Victory against Aids still a long way off
Two years ago, it was unthinkable that Beijing would put Aids education on the school curriculum or that making the blood supply disease-free would become a national priority. Yet that is exactly what has happened - although in an uneven fashion.
In other signs of progress, Shanghai has set up vending machines to distribute free condoms, and needle-exchange programmes for drug addicts are being set up in high-risk areas such as Kunming. It is hoped this more aggressive action has come in time to keep a low-level epidemic from turning into a major one.
Advances are being made, although it will take years of consistent efforts to claim victory. Prudishness about talking about sex, outright misunderstandings about HIV and how it is transferred, and discrimination against those carrying the virus still exist. Universities in Beijing were recently stopped from distributing condoms on campus, so in the end they were left at the sex education centre.
There are impoverished villages in and around Henan where the infections stemming from unsafe blood collection methods are only now being acknowledged and treated, but Aids activists are still sometimes harassed or censored. Rapid HIV-test kits are being distributed to some blood centres and this may be another sign that officials are more willing to enforce blood safety laws that have been on the books since the late 1990s.
As for the danger from increased migration and population mobility - set to increase as business with Southeast Asia and other bordering regions booms, there will be a need to keep an eye on the health implications. Just as education about Sars might be targeted at workplaces employing migrant labourers, there should also be ways to encourage employers to provide Aids information and testing.
There should be no doubt that for Hong Kong there will be new public health questions stemming from the blurring of the mainland border. Should we have a more active programme for informing recent immigrants and mainland prostitutes about how to lower their risk? It is an issue that needs discussion at the new Centre for Health Protection and the Hospital Authority, which runs the public hospitals where the majority of residents are treated.
While Hong Kong policies are being reviewed, the government will need to look urgently at the decision to drop universal coverage at Hong Kong's public sexually transmitted disease clinics. Since last year, those without Hong Kong IDs are being asked to pay many times the subsidies fees for testing, consultation and medicine. Not surprisingly, clinic visits dropped immediately and drastically. A decision has been taken to exempt tuberculosis treatment from the new rules because of the public health interest. Whether the same should be done for Aids and HIV should be seriously considered.
