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. Last Updated: 07/27/2016

AIDS Sufferers Stranded by Chinese Health Care

KUNMING, China -- On the day she arrived at the No. 3 People's Hospital to seek treatment for HIV, Cai had no symptoms. But she did have a little bit of money, and that gets attention in the modern-day Chinese health care system.

When she asked for the free anti-AIDS drugs the central government has begun providing to the poor, the doctors rebuffed her, she said, until she agreed to pay for costly tests. When she ran through her money and all she could borrow -- her 45-day stay exceeding $1,400 -- the doctors cast her out.

After years of denial about the extent of AIDS, China's leaders have unleashed a well-financed campaign to stem an epidemic that by the government's reckoning afflicts 840,000 people. But these efforts are being undermined by a relentless drive for profit within the Chinese health care system, a product of the country's shift toward capitalism.

"In China today, if you don't have money, you don't dare go to the hospital," said Odilon Couzin, director of China AIDS Info, an advocacy group.

The troubles vexing China's anti-AIDS efforts reflect a broader crisis assailing the health care system. From 1980 to 2004, the central government's share of total funding for health care dropped from 36 percent to 17 percent, according to a recent state study. Doctors and hospitals had to live off their profit.

Pharmacies have become profit centers for Chinese hospitals, the source of up to 90 percent of revenue, encouraging doctors to overprescribe drugs, Chinese experts said.

In April, Cai landed in the hospital with pneumonia. On the way out, one of the doctors took her aside. Married and not a drug user, she had tested positive for HIV. Her husband confessed that he had been cheating, she said.

On May 25, Cai went for treatment to the No. 3 People's Hospital special AIDS ward. The radiologists whispered that they should not touch her. "She's got that disease," she heard one doctor say.

She surrendered a $375 deposit, nearly all the money she had. They gave her a bed in a room with three other women. The toilets were filthy. Bowls of rice contained sand and worms.

No one on the hospital staff mentioned the free anti-retroviral drugs, she said. She heard about them from visiting Red Cross volunteers.

About 2,000 of the 19,000 patients who have received free drugs have stopped taking them because of side effects such as low blood pressure, insomnia, and nausea, according to medical experts. The campaign is encountering resistance from doctors who would rather prescribe expensive medicines than give away something for free.

"The reform process has made hospitals into clubs for the rich," said Zhang Ke, an AIDS specialist at Beijing Youan hospital. "If the hospital is focused on making money, why would they tell anyone about these free drugs? There's a basic conflict of interest."

On June 23, the doctors said Cai could have the free drugs. In September, she went back for a third refill. This time, it was $60 worth of tests or no pills. She did not have it. As the month drew to a close, Cai nervously inspected her pillbox, wondering how she would get more pills. Wondering what would happen to her body without them.