I’ve been invited to China as a guest of the Global Fund to Fight AIDS, Tuberculosis and Malaria to observe the first Global Fund board meeting, to be held in Kunming. Over the coming days, I'll provide some observations and photos of my visit.
On the way to Kunming, the Fund invited me to visit Shaanxi province (population 37 million, of whom 61% are living in poverty). Global Fund support for provincial TB programs began in April 2003 and assisted Shaanxi province to establish a universal system for patient identification, testing and treatment under an integrated TB control plan. Between April 2003 and June 2007, 326,588 cases of suspected pulmonary TB were tested and 117,578 active TB patients were identified. There is a cure rate of 90%.
We called on Dr Zhang Ding Chao and his team in the Yongle town hospital, central Shaanxi province, for a briefing on their efforts to control, contain and reduce tuberculosis. The gulf that has opened up between the booming cities and the more distant provincial centres was brought home to me by the very dilapidated and old clinic facilities in which the meeting took place. But with Global Fund assistance, Dr Zhang has implemented a comprehensive TB program in Zhen’an county. By the end of 2007, 8,900 cases of suspected pulmonary TB were tested and 938 cases of active TB identified. The county has also integrated TB and AIDS programs into routine health care services.
Dr Zhang is director of TB services for Yongle town and district. He briefed members of the Global Fund delegation on how TB funds provided by the Global Fund were being spent in the remote village of Wangjiaping.
The dedication and professionalism of Dr Zhang and his team was very obvious when they escorted us to the remote village of Wangjiaping, which was some 30 kilometres from Yongle. A villager with TB explained that his medicines were provided free of charge by the government. Dr Zhang said that Global Fund support enabled the authorities to provide large-scale testing and analysis, support, counseling and education. There is some evidence of the emergence of more drug-resistant versions of TB in the province. These forms of TB must be treated with so-called second-line drug therapies, which are expensive. The Chinese government does not provide these drugs free of charge.
The delegation then visited the local primary school. Because transportation is difficult, the students live at the school during the week. With some many young people living together in basic conditions, the teachers are responsible for more than their students’ academic progress. They take great care to ensure that the students are educated about basic health care, including tuberculosis.
Bill Bowtell and students of Wangjiaping Primary School, central Shaanxi Province, 9 November 2007. The students live in a district with high levels of tuberculosis infections and are taught basic health care information as part of their studies.
