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VII. RECOMMENDATIONS

To the Chinese Government:

On the blood transmission scandal:

• Authorize a full, independent, and impartial investigation into the involvement of local authorities in the blood collection and transmission scandal in Anhui, Hebei, Shandong, Henan, Hubei, Shanxi, and Shaanxi provinces and any other parts of China where HIV-contaminated blood was bought and sold and used to infect large numbers of people. If this cannot be accomplished, the United Nations or other credible international body should be authorized to conduct such an investigation. The findings of such a report should be widely publicized, including on state television and radio and on official websites.

• Initiate criminal investigations into the blood collection and HIV transmission scandal. Criminal prosecutions should be initiated against those who knowingly or recklessly engaged in such commerce and against officials who were complicit or acted to cover it up. Prosecutors and investigators should be brought in from another province to ensure maximum public confidence in the integrity of the investigation.

• Take appropriate action, including dismissal, against any officials determined to have been responsible or negligent in the blood scandal or who were involved in the cover-up.

• The government should provide adequate compensation and appropriate treatment to those persons who contracted HIV/AIDS as a result of government negligence or recklessness. The sheer impossibility of separating those infected directly from those persons who contracted HIV/AIDS indirectly as a result of the blood scandal necessitates an expansive notion of government obligation, rather than a narrow one.

• Gather and publicly provide accurate figures on the numbers of persons infected with HIV through unsafe blood collection practices in Anhui, Hebei, Shandong, Henan, Hubei, Shanxi, and Shaanxi.

Freedom of Expression, Association and Assembly

• Uphold the fundamental rights to freedom of expression, assembly, and association by not interfering with free and critical speech on the subject of HIV/AIDS, granting access to non-confidential state-held information on the HIV/AIDS, permitting internet users access to Hong Kong-based and international websites with information on HIV/AIDS, permitting Chinese and international journalists to investigate and report on any and all aspects of the epidemic, and respecting the right to form independent associations and NGOs to work on HIV/AIDS-related matters.

• Revise the “Regulations for Registration and Management of Social Organizations” to permit groups applying for registration as “social organizations” to register with a minimal number of members. End registration restrictions that limit the number of social organizations in the same administrative area that are active in the same area of work.

Antidiscrimination

• Review the Disability Discrimination Ordinance of the Hong Kong Special Administrative Region, and other such laws and regulations in other countries, for language to incorporate into new national legislation protecting the rights of people living with HIV/AIDS against discrimination.

• Establish an independent commission, similar to the Equal Opportunities Commission in Hong Kong, to investigate and resolve complaints of discrimination on the basis of HIV status.

• End the arbitrary detention of injection drug users in forced detoxification centers without trial before a court of law and other due process protections.

• Ensure that all forced detoxification centers meet international health standards. Convert forced detoxification centers into state-subsidized voluntary detoxification centers. Offer methadone or other substitution therapy, psychological counseling, and HIV/AIDS education and prevention programs.

• Revise clause 8 of the Decision of the Standing Committee of the National People’s Congress on the Prohibition against Narcotic Drugs to make treatment for drug users voluntary, not compulsory, and to remove provisions requiring rehabilitation through labor for drug users.

• Withdraw all laws and policies requiring forced detoxification.

• Labor in detoxification centers should be voluntary and provide a reasonable wage.

• Remove HIV/AIDS as a “Class B infectious disease” from the Law of the PRC on the Prevention and Treatment of Infectious Diseases and review all diseases within this provision for possible reclassification.

• Require by law informed consent and doctor-patient confidentiality for those tested for HIV except for sentinel surveillance testing where the results are known only to the test administrators and used only for research purposes.

• Require that anyone tested for HIV be informed promptly of the results and that appropriate counseling be offered before and after the test.

• Establish legal clinics to provide both free and subsidized legal information and services to people living with HIV/AIDS.

• Revise laws and policies on HIV/AIDS to limit mandatory testing to blood and organ donors. Aside from unlinked and anonymous sentinel surveillance, all other HIV testing should be based on informed consent.

• Establish a new national training program for all health care workers on HIV/AIDS. Among the objectives should be the reduction of stigma and discrimination in the provision of health care, training on the disease, universal precautions,⁴⁷⁵ and best practices for treatment and prevention, training on confidentiality, and to ensure the competency of all health care providers.

To the Ministry of Health:

• Establish provincial-level offices to coordinate education, prevention, treatment, and care programs on HIV/AIDS.

• Closely monitor hospitals to ensure that HIV/AIDS wards are functioning, not locked and closed, and to ensure that hospitals accept as patients and treat people living with HIV/AIDS.

• Establish minimum standards of training for health workers about HIV/AIDS, methods of transmission, universal precautions, appropriate treatment and care, and problems related to stigma and related subject. Work with international and Hong Kong non-governmental organizations on the content of training programs, which should include on-the-job monitoring and follow-up training.

• Establish mechanisms of accountability for health workers. Retrain or discharge hospital, clinic, social services, and other government staff who discriminate or behave inappropriately towards people living with HIV/AIDS.

• Establish city and county-level voluntary, free, drop-in “activity centers” for use by low-income people with HIV/AIDS where they can receive medical treatment, psychological counseling, cook and eat meals together, and gather for mutual support and assistance.

• Improve the regulation of herbal medicines sold to treat AIDS by the State Administration of Traditional Chinese Medicine and Pharmacology. Ban all unapproved medicines for AIDS. Enforce a system of administrative and criminal penalties for persons selling unapproved drugs or fraudulently misrepresenting products. Create a system for people living with HIV/AIDS to check whether remedies have been approved to treat AIDS and to report the sale of unapproved drugs to authorities.

To the National People’s Congress:

• Establish a “Committee on the Prevention, Treatment, and Care of HIV/AIDS” to provide oversight of legislation and implementation of laws in relation to HIV/AIDS to ensure that the human rights of people living with HIV/AIDS are promoted and protected.

To the government of the Hong Kong Special Administrative Region:

• Support the long-term viability of the Equal Opportunities Commission as an independent monitoring body. Ensure that the chairperson and members of the Equal Opportunities Commission are insulated from interference by the executive branch and political interference.

• Expand training programs of health workers on HIV/AIDS. Include universal precautions, legal standards on discrimination in such programs.

• To decrease stigma, suggest that information on HIV/AIDS be included in basic training programs related to workplace safety.

• Expand existing public education programs on HIV/AIDS. Include Hong Kong’s legal standards on discrimination in such programs.

• Instruct the Labor department to meet with Hong Kong AIDS NGOs to discuss the problem of discrimination by employers and measures that can be taken to prevent it.

To the Hong Kong Equal Opportunities Commission

• Work with courts to obtain court orders so that people living with HIV/AIDS can file complaints related to discrimination while protecting their identities. Publicize this option widely, including by working with AIDS NGOs.

• Communicate more closely with NGOs to identify possible cases of discrimination and assist people living with HIV/AIDS to file complaints.

To the United Nations, bilateral and multilateral donors, and international NGOs providing assistance or carrying out programs on HIV/AIDS in China

• As part of working agreements with Chinese partners, require independent monitoring of discrimination against people with HIV/AIDS, conditions in forced detoxification centers, mandatory HIV testing, and access to treatment in Henan and other provinces affected by the blood contamination scandal. Require community input by individuals, independent NGOs and associations of people with HIV/AIDS into the design of any AIDS-related programs funded by by donors.

• Include an agreement to observe the principles set out in the U.N. HIV/AIDS and Human Rights International Guidelines, particularly those relating to discrimination and mandatory testing, in all written agreements with government agencies.

• Advocate for the reform of national, provincial, and local laws and regulations on AIDS that discriminate against people living with HIV/AIDS. When joint programs are planned, international NGOs and donors should request and review all local laws relevant to AIDS in the administrative region they plan to serve. Ensure that the disbursal of funds is contingent on progress on legal reforms and practices that ensure the human rights of people living with HIV/AIDS.

• Advocate for the rights to freedom of expression, information, assembly, and association for people living with HIV/AIDS in China and organizations acting on their behalf.

• Emphasize programs related to treatment, counseling, and legal services, in addition to prevention.

• Support monitoring of local hospitals to ensure that HIV/AIDS wards are functioning, not locked and closed, and to ensure that hospitals accept as patients and treat people living with HIV/AIDS. Ensure that all hospital staff are trained in universal precautions. Where hospitals or clinics are reported or observed to refuse treatment to people living with HIV/AIDS, report this to the Ministry of Health, provincial governments, the Chinese Red Cross, the United Nations, other donors, and others who can act to address the problem.

• In all AIDS education and prevention programs, distribute Chinese translations of the U.N. HIV/AIDS and Human Rights International Guidelines, ICCPR, ICESCR, and other relevant international documents.

• Support technical assistance programs to assist the Chinese government to create legal clinics serving people living with HIV/AIDS.

• Work to bring down the cost of antiretroviral and other drugs for that prolong and greatly improve the quality of lives of people living with HIV/AIDS.

• The United Nations Special Rapporteur on Arbitrary Detention should visit forced detoxification centers in Yunnan province and other such sites in China.