Did you know that it has been 30 years since the first case of HIV was reported in Taiwan? Thanks to constant, widespread concern and support for the issue, Taiwanese are paying more attention to the rights of people infected with HIV or AIDS and the medical treatment they receive.
Since the AIDS “cocktail” was introduced in the mid-1990s, combination therapy using various drugs has been able to keep many HIV-positive people relatively healthy and prevent them from developing AIDS. Many people in Taiwan who were infected with the virus about three decades ago are still alive, showing that infection is not an immediate death sentence.
In the runup to the 30th anniversary of the nation’s first reported case of HIV in December 1984, the number of people with HIV/AIDS in Taiwan reached a new high of 29,317 as of Oct. 31, according to data from the Ministry of Health and Welfare.
However, misunderstanding about and discrimination toward the disease has not faded.
Over the past 30 years, HIV/AIDS has posed a challenge to many social systems. In the wake of World AIDS Day on Dec. 1, it is perhaps a good time to take a closer look at how Taiwanese society has handled this issue.
There is no equal sign between the incidence of HIV infection and the younger generation. Ministry data show that 2,099 people with HIV/AIDS are above the age of 50.
However, this figure is vastly underestimated because the government’s data are based on the age that the people were when first diagnosed, whereas many of these people have already entered middle or old age. Nor does this data include foreigners residing in Taiwan.
The eldest person with AIDS in the nation is a man in his 90s who was infected with HIV via a blood transfusion during surgery — a case that runs contrary to many Taiwanese’s suspicion that most elderly patients contracted the virus through contacts with prostitutes. This view is hurtful to middle-aged and elderly people with HIV.
Taiwan is set to become an aged society in 2018 and a “super-aged society” in 2025. By that time, elderly people will account for 20 percent of the total population.
However, the government’s 10-year long-term care (LTC) plan — launched in 2007 to build a complete LTC system within 10 years — will come to an end in 2016. If the legislature does not pass draft bills to establish a long-term care service act and long-term care insurance act in a timely manner, the LTC system will enter a window period.
However, after six years of pushing for the LTC service act, the draft bills remain stuck in the legislature. Putting aside the issue of whether legislators have neglected their duty in this matter, the LTC system is a major national policy that determines whether citizens will be taken care of when they get old — it is a very complex system.
As the long-term care system aims to provide services to all, it should attach importance to the particularities of cultural diversity, as well as gender sensitivity.
All measures related to the planning, implementation and budget of the LTC service plan and network; the training of caregivers; and the handling of various LTC disputes should focus on meeting different needs based on gender and ethnic diversity, while a cultural assessment should also be conducted.
For example, do Aborigines and immigrants need more interpreters? Do such measures respect single people and the needs of transgender people? In particular, do they respect patients’ human rights?
People who have HIV/AIDS are patients like any other, so their exclusion from the proposed LTC service act is puzzling — do people with HIV/AIDS not pay taxes like the rest of the population? How would you feel if you fell ill and found that your illness excludes you from the nation’s LTC services?
To resolve such disputes, the draft bill stipulates a simple passive petition mechanism, without specifying any clear, definite handling procedures of such a petition or its legal effect.
One suggestion is that the government at least establish an appeals mechanism so people who have paid for LTC services their whole lives are not excluded due to the nation’s financial situation.
Everyone hopes to receive quality care once they are old. Single people and divorcees; the unemployed; families with dual income and no kids; the bankrupt; people who are ill and couples with unfilial sons or daughters all form part of today’s diverse society.
By refusing to legally recognize certain kinds of partners as family members, the government is excluding them from receiving respite care services.
It is hoped that in the future, the nation’s LTC policy will also include an impact assessment on gender diversity. LTC staff should be trained to respect different values, lest discrimination become prevalent in the services they provide.
The majority Taiwanese are not rich and powerful — it is the humble request of the people that the government take care of everyone fairly.
Yang Huei-chung is chief executive of the Yu Sheng Law Firm.
Translated by Eddy Chang
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