To free our next generation from the threats of hepatitis B and AIDS, we Taiwanese have made great efforts to reduce mortality rate of hepatitis diseases and reverse younger generation’s view towards AIDS. Hepatitis B is transmitted in some of the same ways as AIDS, which include blood transfusion, sharing needles, tattooing, sex, etc. Based on the understandings towards such similar transmissions, combining predecessors’ efforts and legacy, Taiwan has thus made great contributions on disseminating information, transmission control and surgery performance.
Harm Reduction Program Sheds Light on AIDS Control and Treatment
Is AIDS scary? Not at all. But many tragedies and stigma against gay people exist based on wrong deduction, wrong policies and misunderstandings. Ryan White from the U.S. and Tien, Chi-yuan from Taiwan were both discriminated because of AIDS, forcing them facing tests from humanity, family and love. AIDS not only brings challenges to medical technology, but also makes us examine how we should face those challenges from the perspectives of social system, culture, human rights and justice.
According to Taiwan Centers for Diseases Control, AIDS epidemic in 2004 and 2005 was caused by sharing needles. 3,378 people became newly infected with HIV in 2005, while among them, 2,425 (about 72%) were drug users. Department of Health launched Harm Reduction Program in 2005. This program involves three core strategies, which are health education consultancy, clean needles and alternative medicine. New HIV infections are therefore reduced from some 1300 to some 700.
Dr.Alex Wodak, once an international leader in harm reduction, has participated in planning and providing consultation service for Taiwan’s harm reduction program. He noted that, Taiwan needs to participate in international meetings to share her experiences in harm reduction. Academician David Ho invented cocktail therapy in 1995, developing HIV vaccine in 1999 and released HIV drug, GSK 744LA in 2014. Up till today, cocktail therapy remains to be one of the most frequent in use treatments, making AIDS become controllable chronic disease. David Ho once noted, new HIV infections keep increasing. They do not stop because of the cocktail therapy. We simply won a fight, yet the war is not over.
WHO expands recommendation on pre-exposure prophylaxis of HIV infection (PrEP) in 2015 as one of the major HIV control programs. Taiwan endeavors to introduce such control program even though we have been suffered from the information gaps. In 2016, Taiwan government launched PrEP for HIV and HIV Testing at Home programs. These two programs provide tools to fight against HIV, furthermore, they shield people who are at ongoing substantial risk of HIV infection, effectively reducing risks of getting infected.
Medicine and scientific research cannot relief AIDS patients from misconceptions. To reverse the myth of “one can get HIV by being around people who are HIV-positive”, a group of young generation posted a reality recording in “IfIWereYou” fan page in 2017. When a HIV-positive patient stood on the street and was blindfolded, with a message board next to him full of unpleasant languages, would you give him/her a hug? The video shows that during the 34-minute shooting in Ximen and another 20-minute in Huashan, the HIV-positive patient received 115 hugs, 42 encouraging messages and 0 verbal attack. In the video, the passersby ignored hostile actors. It simply took one hug as a start and more hugs would follow. It proves that one action can make great influences.
Health for Taiwan’s Next Generation is Paid for in Sand and Blood
Hepatic diseases once swept Taiwan. Hepatitis B is one type of viral hepatitis and leads to chronic diseases like hepatocellular carcinoma and liver cirrhosis. It was once estimated that there were 3 million hepatitis B carriers in Taiwan, among them about 15% to 20% were adults. In average, one in five was carrier and over 10,000 patients got killed by hepatic diseases every year.
There was a debate over whether we should give vaccines to prevent hepatitis from becoming liver cancer. Immunologists and molecular biologists were in opposition to it. But R. Palmer Beasley, K.T. Lee and Chin-Yun Lee held a contrarian’s view, and conducted clinical trials in National Taiwan University Hospital and Taipei Veterans General Hospital. The results came out in 1981. After evaluation and discussions, in 1984, Department of Health decided to provide hepatitis B vaccine to infants of HBsAg-positive mothers. Later in 1986, hepatitis B vaccine is recommended for all infants at birth, making Taiwan the first one in the world provide mass vaccination with hepatitis B vaccine.
According to follow-up researches, in 1989 carrier rate for children under the age of 2 has been declined to 1%-2%. It further declined to below 1.5% for children under the age of 10 in 1994, while the greater news was, for children under the age of 8, the rate was below 1%. Mother-to-infant transmission has been effectively blocked and vaccination is therefore proved to be successful. Hepatitis B vaccine has been officially recommended for use by WHO since 1993.
Medical researches on liver cancer has never paused their steps in Taiwan. Professor T-Y Lin developed “finger fracture” technique which was performed during lung operation. In 1954, he tried the technique for the first time on a patient who had cancer on the left side of his liver. Such success builds foundation for liver operations in Taiwan and help build up our skills and talents. As medical technology gets advanced, so does liver cancer transplant which reaches more than 90% of success. Even so, our medical team risks disaster for each operation. As they know, every operation carries expectations from two families.