China Moves to Reverse Bias Against Hepatitis B Carriers
Hepatitis B carriers in China hailed the announcement by the Ministry of Health on December 31 that positive hepatitis B status would no longer be a barrier to schools and employment as a significant breakthrough. This announcement came four years after the publication of hepatitis B prevention and management guidelines, which stated that hepatitis B is not transmitted through general day-to-day contact such as handshakes, sharing of meals or use of public restrooms. On the Internet, 175,453 exuberant comments were immediately posted.
In January, the “Notice Regarding the Protection of Rights of Hepatitis B Surface Antigen Carriers to Education and Employment” was published for public comment. The policy statement eliminates routine pre-entry or pre-employment screening of the hepatitis B panel, which in China includes surface antigen, surface antibody, e antigen, e antibody and core antibody, except when explicitly permitted by the Ministry of Health based on justifications provided by the educational institution or employer. Alanine aminotransferase (ALT) testing for evaluating liver function is, however, permitted under this new policy. Abnormal results will trigger additional testing and medical intervention as needed. (Does this sound a little like a loophole?) Additionally, the policy includes a provision for protecting the privacy of those tested, as well as public education on the modes of transmission of hepatitis B. The policy paper was issued jointly by the Ministry of Human Resources and Social Security, Ministry of Education and Ministry of Health. The public was given a week (January 21-27) to comment by email. As of last week, a newspaper in southern China had published an editorial that pointed out some of the fallacies of this new policy. Referring to the privacy provision, the editorial suggested that protecting the rights of the infected might result in an environment that breeds suspicion and discomfort. It also suggested that the new policy diminishes the independence of institutions and their right to make their own policy decisions.