since the province recorded its first HIV outbreak among drug users in 1989, authorities have reported more than 5,500 foreign sufferers, mostly people from Myanmar. The numbers are increasing, Jia said.

"With a border measuring more than 4,000 kilometers, more foreigners living with HIV and AIDS will come to Yunnan for employment and business,” she said.

"Given that this trend cannot be reversed, the government should make clear its policy concerning HIV/AIDS intervention among foreigners in China, including treatment.

"Early treatment reduces secondary infection and better treatment for those living for extended periods in China also helps with the comprehensive program to combat HIV/AIDS,” she added.

Jia conceded that funding was a key issue in expanding treatment for foreigners.

Zhao Yan, however, ruled out special regulations concerning the treatment of foreign sufferers in China.

"China is huge, and the needs of regions vary."

HIV cases among foreign trafficked women have also been reported in Shandong and Shanxi.

Tao Xiaorun, a top AIDS specialist for Shandong’s center for disease control and prevention, said his office carried out a mass HIV screening program since 2005 targeting mainly foreign women, including mail order brides and sex workers.

"More than 60,000 were tested. They mainly came from Vietnam and Myanmar, and some from Yunnan,” she said, adding that, at present, about 10 are receiving free medication.

The situation in Beijing is a bit different, said Zhao Hongxin, who heads the AIDS department at Beijing Ditan Hospital Capital Medical University, one of the four designated hospitals in the capital to provide AIDS treatment.

"We’re treating a patient from Africa but he had to pay for the drugs himself,” he said.

About 15 foreign patients have been treated at the four outlets in the past few years.

In 2003, the government began to offer free AIDS treatment to Chinese patients on the mainland and more than 150,000 are now benefiting from it.

shanjuan@chinadaily.com.cn