In 2010, after seven years of providing HIV care in the city of Guangxi, Médecins Sans Frontières and the Guangxi Centre for Disease Prevention and Control (CDC) handed over their project to local health authorities.

HIV/AIDS treatment in Guangxi

Guangxi province, in southwest China, has one of the highest rates of HIV infection in the country. Médecins Sans Frontières, together with the CDC, established a project in the provincial capital Nanning in 2003.

The project targeted high-risk groups: the testing and treatment of injecting drug users, sex workers and men who have sex with men. Patients responded well to the treatment and were able to stick to it. Prior to the project’s opening, Chinese health officials had doubts regarding the likely adherence of drug users to antiretroviral (ARV) treatment. Dr Wu Zunyou, director of the National Centre for AIDS/STD Control and Prevention, said: “In the early stages, we had no experience in providing treatment to drug users and AIDS patients overall. We just started in 2003 and we were very hesitant to launch antiretroviral treatment for drug users because we were not convinced they had good adherence rates, but we reviewed Médecins Sans Frontières data and found they did not have worse adherence rates than non-drug users”.

Targeting people living with HIV from particularly marginalised populations was a key part of the project in Guangxi. Teams went out into these communities to encourage people to seek testing and treatment. This approach saved lives, and once the disease was managed effectively through medication, patients’ quality of life was greatly improved. Counselling, previously regarded with suspicion by health authorities, became an important part of patient care.

People on ARV treatment often suffer from opportunistic infections that take hold as a result of their weakened immune systems. Over the course of the project in Guangxi, Médecins Sans Frontières was able to implement new protocols for the treatment of such infections. Tuberculosis was the main opportunistic infection targeted and treated. Our team also helped train national staff to diagnose and treat cytomegalovirus, a viral infection that can cause blindness in people with HIV.

Over seven years, the project team had developed a system of care that addressed the psychological and medical needs of patients. Our staff assisted in drafting guidelines for the testing and treatment of HIV/AIDS that formed a basis for the province’s approach. Aspects of the provincial guidelines were then used in the national protocol for tackling the epidemic. The project provided training for many health workers in Guangxi, which now has 45 antiretroviral treatment centres, compared to a handful in 2003. A total of 1,724 patients received free and confidential treatment and care. Around 80 per cent of these patients were continuing to follow treatment at the time of the handover.

Earthquake in Tibetan Autonomous Region

In April, a 6.9 magnitude earthquake hit Qinghai province, killing around 2,700 people and injuring some 12,000. Médecins Sans Frontières sent a team to explore the possibilities of assisting the population in Jiegu, the worst affected town, where around 100,000 people were made homeless. Médecins Sans Frontières made donations of coal, medical kits and other equipment to help the affected population.