China rebuilding rural cooperative medicare system

 XI'AN, Feb. 21 (Xinhua) -- The old lady might still be hesitating if she should have her liver disease treated, if not for the cooperative medical care.

    Pang Chunxiang, 61, from the Beizhai Village of northwest China's Shaanxi Province, was glad to receive more than 9,000 yuan reimbursement for her surgery that cost her 23,814 yuan (about 3,072 U.S. dollars), roughly tenfold of the poor farmer's annual earning.

    Pang is only among millions of beneficiaries of the rural cooperative medicare scheme, launched nationwide after the outbreak of SARS (Severe Acute Respiratory Syndrome) in 2003.

    Under the system, a farmer who is willing to take part in the program is to hand in 10 yuan a year out of his own pocket, while the state, provincial, municipal and county governments jointly put in another 40 yuan for the farmer.

    The participant could have part of his expense reimbursed in case he is hospitalized. The rate of reimbursement varies according to different kinds of illness and the actual cost of medical expenses incurred.

    In Shaanxi province, the average rate is 35 percent and the fund has reached 612 million yuan (about 78.6 million U.S. dollars) since 2003, covering more than 12 million farmers, or 44.5 percent of the rural population in the province.

    The total reimbursement was 390 million yuan (about 50 million U.S. dollars) last year, almost seven times of the amount in 2005,said Li Hongguang, head of the Shaanxi Health Department.

    Cooperative medicare is not new in China. It was adopted by thegovernment as a national policy in 1956 and had helped built one of the best rural healthcare networks in developing countries over the past decades.

    A market-oriented reform since the 1980s, however, have led to the dismantling of the system. Without government support, rural hospitals and clinics had been left to struggle for survival. Man yof them were simply abandoned as doctors looked for greener pastures.

    Rocketing medical bills have pushed health service farther from farmers.

    A survey by the Ministry of Health showed one third of poor rural patients choose not to go to hospital, and 45 percent of farmers in hospital ask to be discharged before they have recovered.

    "With the co-op medicare system, an illness does not mean a catastrophe anymore," said Lu Zhenshan, a farmer in his fifties who claimed 30 percent reimbursement after having a heart surgery.

    So far, China's central and local governments have invested over 18.9 billion yuan (about 2.4 billion U.S. dollars) into the medicare scheme to provide 400 million times of reimbursements to the farmers.

    Nationwide, the system has covered 51 percent of the rural farmers, and will be extended to cover all the rural areas by 2008,according to Gao Qiang, the Minister of Health.

    The new system also brought changes to rural clinics. In the Niudong Clinic where Lu Zhenshan attended, the hospitalized patients totaled over 60 last year, quadrupling the number in years before the program was launched. Among the patients, one third had chronic diseases, for which they had been reluctant to go to hospital before.

    "If not for the co-op system, our clinic would be bankrupt," said Li Xiangmin, head of the clinic, noting that their revenue was 286,000 yuan in 2006, a sharp increase from the less than 200,000 yuan before. He is thinking of purchasing some new medical equipments.

    But the national drive is also met with difficulties. "Many counties and towns do not have enough financial power to supply their portion in the fund," said Li Ling, professor from the Chinese Economy Research Center in Beijing University.

    In addition, many clinics are in shortage of eligible doctors and equipments. In over 1,600 clinics in east China's Anhui Province, there are only 723 college graduates, less than two percent of the total number of doctors. Half of the clinics are not equipped with stomach pump and 30 percent without electrocardiograph.

    Fund resources need to be expanded, and the funds from richer counties may need to be diverted to support the poor ones, Li Ling noted.

    More efforts are needed to lower the costs of medicine, and support under-funded and poorly equipped village clinics, she added.

New bid to stop the spread of HIV

SHANGHAI: A new scheme has been launched to help stem the growing number of HIV infections in East China's Zhejiang Province.

As part of their ongoing job training, officials from all government departments will be lectured on how to prevent and treat HIV and AIDS within the community.

The requirement came from Zhejiang's new regulation on AIDS prevention and treatment, which was passed by the provincial People's Congress.

"AIDS prevention and treatment requires effort from top to bottom," Cong Liming, director of the Zhejiang Disease Prevention and Control Centre, told China Daily.

He declined to disclose the figures of the province's HIV-infected and AIDS patients, but said the rate was growing by 40 percent each year.

After Zhejiang found the first HIV-infected patient in 1985, the province had reported 1,859 HIV-infected and AIDS patients by the end of November last year, according to Xinhua News Agency.

In the first 11 months of last year, 571 Zhejiang residents became infected with the HIV virus or were confirmed as AIDS patients, almost 31 percent higher than 2005, when 436 cases were reported.

The agency said there were probably close to 20,000 HIV-infected and AIDS patients in Zhejiang.

New regulations in Zhejiang state that government officials and employment intermediaries should educate migrant workers about AIDS prevention and treatment.

Employers should also educate their employees about AIDS prevention, and make it an integral part of ongoing employee job training and safety education programs, the regulation said.

To stem the spread of AIDS, regulations forbid the use of any blood that has not been screened for HIV, the same with human organs, cells, marrow and sperm.

Expectant women and patients waiting for surgery will be tested for HIV free of charge.

 

China's NGOs learn to stand alone

The government eases up on independent groups, giving them a chance at a more active, effective role.

By Evelyn Iritani, Times Staff Writer
March 6, 2007

 

BEIJING — Wang Xingzui is trying to take the go out of his gongo.

Step by methodical step, the executive director of the China Foundation for Poverty Alleviation is weaning it from the things that have made his group an oxymoron: a government-organized nongovernmental organization, or gongo.

The foundation, one of China's leading anti-poverty groups, has removed all but two of the government representatives on its 21-member board. It has stepped up fundraising efforts, though it still depends on government support. And it has revamped its micro-credit program, establishing independent loan offices to replace branches co-managed by provincial officials.

"We are quite unique," Wang said proudly during an interview at his organization's headquarters in Beijing.

The group's attempt to assert its independence marks an important step forward in a country where the government has long been fearful of the kind of grass-roots revolution that toppled Communist regimes across Eastern Europe.

Lawrence Greenwood, vice president of the Manila-based Asian Development Bank, speaking at an anti-poverty forum here recently, said that the pioneering effort could "fundamentally reshape poverty alleviation and development efforts."


A new attitude

Decades after opening its borders to foreign products and ideas, the Chinese government still maintains tight control over nongovernmental groups, whether they are chambers of commerce, churches or environmentalists. China has 350,000 registered nongovernmental organizations, but many thousands more, including most international organizations, operate without official approval.

Some lines can't be crossed. Anyone posing a direct challenge to the Communist Party risks swift retaliation, as political bloggers, labor organizers and the followers of the spiritual movement Falun Gong have discovered.

But the Chinese government's attitude toward nongovernmental groups has started to change. Concerned about the fast-widening rift between the rich and poor, President Hu Jintao has embarked on a campaign to build a more "harmonious society."

In January, the Catholic Social Service Center of the Liaoning Diocese in northeastern China held the country's first ecumenical conference on HIV/AIDS. Officials from China's Ministries of Religious Affairs and Health attended the meeting, where the group adopted a plan to create a network of religious organizations to work on preventing the disease.

The NGO issue is something the Chinese government is "really struggling with," said Elizabeth Williams, an AIDS expert at the New York office of the Asia Society. "It definitely appears that there is a recognition they need to foster, support and encourage civil society development. But there's also a fear of how far that will go."

The struggle to forge a new role for China's nongovernmental groups is underway at the China Foundation for Poverty Alleviation, which makes its home in a well-worn building in a neighborhood of fast-food chains and clothing shops next to the People's University.

The organization was founded in 1989 by retired provincial party officials who were looking for a way to help the government deliver services to poor villagers, Wang said. At first, he said, the group was set up as a mirror image of the government, a "mini Central Committee."

But a decade of experience, and exposure to international anti-poverty organizations, convinced the foundation's leaders that the organization needed to operate with greater independence so it could act more quickly and efficiently.

Wang stressed that his organization was not challenging the party's authority, and in fact had the blessing of its government partners, the Ministry of Civil Affairs and the State Council's Office of Poverty Alleviation and Development, with whom it maintains close contact.

"I am not advocating protesting against the government, not at all," he said. "We want to see a strong NGO sector that will do things that can't be done by the government or by business."

After operating on the sidelines for so long, most Chinese nongovernmental groups lack the basic technical skills or business expertise necessary to deliver services on their own, Wang said. So in addition to managing its own restructuring, the foundation has begun offering training programs to other groups interested in taking the same path.

"I firmly believe one good NGO is not enough," he said. "You need to help develop an NGO section in the civil society so the Chinese society will be a stable one."

Project in Jiangxi

Chris Spohr, an economist with the Asian Development Bank's office in Beijing, is working with the foundation on its collaboration with the government on poverty reduction programs in the southeastern province of Jiangxi. The foundation is helping select and train nongovernmental groups that are working with villagers to identify the root causes of their poverty and devise solutions.

Spohr said the project had been launched in Jiangxi because provincial leaders were willing to allow nongovernmental groups to work directly with the villagers. He said it was the first time the government had given anti-poverty funding directly to competitively selected NGOs, streamlining the process and reducing the opportunity for graft.

If the project succeeds, he said, it could help convince skeptical officials in other parts of China that these groups can be partners in solving some of their thorniest problems.

"We're not talking about NGOs displacing governments," he said. "We're talking about bringing to bear their comparative strengths."

The early results are encouraging, said Liu Dongwen, the foundation official in charge of the Jiangxi project. One group conducted a survey and determined that a proposed road should be rerouted so it would reach two remote villages. In another instance, a group helped a village resolve a contentious land dispute.

"In the past, villagers tended to think, 'These are government projects — why should I care?' " he said. "Now it's changed. They think, 'This is our project.' "

EU needs to coordinate AIDS research better: Germany

Sun Mar 11, 2007 10:52 AM BST

BERLIN (Reuters) - European Union member states should improve coordination in their efforts to develop a vaccine against HIV/AIDS, German Health Minister Ulla Schmidt told Reuters.

Schmidt, who will preside over an international HIV/AIDS conference in the northern German city of Bremen on Monday, said she was in discussions with key players in the pharmaceutical industry on the price of AIDS medications.

"We want to ensure that there is access to prevention and affordable treatment everywhere in Europe and enable all those infected in Europe to live their lives without being stigmatized or discriminated against," she said on Saturday.

Regarding an HIV vaccine, Schmidt said it was necessary "to better coordinate the research efforts of EU member states."

Germany is currently the president of the EU and the Group of Eight (G8) industrialized nations.

German Chancellor Angela Merkel has said Africa and the epidemic of HIV/AIDS that has devastated the continent would be among the focal points of Germany's G8 presidency.

"This epidemic has not only caused great human suffering but also threatens economic and social development and affects the political stability of entire regions," Schmidt said.

Bush's daughter writes book on teen mom with HIV

Photo : REUTERS

Jenna Bush, 25, will release in the fall "Ana's Story: A Journey of Hope," based on her work as an unpaid intern with United Nation's children's agency UNICEF.

Publisher HarperCollins said in a statement on Tuesday that it had bought the world rights to the book.

Susan Katz, publisher of HarperCollins Children's Books, said the young-adult, non-fiction project would be based on Bush's experiences with UNICEF in Central America. It will focus on the story of a 17-year-old single mother living with HIV, the virus that causes AIDS .

Bush said she had been inspired to write the book by her work with adolescents in Central and South America.

"These young people have faced extreme hardships and exclusion but are strong in spirit and have an incredible will to succeed," Bush, who is currently teaching at a shelter in Panama several days a week, said in a statement.

"Through their stories, it is my hope to motivate young Americans to increase their awareness of other young people around the world...," she said.

A portion of the author and publisher proceeds will go to the U.S. Fund for UNICEF.

Bush, who graduated from the University of Texas at Austin in 2004 with a degree in English, was an elementary school teacher in Washington, D.C., for a year and a half before embarking on an internship with UNICEF in Panama.

Bush gained a reputation as a party girl in her college days, when she and sister Barbara faced charges of underage drinking.

The White House has tried to keep the twins out of the public spotlight although they did make the headlines in Argentina in November when one of the twins had her purse stolen in San Telmo, a popular tourist area.

AIDS hits blacks harder than other groups: CDC

Thu Mar 8, 2007 6:46 PM ET

By Matthew Bigg

ATLANTA (Reuters) - Black men in the United States are nearly seven times more likely to be diagnosed with HIV than their white counterparts, the U.S. Centers for Disease Control and Prevention said in a report released on Thursday.

Blacks represent 13 percent of the U.S. population but account for nearly half of Americans living with the disease, and 40 percent of AIDS deaths and 61 percent of all new diagnoses of people aged 13-24 are black, the CDC said.

The report, which is based on 2001-2005 data, does not reveal a dramatic increase in the rate of HIV infection among blacks and it shows a significant decline in black mother-to-child transmission of HIV.

But it cements a picture of an epidemic that disproportionately affects the black community, said Robert Janssen, director of the CDC's division of HIV/AIDS prevention.

"What is beginning to happen is a recognition of the severity of the problem," Janssen said in an interview.

"Black men particularly are hard-hit. The HIV diagnosis rate among black men is seven times higher than among white men," he said, adding that men who have sex with men account for around half of those cases.

In Philadelphia and Washington, some 3 percent of blacks are living with AIDS, a rate higher than Senegal's and on par with Cameroon in central Africa, he said.

Blacks do not engage in riskier sexual behavior than other groups, Janssen said, but high HIV infection rates mean blacks who have sex with other blacks are more likely to get HIV than people within other ethnic groups.

Federal allocations to the CDC for directly funding community organizations to fight AIDS in the black community have increased 10-fold since 1988 and now stand at $30 million while total program funding is $300 million, the CDC said.

Janssen said the agency was expanding prevention services, increasing opportunities for diagnoses, encouraging all blacks to know their HIV status and developing new interventions.

As part of that effort, the CDC organized a meeting for black community leaders on Thursday.

"NOT IN MY FAMILY"

Black leaders have been criticized for being slower to mobilize against HIV and AIDS than leaders of other groups such as gay whites.

Janssen said the stigma over sexual issues within the black community had been damaging.

"Certainly (there is) a sense of stigma related to homophobia. There is certainly a stigma around how HIV is transmitted. There has not been a recognition in the community of how serious the problem is," he said.

The reasons for this lack of leadership are complex, said Ivory Brown, a black entertainment, sports and family lawyer who has written about the issue.

"There is a silence. I don't want to say the African-American community is not an open community. We are more prone to adopt people and issues that are cast-offs to the rest of society," she said.

"I don't believe that ... our religion makes our people homophobic. What I do believe is that a lack of education and information makes it is easier for our community to turn a blind eye to the problem," she said.

Brown contributed to "Not In My Family," a book in which dozens of black celebrities, politicians, civil rights leaders, academics and others write about AIDS.

Groups link fight against AIDS to rape prevention

Tue Mar 6, 2007 6:31 PM ET

By Michelle Nichols

UNITED NATIONS (Reuters) - The world's top AIDS donors, including the U.S. president's fund, need to link the fight against the deadly virus to preventing the rape and abuse of women and girls, rights groups said on Tuesday.

The Women Won't Wait coalition said violence against women and girls was a cause -- through rape -- and a consequence of a rapid spread of HIV among females, who now make up nearly half the 40 million people infected around the world and account for more than 60 percent infected in sub-Saharan Africa.

The group said that many women become infected with AIDS when they are raped, many by their husbands, but when it becomes known that they have the virus then they are blamed and face more violence.

"It is vital that the policies, programs and funding streams of national governments and international agencies transparently address the intersection of HIV and AIDS and violence against women," said Mary Robinson, president of Realizing Rights and former president of Ireland.

A Women Won't Wait report found the Global Fund to Fight AIDS, Tuberculosis and Malaria, President George W. Bush's Emergency Plan for AIDS Relief, the World Bank, Britain's Department for International Development, and UNAIDS, the United Nations' AIDS organization, provide "scant resources" for efforts to combat violence against women that are largely separate from AIDS programs.

"Their ultimate failure to address the linkages of violence against women and girls and HIV/AIDS means that they also fail to articulate and execute an agenda that gives priority to securing the human rights of women," wrote the report's author, Susana Fried.

The report was also critical of Bush's Emergency Plan for AIDS Relief for its emphasis on abstinence, faithfulness and appropriate use of condoms, saying it fails to recognize that in certain countries faithfully married women are the most at risk.

"Women and girls of Africa are pawns within the ideological battle underway in the United States," said Lori Michau of Uganda-based women's rights group Raising Voices.

"We must demand that universal principles of human rights, scientific evidence, and common humanity guide the formation and implementation of U.S. government policy -- not political and religious ideology."

[Home]  [Previous news]