Hepatitis B in China: The end of discrimination?
---CSR Asia staff [email protected]
China has one of the world’s highest infection rates for hepatitis B (see boxes below for more information). Apart from being a serious medical condition that can lead to death, hepatitis B virus (HBV) carriers also face discriminatory workplace regulations and practices that make finding or holding a job difficult in a range of sectors (particularly the civil service). Although rarely making headlines in the English-language media, HBV has become a prominent issue in China over the last couple of years.
For instance, in 2003 the Chinese press extensively covered the story of a college graduate from Zhejiang who stabbed an official to death and badly injured another over the rejection of his job application for the civil service on the basis of being a HBV carrier (HBVer); he was sentenced to death and executed as a result. In Anhui, the story of a young man who sued the local government for rejecting his job application for being HBV positive made headlines.
Despite high profile coverage in the Chinese media and online (Internet communities linking HBVers and their supporters abound on mainland), there is little awareness by foreign companies of the discrimination faced by HBVers. Few foreign investors or buyers know about the strict pre-employment medical checks most job applicants must undergo, or that these are used to screen applicants and deny jobs to HBVers. Routine testing is also used to unearth employed HBVers and terminate their employment.
All of this might be of only marginal interest if it were not for the fact that regulations concerning pre-employment checks for civil service applicants with HBV have just changed. Foreign companies in particular should be aware of changes in these regulations that act as a model for private and other enterprises, and ensure that those changes are effectively implemented. This piece is a short outline of the regulatory amendments that came into force in January, and includes some quick facts and definitions about the virus itself.
The origins of workplace discrimination against HBVers can be found in a set of regulations that - ironically - make no mention of HBV (or any medical condition) at all. In 1994, China’s Ministry of Personnel published the “Employment Regulations for National Civil Service Applicants.” These regulations outlined the criteria by which applicants should be admitted to government employment, but they contained no items or standards relating specifically to reemployment medical check-ups. What they did contain, however, was Article 26, which prescribed that departments could determine their own regulations regarding pre-employment
The level of awareness about HBV in the mid-regulations on medical 1990s was poor. Most people, including those in check-ups might like to government departments, were poorly informed consider dispensing with about transmission methods. As is still some-HBV testing altogether”times the case today, employers wrongly believed all types of the hepatitis virus (A, B, C, D, E, F and G) could be transmitted through casual daily contact. As a result, most local governmental bodies included a mandatory HBV serologic test in their pre-employment medical check-up. Applicants testing positive on the HBV serologic tests were excluded from civil service positions. A typical example of these regulations can be found in Hunan’s medical check-up standards from 1995 that stated: “Applicants returning abnormal results for the HBV serologic test are not qualified for government positions.”
By 2000, public awareness campaigns had alerted people to the fact that hepatitis B could not be transmitted by casual contact. The plea to eliminate discrimination towards HBV carriers became stronger, which was partly the result of well-organised online communities who published factual information and organised grass roots educations campaigns. Governmental bodies started to modify medical check-up standards with an emphasis on relaxing regulations that would enable more people to have access to employment in the civil service. In 2004, the Ministry of Personnel and the Ministry of Health released the first draft of a new general medical check-up standard. After a consultation period involving the public and academics, the new medical check-up standard came into force on 19 January 2005. The key is Article 7, which states in full: “Applicants with any form of acute or chronic hepatitis are not qualified. HBV carriers qualify if they are not diagnosed as having hepatitis.”
This requires some explanation, for which reference to the draft regulations issued last year is helpful. The draft regulations stated that “Applicants who have recovered from acute hepatitis are qualified, if their ALT and AST [see box above for definitions] have been in the normal range for more than half a year.
Those who have recovered from chronic hepatitis are also qualified, if their ALT and AST have been in the normal level for more than 2 years. Applicants who test positive for the hepatitis B or hepatitis C virus identification test (including HbsAg, HbeAg, …) are qualified, if their ALT and AST are at the normal level.”
In short, if tests show that liver function is within normal levels and/or liver damage (as measured by ALT and AST) is within normal levels for the indicated periods, then the applicant is qualified to enter the civil service. This is good news for all HBV carriers. However, many are still worried that since the new regulations do not forbid the use of HBV serologic tests, local government bodies may still be able to disqualify HBV carriers using other means. HVBers are still urging the government to dispense with mandatory testing for HBV completely. They point to the International Labour Organisation’s (ILO’s) code of Practice on Employment and HIV/AIDS, which states in Article 8.1: “Prohibition in recruitment and employment: HIV testing should not be required at the time of recruitment or as a condition of continued employment. Any routine medical testing, such as testing for fitness carried out prior to the commencement of employment or on a regular basis for workers, should not include mandatory HIV testing.” Companies wishing to move beyond the new regulations on medical check-ups might like to consider dispensing with HBV testing altogether.
[此贴子已经被作者于2005-3-11 18:34:21编辑过] | 
发表于 2005-3-11 01:01
