Strong national leadership from the Chinese government and Communist Party is needed if the country is to prevent a massive explosion of new HIV cases, according to an article published in the 28 June 2002 edition of Science.
The recommendation comes hard on the heals of UNAIDS report suggesting that 1.5 million Chinese are currently living with HIV and as many as 10 million could be infected with the virus by the end of the decade.
The authors of the Science article recommend that Chinese local governments commence HIV prevention and care programmes founded on international best practices. However, the authors note that as China has a high level of government infrastructure and control, and without backing at the highest level from the national government and Communist Party, it is highly unlikely that local administrations will initiate HIV prevention and treatment schemes.
The recommended steps are likely to prove challenging for China's government and society. They include:
- Legislation to protect the rights and confidentiality of people infected with HIV, and the establishment of a confidential HIV testing and counselling service
- A national HIV public education programme directed at every citizen in China, but particularly those at highest risk, on safer sex and drug use. The national propaganda infrastructure should be used
- Sex education for young people must be started as soon as possible, and messages should go beyond traditional abstinence advice and include accurate and explicit information on safer sex. Young people should be involved in these efforts rather than just being their targets
- Prevention efforts should be targeted at drug users and sex workers and clean needle schemes should be started
- Sex workers, bar owners, and their clients should collaborate on condom promotion initiatives, similar to the Thai 100% condom programme
- All health workers should be trained in safer injecting practices and learn about HIV/AIDS opportunistic infections and how to prevent mother-to-baby transmission of the virus
- A plan should be developed to provide treatment and care for all people infected with HIV, especially as Chinese generic drug manufacturers have said they can provide antiretroviral therapy for $360 per year.
The authors note that China may face particular difficulties in developing prevention and care activities unless it can "reach out to new civil society organizations [sic] working on AIDS, as well as people living with AIDS and [to] include them routinely in policy and evaluation." At present China has few visible community based organisations independent of government in any sphere.
Failing to act now could result in dire consequences, warn the authors, “quickly unravelling” the “steady and dynamic economic growth” of the past 20 years.
Reference:
Kaufman J et al. China and AIDS – The time to act is now. Science 296: 2320-2324, 2002.