Anti-AIDS Action Accelerates

TOWARDS the end of 2013， several foreign-funded AIDS prevention and control programs in China successively wound up. They included the five-year Bill Melinda Gates Foundation Global Health Program， which committed US $50 million to working in partnership with the Chinese government and non-governmental organizations to expand HIV （human immunodeficiency virus） prevention efforts， the Global Fund， the Clinton HIV/ AIDS Initiative （CHAI）， the China Global Fund AIDS Program， and the ChinaMSD HIV/AIDS Public-private Partnership.

This departure left China’s central finance with the task of supplementing the 30 to 50 percent of financial resources towards combating HIV/AIDS that these foreign foundations had contributed. Statistics show that in 2013， this department provided more than 90 percent of the funds necessary to maintain the country’s HIV/AIDS prevention and control efforts. Taking into account support from local budgets， these monies came mainly from China’s central and provincial governments. In 2003， the Chinese government started and gradually expanded the free drugs and treatment program for people living with HIV/AIDS. Reliance on the supply of medicine and treatment for HIV/AIDS in China has hence shifted from foreign aid to the Chinese government. In 2012 it indeed spent RMB 813.48 million on anti-AIDS drugs – 59.36 percent of the country’s total spending on combating AIDS.

Central and Local Governments Take Responsibility

Li Xiang is a hemophiliac from Jilin Province. He became infected with HIV in 1993 from the blood transfusion he received after suffering a gastric hemorrhage. Foreign institutes donated the anti-retroviral drugs he was first prescribed， but each batch contained different quantities， and there was no guarantee of consistent supply. Li’s situation was therefore precarious. Since expansion of the free anti-retroviral drug supply program in 2006， Li can be sure of fixed periodical doses of the drugs he needs. His condition has greatly improved， to the extent that he married and has a child. Procreation for people living with HIV requires close monitoring of the viral load in the blood until it reaches an undetectable level， to ensure that there is no risk of infection. Li， his wife and their one-and-half-year-old son now live as happy a family life as any young couple.

Bill Gates said in 2007 after arriving in China to expand HIV prevention efforts： “China’s epidemic isn’t necessarily unique from a medical perspective – other countries also face AIDS epidemics that are concentrated among high-risk groups but threaten to spread to the general population. What’s remarkable is how in just a few years， the government stopped overlooking HIV/ AIDS and instead made it a top national priority.”

On May 19， 2013 at the 30th International AIDS Candlelight Memorial， the Ministry of Health of China released statistics showing that there are around 500，000 registered cases of people living with HIV and 380，000 of people living with AIDS. In the past 10 years， the number of patients in China receiving free anti-retroviral drugs has risen from zero to more than 200，000. In 2012， 100 or more million people underwent HIV tests.

China first went public with its epidemic status in 2003. The figures were alarming： they showed that there were 840，000 HIV carriers and 80，000 AIDS patients， making China the worst affected country in Asia next to India. People infected with HIV generally develop AIDS within seven to 10 years. Without timely anti-retroviral treatment their weak immune system makes them extremely vulnerable to disease， to the extent of not being able to fi ght off colds or flu. If AIDS were to continue unchecked， it could wreck a society within three generations， according to a World Bank report published that year.

The early epidemics were concentrated in Henan and Anhui provinces， according to Lü Fan from the National Center for AIDS/STD Control and Prevention. The main victims of HIV infection were intravenous drug users and people who had sold their blood.

At that time， the Henan provincial government instituted free testing and treatment， and free schooling for AIDS orphans. Li Keqiang， then secretary of the CPC Henan Provincial Committee， announced that funds would be allocated to setting up city-level blood donation stations， in a bid to guarantee sources of uninfected blood.

Trials proved effective. In early 2006 the Chinese government promulgated the AIDS Prevention and Control Regulations. They constitute legislation on free testing， treatment， and antiretroviral drugs for HIV-infected pregnant women to prevent mother-to-child transmission， free schooling for AIDS orphans， and living subsidies for AIDS patients.

Since 2008， China has incorporated all HIV/AIDS-related data， such as reported HIV/AIDS cases， interventions to prevent and control HIV infections among high-risk groups， and anti-retroviral treatment into one national system， according to Wu Zunyou， director of the National Center for AIDS/STD Control and Prevention. China also has unified nationwide management of HIV/AIDS patients， whereby upon establishing that a person is infected， the health system follows up and provides life-long service.

Today， China carries out interven- tions among 125，000 people in high-risk groups every month. The effectiveness of this measure is apparent in the fall in reported new HIV infections – from 70，000 in 2005 to 48，000 in 2011.

Moreover， Traditional Chinese Medicine （TCM） has demonstrated great potential in treating AIDS since trials started in the mid-90s. Since 2004， China’s central finance has allocated RMB 90 million to providing free TCM treatment for around 6，000 AIDS patients. It has been proven highly effi cacious at low cost.

Power of NGOs

The government’s growing openness and support for AIDS patients， along with the involvement of foreign founda- tions， has drawn the participation in AIDS prevention and control of certain domestic NGOs.

In 1990， the Beijing You’an Hospital， affiliated with the Capital Medical University， became the first medical institution to receive AIDS patients. In 1998 the hospital established the Beijing You’an Loving Home – the fi rst NGO in China to provide care to AIDS patients. The institute has formed a mature working system where doctors， nurses and volunteers living with AIDS all work together to provide service and training in the care of AIDS patients.

Six workers in the Haihe Star， an AIDS relief organization in Tianjin， give consultations in an apartment building to people living with HIV and those in high-risk groups. Li Hu， who previously ran his own human resource company， was diagnosed HIV positive in 2006. He is in charge of the organization. Since 2007， Li has used his personal savings to establish and operate the Haihe Star organization. His aim is to help AIDS patients build self-confidence； also to eliminate discrimination and prejudice by reassuring people that they run no risk of HIV infection from shaking hands with or having dinner with a person living with HIV/AIDS.

In October 2012， a hospital in Tianjin refused to perform surgery for lung cancer on a 25-year-old male resident of the municipality， because he is HIV positive. The event triggered heated social debates nationwide. The man fi nally received treatment after Li Hu called on the general public for their support. On November 26， Vice Premier Li Keqiang， who is also head of the State Council Commission on the Prevention and Treatment of HIV/AIDS， held a discussion with a group of NGO representatives， Li Hu among them.

Li Keqiang stated during the meeting that the government would purchase the services of experienced NGOs and so help them resolve financial difficulties. The logic behind this move is that the joint efforts of NGOs， the Center for Disease Control （CDC）， and public hospitals will make combating AIDS more effective. Li also proposed that the State Council establish an anti-AIDS foundation to support the work of NGOs in this regard.

Li Hu is now in the throes of establishing a website aimed at safeguarding the legal rights of people living with HIV/AIDS by encouraging more lawyers to help AIDS victims. The winding-up of certain international programs made other NGOs shy away from the area. But Li Hu is determined， and has a bold plan in mind. “Maybe I’ll open a restaurant where the chefs and waiters are all HIV positive. Would you come？” Li asked.

Inspired by the operation model of international anti-AIDS organizations， the Chinese government has shown its support for NGOs in recent years by purchasing， in accordance with Li Keqiang’s statement， their services. Ministry of Health officials revealed that the ministry would promulgate documents facilitating the registration of anti-AIDS NGOs， and continue to support the participation of NGOs in their fi ght against the epidemic.

Dispel Discrimination

Wang Mengcai， a farmer from Northeast China， was diagnosed with AIDS in 2003， having become infected with HIV through a blood transfusion. At that time， the mere mention of AIDS kindled widespread fear and dread. Consequently Wang dared not leave his home for six months.

After undergoing a course of antiretroviral drugs， and with the help of an AIDS relief organization， Wang opened a small farm machinery workshop that sells farm machinery parts and does repairs. A few years later， he bought a car and became a self-employed taxi driver. Consequently his living standards have significantly improved. In 2011， Wang Mengcai was elected the head of his village.

The government stipulates in the AIDS Prevention and Control Regulations that the law protects the rights of people living with HIV/AIDS and their family members to marry， work， and receive education and healthcare. But people are still generally unwilling to come into close contact with AIDS patients. When giving interviews， Wang Mengcai is open about his condition as a person living with AIDS， but nonetheless requested this journalist not to mention the name of his hometown.

To dispel discrimination against people living with AIDS， on the day prior to the World AIDS Day in 2012， Xi Jinping， general secretary of the CPC Central Committee， visited a group of people living with HIV/AIDS in a community clinic in Beijing. He said that AIDS is less terrible in itself than the ignorance about HIV/AIDS that spawns prejudice against those infected. He concluded by saying that people living with HIV/AIDS are fellow human beings that deserve all the love， compassion and respect that society can muster.

Wu Zunyou pinpointed the challenges that China faces in AIDS prevention and control. Besides the shortages of professional healthcare specialists， constraints wrought by preconceived ideas about AIDS， and the enormous risks that China’s floating population poses， he cited prejudice as the biggest obstacle. It is prejudice and discrimination that makes people living with HIV/AIDS and those at high risk reluctant to make use of the testing and early treatment programs that the government has set up.

The Chinese government aims to reduce new cases of AIDS by 25 percent as compared to those in 2010， and to reduce AIDS deaths by 30 percent. This means the number of people in China living with HIV/AIDS will fall to 1.2 million by the end of 2015. Wu Zunyou believes that， with the joint efforts of government and all sectors of society， most of the existent challenges can be overcome.