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http://www.nytimes.com/2002/06/02/international/asia/02HEPA.html

China to Vaccinate Infants Against Hepatitis B

By ELISABETH ROSENTHAL

EIJING, June 1 — China plans to vaccinate all newborns against hepatitis B within the next five years, a major step toward eradicating a disease that is widespread here and whose aftereffects are a leading cause of death in this country.

In an agreement signed today by China's health minister, the Global Alliance for Vaccines and Immunization, a project largely financed by the Bill and Melinda Gates Fund, will provide $37.5 million to pay for the vaccination program. That donation will be matched by the Chinese government. The money will be used to purchase vaccines, train health workers and to provide 500 million syringes with a disabling device to prevent reuse. A major transmission route for hepatitis B here is the reuse of syringes.

large number of people with chronic hepatitis B develop liver failure and liver cancer.

Liver cancer, rare in the United States, is the most common cause of cancer deaths in China, causing hundreds of thousands of deaths a year and filling entire wards of hospitals.

Hepatitis B can be transmitted by contact with tainted blood or during sexual relations.

Studies sponsored by the United Nations show that a third of Chinese children have contracted hepatitis B by the time they are 5 years old, many from poor medical practices. The goal of the new project is both to make the hepatitis B series one of the government's routine immunizations and also to encourage safe injection practices.

Three decades ago, China had a vaccination program that was the envy of the world, but it has not expanded the program for about 20 years because of an economic crisis in its health care system.

For this reason, even though the hepatitis B vaccine has been available since the 1980's, it has never been included in routine, cost-free immunizations here. Although the vaccine is now commonly prescribed in prosperous cities, it is rarely affordable for rural residents. In China, the vaccine costs about $4 for the series of three shots.

"There isn't a more important country if you're going to try to take on hepatitis B," said Carol Bellamy, executive director of Unicef, which is a partner in the Global Alliance for Vaccines and Immunization. "A million people die a year from hepatitis B and one-third of them are here."

The goal of the Global Alliance is to introduce vaccines that are available in wealthier countries to poorer nations that need them desperately but can not afford them. The Chinese government applied for the grant and later agreed to match it.

"We've never had a country that's done that before," said Jim Jones, executive vice president of The Vaccine Fund, the financial arm of the Global Alliance. "The government of China has added money in and so really has ownership of this issue."

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