Healthcare

A scourge of China

Why the government has launched a massive vaccination campaign

You'll thank me later: a child is vaccinated at a health care centre in Hefei

Going to school used to be a simple matter. Buy a backpack, grab a few pencils and head for the door. But in China, the academic survival kit is not complete without a vaccination against hepatitis B, a virus that can cause lifelong infection.

In China, the hepatitis B strain (HBV) is endemic, with at least 93 million carriers – around a third of the global total.

Discrimination against those who carry the virus is also commonplace. Children who carry HBV have been denied admission to kindergartens if they test positive. Last year, 101 mothers petitioned the State Council when their toddlers were turned down for nursery places because they had the HBV.

Discrimination has also extended into the workplace. Foreign firms often refuse to employ local people with HBV, according to a survey by Beijing Yirenping Centre, a non-profit organisation dedicated to social justice. At least 84% of the multinational companies surveyed required job applicants to take HBV tests.

Two years ago the Ministry of Labour and Social Security and the Ministry of Health ordered that hepatitis B tests could not be used in recruitment. But Li Fangping, a lawyer from the Beijing Ruifeng law firm, said the punishment for violators remains too light.

“Obviously, requests for a hepatitis B test by firms is against the law,” says Chen Jun, chief coordinator of the Yirenping Centre. Chen added that multinationals seldom request applicants to test for HBV in other countries, despite doing so in China.

HBV can be transmitted in different ways. Mothers pass it to their children, and it can also spread through poor hygiene or sexual contact (not unlike HIV). In China’s rural areas it has also been spread by incompetent doctors who reuse needles.

The disease can also be transmitted through infected saliva inadvertently passing into the bloodstream. This is a bigger issue in China where ‘family dining’ is the norm and chopsticks dip into common plates of food.

So, if you shared a meal with an HBV sufferer and you had an open sore in your mouth, it would be possible for the disease to get into your bloodstream. This assumes that the carrier’s saliva touched food – via their chopsticks – that you then ate.

The chances of this actually happening are quite low, but that doesn’t stop people feeling paranoid about the risks.

It also feeds some of the discrimination. In fact, it wasn’t until 2005 that the Chinese government lifted a ban that prohibited HBV carriers from becoming civil servants. In light of public concerns, the government still bars them from working in the food industry.

It now seems, however, that the government is opting for a more preventative approach. As a part of the recently announced Rmb850 billion healthcare reform package, the hepatitis B vaccination programme will be extended to cover all children under 15 years old who have not yet been vaccinated. Over the next three years about 23.3 million people, or 31% of the target population, will be given shots for free, the authorities said.

A major beneficiary could be Dutch firm, Crucell, reckons the pharmaceuticals publication, China Bio Today. It makes Hepavax-Gene, a vaccine specially targeted at the China market.


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