Posted by Jirair Ratevosian, October 14, 2010
In Baoding, China, Dr. Bian Dong Da runs a makeshift clinic for MSM who have nowhere else to go.
In Baoding last week, we were advised not to be late for our doctor’s appointment. In the midst of festivities for China’s National Day on October 1, we were to meet with Dr. Bian Dong Da, who runs a makeshift clinic for MSM who have nowhere else to go. Some travel over 200 km to see the good doctor! “He treats patients in a humanitarian way,” said Murong Feng of Hebei Light of Love Care Group for PWHA, which refers men living with HIV/AIDS from Hebei and surrounding provinces to his care. As the doctor explained, public health systems set up to serve general populations can be problematic for those most vulnerable to HIV. Indeed, many who visit him have been refused care by the public health system; others go there because they are fearful of discrimination and hesitant to rely on a health system plagued by discrimination and ignorance. Some 5,000 patients have visited the clinic since it separated from the local public hospital five years ago.
China’s post-SARS leadership is alert to the pitfalls of neglecting the country’s public healthcare system, and everyone is on high alert about HIV/AIDS. Back in Beijing a few days earlier—at a WHO meeting to discuss forthcoming recommendations on HIV/AIDS and STIs among MSM and transgender people—there was a buzz about a recent speech at the UN by Premier Wen Jiabao. Dr. Zunyou Wu, director of China’s National Center for AIDS/STD Control and Prevention, opened the meeting quoting from the Premier’s speech in New York: “To fight against HIV/AIDS is the common responsibility of mankind.”
The first-ever WHO consultation entailed direct conversations between senior leaders from the Chinese government, other stakeholders, and openly gay and HIV-positive community representatives working on the front lines of the AIDS response. While impressive to witness, the mood was sober. One after another, Chinese officials acknowledged the alarming increase in HIV among MSM throughout the country. Frustrated by inaction, community reps noted the grave social stigma and lack of appropriate health services that keep many MSM hidden and at risk for HIV infection.
China is not alone. Where estimates are available from around the world—and often little research has been conducted—HIV prevalence among MSM is very high. Yet only a small percentage of prevention funding in high-prevalence countries is devoted to MSM according to a recent amfAR report. In China, despite high-level attention to AIDS and recognition of MSM as a priority in the national AIDS response, the government has yet to develop a plan of action. Subsequently, much-needed resources remain out of reach from community groups working on the frontlines.
While some are optimistic that Premier Wen Jiabao’s words will catalyze change, many we met in China acknowledged that turning the tide will require real partnership between government, stakeholders, and community-based groups.
Dr. Bian Dong Da’s is one of many who remain optimistic. In a country struggling to make progress in the fight against HIV/AIDS, his makeshift clinic and the positive impact of small community-based programs offers a lifeline to many.