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Epidemic and Response


A Overview of HIV/AIDS Education and Prevention Situation in China

Source: CHAIN

Since the first cases of AIDS were discovered in China in 1985, the Chinese government has responded to the epidemic with increasing aggression. In the past year alone the government has made major strides in promoting HIV/AIDS education, treatment and control policies. The government has also pledged its support by dedicating significant funds towards prevention, treatment and control of HIV/AIDS, and top government officials have publicly shaken hands with AIDS patients in an effort to de-stigmatize people affected by the virus. In general there has been increasing willingness on the part of the government to address sensitive but crucial issues that directly affect the spread of HIV/AIDS, such as Men Who Have Sex with Men (MSM) and Injecting Drug Users (IDUs). As the AIDS epidemic continues to spread worldwide, the Chinese government has absolutely made prevention, education and treatment a national priority.

Initially, the Chinese government's AIDS policy amounted to restricting entry into China of people infected with the virus, as well as initiating measures that reinforced the illegality of homosexuality and drug use. As the epidemic continues to spread throughout China the government has taken a much more active role in HIV prevention, including creating policies to care for carriers of the virus. At the center of China's HIV/AIDS policy is the China CARES program (China Comprehensive AIDS Response). China CARES originally addressed AIDS patients who were infected with the virus due to unsafe blood collection, particularly in Henan province. Recently the China CARES program has been expanded to respond to a more diverse patient group and has an increasing focus on health education and comprehensive treatment.

A major accomplishment in prevention and treatment came in 2003, with the establishment of the Four Frees and One Care policy. Announced by Premier Wen Jiabao on World AIDS Day 2003 the policy consists of five major points:

1) Free ARV drugs to AIDS patients who are rural residents, or people with financial difficulties living in urban areas;

2) Free Voluntary Counselling and Testing;

3) Free drugs to HIV infected pregnant women to prevent mother-to-child transmission, and HIV testing of newborns babies;

4) Free schooling for children orphaned by AIDS;

5) Care and economic assistance to the households of people living with HIV/AIDS.

Significantly, this policy not only speaks to an acknowledgment on the part of the government of the scope of the epidemic, but also recognizes that the epidemic is increasingly spreading into the general population. HIV/AIDS can no longer be considered the epidemic of IDUs and MSM, as is demonstrated by the concern for mother-to-child transmission.

Because of the rapid rate at which HIV/AIDS is spreading, the Chinese government has initiated education programs on both the national and provincial levels. In March 2004 State Council Document no. 7 was released, detailing a comprehensive framework for controlling the epidemic within China. The policy promotes: “prevention first, integration of prevention and treatment, and comprehensive prevention and control,” making education a top priority. A State AIDS Working Committee was created in 2004 to ensure effective implementation of State Council Document no. 7. The leaders of this committee have promoted and implemented education programs on all fronts. These education campaigns include: creating teaching materials for secondary school students, and posting bills in public spaces, such as train and subway stations, which raise awareness about the virus and cite the advantages of consistent condom use during sexual activity. These education programs target all sections of society, and have empowered some groups, such as the youth, to take an active role in educating others about the virus.

On the national level the Chinese government has created television shows that teach about AIDS/HIV. As dictated by the government, these programs are broadcast throughout China. Sexual health is also becoming a mandatory aspect of secondary school health education.

The Chinese government has also reinforced its commitment to controlling the spread of AIDS/HIV by dedicating increasing funds to fight the epidemic. In 2003 government spending for HIV/AIDS totaled 390 million RMB. In 2004 that figure more than doubled; the amount spent reached a total of 810 million RMB. Along with this significant increase in financial resources, the Chinese government has become more willing to work with international organizations in an effort to control the virus. Many international organizations, such as The Global Fund To Fight AIDS, TB and Malaria, have expertise in the control and prevention of major epidemics, and can offer guidance and advice to the Chinese government. This willingness to cooperate with international partners represents the government's acknowledgment of the scope of the epidemic, as well as its commitment to ensure that the fight against HIV/AIDS remains a national priority.

To monitor the effectiveness of recent policy changes, the government is conducting a mid-term evaluation of the China's Medium and Long Term Programme (sp?) for the Prevention of AIDS (1998). This plan aims to limit HIV infections to 1.5 million by 2010. The program's points of focus include: ensuring safe blood collection and use practices, implementing health education, and providing care for HIV/AIDS patients and their families. This mid-term evaluation will enable the government to assess which prevention and treatment strategies are effective and which need to be altered. There have been major achievements in ensuring that blood is collected safely. Currently volunteers donate 88% of the total clinical blood collection, up from 22% in 1998. Other measures, which are in the nascent stage and in the process of evaluation, are needle exchange programs and the establishment of methadone clinics. Given that the spread of HIV through IUDs is so prevalent these new prevention methods could have a significant affect on the trajectory of the AIDS virus in China.

The SARS outbreak in 2003 pushed the central government to markedly improve China's healthcare infrastructure, pledging money to assist every province in establishing a disease control and prevention center. The government also responded to the crisis by purchasing more than 10 billion RMB worth of medical equipment to improve hospitals and clinics. The nature of China's national healthcare system directly relates to the state's ability to control an epidemic such AIDS. Such improvements in the healthcare system are necessary for the prevention and treatment of HIV/AIDS.

While there has been tremendous progress in government's response to the epidemic, there are still challenges to be overcome. Education has become broader and more in-depth, and yet there are still certain groups that remain marginalized. These groups tend to include the most at-risk people. Migrant workers, for example, by nature of their status in society, do not have easy access to HIV/AIDS educational resources. If a migrant worker contracts the virus he is less likely than a permanent resident of a city, to know how to prevent HIV from spreading to someone else. Because migrant workers are a main vehicle by which HIV is spread to the general population, this issue of education must be addressed.

Despite recent efforts to de-stigmatize HIV/AIDS, entrenched discrimination towards people who are affected by HIV/AIDS still exists. This stigmatization is dangerous, as it discourages people from adequately learning about the disease, and discourages them from disclosing that they are infected. It also silences dialogues between people, dialogues that could be as effective as government policies in HIV prevention. The government, as well as educators and volunteers, must make a consistent effort towards the de-stigmatization of HIV/AIDS, while also recognizing that this will be a long process.