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Spencer Michels reports on the campaigns to fight hepatitis B among Asian populations worldwide. The potentially fatal liver disease is100 times more likely to afflict Asians than non-Asians.

JUDY WOODRUFF: And to another story affecting millions of Chinese, as well as one in 10 Asian Americans.

"NewsHour" correspondent Spencer Michels looks at the disease called hepatitis B.

DR. SAMUEL SO, Stanford University: Good morning, Mr. Zhang. How are you?

GREG ZHANG, patient: Good morning, Dr. So.

DR. SAMUEL SO: How's your appetite?

GREG ZHANG: Very good. Very good.

SPENCER MICHELS: Forty-six-year-old Greg Zhang, who works in California's Silicon Valley, is recovering from a recent operation to remove a tumor from his liver, a result of his lifelong infection with hepatitis B. It's a disease that strikes Asians 100 times more than non-Asians.

DR. SAMUEL SO: The incision is well-healed. Everything looks good. No problem.

GREG ZHANG: Yes. Yes.

SPENCER MICHELS: Zhang's surgeon, Stanford liver specialist Dr. Samuel So, was concerned about a C.T. scan which revealed several new growths.

DR. SAMUEL SO: On this side, you can see one, two, three, four, at least.

GREG ZHANG: Wow.

SPENCER MICHELS: The hepatitis B virus is found in blood and bodily fluids. Many people can live with the virus and never get sick, but 25 percent of those infected get severe liver damage or cancer.

The virus can be transmitted by unsafe sex and unsterile needles, but most people who suffer from the disease, like Zhang, who was born in China, became infected at birth from their mothers.

GREG ZHANG: This is my brother with his two kids.

SPENCER MICHELS: His younger brother, Haiyang, also became infected at birth, but, like many of those with the disease, he had no symptoms until it was too late.

Two years ago, at the age of 42, he went to see a doctor about a pain in his side. He was told he had advanced liver cancer, and there was nothing that doctors could do. Zhang flew his brother to Shanghai to try to get a liver transplant, but he died three days after arriving there.

GREG ZHANG: Well, he passed away. My sister-in-law and his two kids were on a plane going from here to Shanghai. He didn't make it.

DR. SAMUEL SO: This is a cancer which often affects people at the prime of life, between 30 to 60 years of age.

SPENCER MICHELS: Dr. So has been leading efforts in the San Francisco Bay area and around the world to raise awareness about hep B. He has a research lab at Stanford focused on finding new ways to diagnose and treat liver cancer.

There's no cure for hep B, although the virus can be kept in check with antiviral medicines. Those infected need to have yearly ultrasounds and blood tests to screen for early stages of liver cancer.

Dr. So is the founder of the Asian Liver Center, dedicated to creating awareness about hep B both in the U.S. and overseas, especially in China.

DR. SAMUEL SO: A hundred million people in China are chronically infected. So, there's a huge burden of disease in China. Every, you know, two, three minutes, someone in China is dying from liver cancer caused by this virus, which could be prevented by a vaccine. And, still, most people in the world are not vaccinated against it. It's just ridiculous.

SPENCER MICHELS: An effective vaccine for hep B has been available for almost 25 years.

Newborns need a vaccination within the first day of life to prevent transmission of the virus from their mother. Two more doses are needed within the first six months for full immunity. And about half the babies in the U.S. do get vaccinated.

But, in many countries where hep B is endemic, like China, vaccination programs for infants are often spotty. And there are hundreds of millions of adults worldwide born before the vaccine was developed who are infected.

A recent documentary highlighted a program in China's Qinghai Province aimed at vaccinated more of the population, a campaign inspired by Dr. So. But one big hurdle in enacting reform in China has been the enormous social stigma associated with the disease.

WOMAN (through translator): If our neighbors knew our kids have hepatitis B, they wouldn't dare let their kids play with our kids.

SPENCER MICHELS: Those who test positive for hep B in China are often denied jobs, and infected children can be rejected from schools.

Along with the disease itself, that stigma has crossed the ocean with immigrants to this country. Many Asian Americans don't want to discuss it or even learn their own status.

What is unsettling is that many carriers of the hepatitis B virus are unaware that they are infected because the symptoms don't appear for many years. But what also bothers health officials in San Francisco and other cities with large Asian populations is that many Asians don't see the need to be tested for hepatitis B.

With one of the largest Asian populations in the U.S. and the nation's highest rate of liver cancer, San Francisco is now waging an aggressive campaign to bring the disease out of the shadows at events like the Asian Heritage Festival.

WOMAN: There's free hepatitis B screening to the right over here. It's free. They just take a little bit of blood.

SPENCER MICHELS: The city's Hep B Free campaign offers free testing and vaccinations.

KEN MURRA, San Francisco: I believe myself, you know, I don't have that kind of problem, but I'm just making sure.

SPENCER MICHELS: Not only does the general population lack knowledge and awareness of the disease, but so does the medical community, according to a recent report from the Institute of Medicine.

That's something that concerns Janet Zola, who is heading up the campaign for San Francisco's Department of Health. She says everyone, not just Asian Americans, should be aware of the disease.

JANET ZOLA, San Francisco Department of Health: It affects everybody. People intermarry. People have a large employee base of Asian employees who can get sick. So, it isn't really just about one isolated sector of the population, even though they're at highest risk.

NARRATOR: One in 10 Asian Americans is infected with hepatitis B.

SPENCER MICHELS: A controversial ad now running on local TV stations and on billboards asks which of these 10 Asian beauty pageant contestants deserves to die.

But, in the Asian community, such frankness is shocking. That attitude is something that California Assemblywoman Fiona Ma from San Francisco, who is hep B positive, is working hard to change.

FIONA MA, California assemblywoman: My cousin, who was born in China, actually got very upset and said, please don't talk about it. People are going to think that you're sick, and they're not going to vote for you.

And my message was, I am a public figure. This is my responsibility.

SPENCER MICHELS: Ma says San Francisco's program is working well, but the state needs to do more. She sponsored a bill to get the state to pay for hep B vaccinations and treatment, but was unsuccessful

FIONA MA: We should be trying to cover hepatitis B folks earlier in the process, instead of later. In California, Medi-Cal only covers you if you're in your last stages of liver cancer or require a liver transplant. Clearly, that's too late and it costs too much.

SPENCER MICHELS: Hep B is slowly starting to get more attention on a national level.

SPENCER MICHELS: Participants at a recent rally on Capitol Hill called for more federal funding for the disease. But Stanford's Dr. So, whose mother-in-law died from liver cancer, believes there's still not enough being done by the global health community or in the U.S.

He says other diseases get more public attention and, therefore, more money.

DR. SAMUEL SO: One in 20 people in the world are chronically infected, one in 20, 10 times more than people in the world infected with HIV. There's huge advocacy for the HIV community and very few advocates for hepatitis B.

SPENCER MICHELS: For now, the battle against hepatitis B is concentrated in communities with large Asian populations. Philadelphia and Los Angeles are among a handful of cities planning to replicate San Francisco's efforts.

JUDY WOODRUFF: Spencer's story was part of a partnership with NPR. Their report will air on "Morning Edition" tomorrow.

Spencer Michels reports on the campaigns to fight hepatitis B among Asian populations worldwide. The potentially fatal liver disease is100 times more likely to afflict Asians than non-Asians.

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Ray Suarez wraps up his reporting trip to China on global health issues with a discussion about the health challenges facing the country's growing middle class.

JIM LEHRER: Obesity, of course, is not just an American problem. China, the world's rising superpower, is dealing with the rise of weight as well.

Ray Suarez reported on it this week from China for our Global Health Unit.

Ray, what -- did you come away with an impression of the state of the population's health in China?

RAY SUAREZ: Well, I'm not a doctor, and I don't even play one on TV.

JIM LEHRER: Yes.

RAY SUAREZ: But you can see that people are better fed than they were at an earlier time in Chinese history. It was common to see adults who were of larger stature than their own parents who they accompanied on the street, and had children who looked like they were on their way to be -- being larger than they are.

China gets a better-than-average diet, better than the one set by the U.N. as the base point for being properly nourished. So, you're watching a country that's getting richer and has the chance of getting healthier at the same time.

JIM LEHRER: You did -- one of your pieces, of course, was about smoking. What about -- has there been any connection between the rise in smoking or the prevalence of smoking and cancer?

RAY SUAREZ: Well, yes.

Chinese smoke more than they did 20 and 30 years ago. They have more money to smoke. And smoking products are more available. About a million people die of smoking-related disease in China now. And public health officials are looking for that doubling and tripling in the decades to come, and they're -- they're pretty worried about it.

JIM LEHRER: What about heart disease?

RAY SUAREZ: Heart disease, the diseases of affluent, more affluent and industrialized societies.

So, in urban China, you're seeing more lung, circulatory system, and heart disease, because there are very heavily polluted environments in those places. And you're starting to see -- in more urban, more affluent, more automobile-dependent China, you're going to see a growth in those diseases.

JIM LEHRER: But you reported -- or you made a comment in one of your stories that the health care system is not growing with the need, as other things are, right?

RAY SUAREZ: Well, this reporting trip came as China is in the midst of a massive transformation, from a basically government-provided system, with tremendous gaps in availability of care between urban and rural, and something that looks more like a privatized system.

However, those gaps between urban and rural are still there, terrible, terrible access to care as China sets up a new rural health care system. But the demand so heavily outstrips the supply in the urban areas that people line up for hours before hospitals even open.

There are no clinics. There are no private doctors. There aren't enough doctors in China. So, when those places open in the morning, they have to handle -- and we were there one day to see this -- a rush of thousands of people through the front door of a health facility, and overburdened triage personnel trying to figure out; OK, you go here. You go there. You, we will take care of right now.

JIM LEHRER: And your feeling was, it's going to get worse before it gets better?

RAY SUAREZ: Well, the Chinese government has committed itself to really rapidly raising the spending per person in China on health care. But, right now, it's a fraction of what's spent in wealthy industrial societies.

JIM LEHRER: More generally, Ray, what -- what was your impression of the -- a lot of talk -- you mentioned it, of course, in your pieces as well -- the -- kind of the energy, the economic energy, the lifestyle energy?

Give us a feel for that. And compare it with prior times. And what do you expect to happen?

RAY SUAREZ: It is jaw-dropping to be in a place where everything is going to be new. Everywhere you go, there's new stuff, new highways, new rail lines, new train stations, new bus barns, new office high-rise buildings, and clusters of apartment buildings that would be a showpiece, just a remarkable feat of building in a city anywhere else in the world, but right behind that one that you're looking at is another one and then another one and then another one, sometimes, clusters of 30 and 40 20-story apartment buildings.

The scale, the numbers are -- can be bewildering, really, because everything is a superlative in a country of 1.3 billion people that's getting rich fast.

JIM LEHRER: And it is all superlatives?

RAY SUAREZ: Well, no. I mean, obviously, these -- these -- all of this has an underside. All of it has a dark side.

Lots of people are being relocated, not necessarily with their informed consent. They're just being told to clear out. A lot of neighborhood are being torn down, a lot...

JIM LEHRER: But to build these new -- new everythings?

RAY SUAREZ: Right, to build new everything.

And people who want to escape the terrible grinding poverty of the urban areas and get a little bit of that new affluence in the cities can't do that easily as well. China is trying to forestall just a rush into already overburdened cities. There isn't enough housing. There's not enough jobs.

How are you going to keep them down on the farm is not just an old punchline. It's a real question.

JIM LEHRER: OK. Ray, thank you very much. Good stuff.

RAY SUAREZ: thanks.

JUDY WOODRUFF: And to another story affecting millions of Chinese, as well as one in 10 Asian Americans.

Ray Suarez wraps up his reporting trip to China on global health issues with a discussion about the health challenges facing the country's growing middle class.

Mississippi has the highest rate of childhood obesity in the country -- 44 percent of kids ages 10 to 17 are obese or overweight. Recently, the NewsHour health unit traveled to the state to look at some causes of -- and possible solutions to -- the problem.

In the first report, correspondent Betty Ann Bowser talked to local officials, public health experts and families about efforts in the region to combat obesity, including taking fried food out of schools and bringing more physical education programs in.

On Thursday's NewsHour, we'll examine the issue of "food deserts" -- areas where residents have a hard time finding access to fresh, healthy foods. Many towns in the Delta could be considered food deserts, even though they're surrounded by farmland. Below, watch a Web-only report on efforts to teach local students to grow their own vegetables.

Learn more about the issue in this U.S. Department of Agriculture's report. You can also examine access to food in your own community in the department's Food Environment Atlas.

Mississippi has the highest rate of childhood obesity in the country -- 44 percent of kids ages 10 to 17 are obese or overweight. Recently, the NewsHour health unit traveled to the state to look at some causes of -- and possible solutions to -- the problem.

As part of his series from China, Ray Suarez reports on the ongoing 2010 Shanghai Expo, where the large and decadent Chinese pavilion captures the country in transition.

As Haiti continues to rebuild more than four months after a devastating earthquake killed 200,000 people and wiped out much of the capital city, the country still faces a number of immediate and longer-term challenges.

In the second in his series of reports from China on global health issues, Ray Suarez reports on the dramatic increase in obesity as the country's growing class of educated and well-paid consumers adopt some Western-style shopping and eating habits.

If one picture from China can tell a story of how this country has changed in the 21st century, it's one of a line of youths boarding a bus in front of a hospital for a field trip. It's a fat reduction hospital. The trip is to a nearby gym. And all the young people are obese.

In the first of three global health reports from China, Ray Suarez examines the work of anti-tobacco advocates in China, where the government -- which is a huge producer of tobacco products -- has done little to quash the deadly smoking epidemic.

The number of women choosing to smoke is on the rise in some developing countries.

Ray Suarez previews his series of health reports from China, airing this week on the NewsHour. First up, the nation's smoking epidemic and why the government might not want to stop it.

Fewer children are dying around the world each year and the decline in child deaths is accelerating, according to a study published Monday in the Lancet.

Researchers have created the first cell powered by a man-made genome, according to a paper published Thursday in the journal Science.

World health ministers agreed Thursday that alcohol advertising targeted to young people should be limited, and sponsorships regulated.

In the heart of the Mexican drug war in Juarez, emergency medical technicians face unique challenges as they respond to the bloodshed. Global Post reporter Ioan Grillo reports from Mexico.

Dave Iverson of KQED San Francisco explores two Haitian-led aid groups that are helping to feed the hungry after the devastating earthquake.

In the first of two reports from Haiti, Dave Iverson of KQED in San Francisco describes Haiti's struggle to rebuild after the earthquake and the crucial role of non-government organizations in the relief effort.

On May 12, 2008, a 7.9-magnitude earthquake hit China's Sichuan province, leaving more than 70,000 people dead. In an effort to document life in the region now, the American Red Cross distributed 200 disposable cameras to students for a photo competition.