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China’s HIV response sharply criticised

9th December 2008

Despite increasing praise for China’s stepped-up response to HIV, Human Rights Watch says the country’s police and security forces are driving drug users away from the treatment they need.

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China’s police and public security forces are undermining the country’s response to HIV, driving drug users away from community-based prevention services and denying them access to treatment, Human Rights Watch said in a report.

In its December report, “Unbreakable Cycle: Drug Dependency, Mandatory Confinement, and HIV/AIDS in China’s Guangxi Province,” and article in the medical journal PLoS Medicine, the New York-based nonprofit group sharply criticised China’s treatment of drug users - despite increasing praise for a stepped-up national response.

“The government has expanded prevention and treatment programs for drug users,” Joe Amon, HIV/AIDS program director at Human Rights Watch, said.

“But at the same time, the police are detaining drug users trying to access these services, and putting drug users in so-called ‘drug rehabilitation centers’ where they are provided no drug dependency treatment and no HIV prevention or treatment services.”

“The Chinese government claims that drug users are sent to these facilities for drug dependency treatment,” Amon said. “But instead of treatment they are put in overcrowded cells, denied medical care, beaten, and forced to do menial work. On top of it all, their families are forced to pay for the ‘therapy’ they receive.”

Millions of users

According to official government reports, China has 3 to 6 million drug users, and nearly half of all recent HIV transmission is linked to drug use. Since 2000, the Chinese government has set up more than 500 methadone treatment clinics with the capacity to treat 100,000 drug users. 

But at the same time, the government has increasingly put drug users in mandatory rehabilitation centers, which lack effective drug treatment.  As of 2007, some 700 mandatory drug detoxification and 165 “re-education through labour” centers housed at least 340,000 drug users in China.  Sentences range from one to three years.

Human Rights Watch said detoxification and re-education centers subjected drug users to abusive, inhuman, and degrading treatment. The centers not only failed to provide HIV prevention and treatment to drug users, but also facilitated its spread.

The report called on the Chinese government to close mandatory detoxification and re-education through labour centers housing drug users and to expand voluntary community-based drug treatment and HIV prevention efforts.

Human Rights Watch also called upon United Nations agencies and international donors to support efforts to reform Chinese anti-narcotics laws and regulations, and to advocate for the rights to freedom of expression, information, assembly, and association for people living with HIV/AIDS and organisations acting on their behalf.

Detained for speaking out

China has repeatedly detained and intimidated AIDS activists trying to promote treatment and prevention efforts and speak out about government HIV policies.

The HIV virus that causes AIDS gained a foothold in China largely due to unsanitary blood plasma-buying schemes and tainted transfusions in hospitals.

While health authorities say sex has overtaken drug use as the main cause of HIV infections in China as a whole, veteran activist and retired gynecologist Gao Yaojie has repeatedly said that infections through transfusions is a continuing scandal in poverty-stricken Hunan.

Lawyers and civil rights activists say people with AIDS are constantly denied treatment in hospitals in China and have died as a result. Without heavy external pressure, children with AIDS are also denied entry into schools.

Official estimates put the number of people living with HIV in China at about 700,000, with around 85,000 people with full-blown AIDS, according to UNAIDS.

A hot zone

The Guangxi Zhuang Autonomous Region, in southern China, has a population of 49 million and is a hot-spot for illicit drugs. Guangxi has the third-highest rate of HIV/AIDS among provinces in China. An estimated 92% of all HIV infections in Guangxi can be attributed to injection drug use.

In China, illicit drug use is an administrative offense, and Chinese law dictates that drug users “must be rehabilitated.” Chinese law requires that all patients in compulsory rehabilitation centers be provided with “medical and psychological treatment, legal education, and moral education.”

In 2007, the Standing Committee of the National People’s Congress passed a new drug law, in effect since June 2008, which substantially restructures the detention system for individuals detained for administrative drug offenses but has significant ambiguities.

While eliminating the use of re-education through labour centers to detain drug users, it allows up to six years of confinement for a single drug offense, with one to three years in “compulsory isolation detoxification” followed by up to three years of “community rehabilitation.”


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