an Eldis Resource

At the end of 2001, all indications point to the brink of explosive HIV/AIDS epidemics in increasing numbers of areas and populations, with an imminent risk to the widespread dissemination of HIV to the general population through sexual transmission, and potential severe consequences for individual health, community development and social stability. Surveillance and monitoring of HIV trends are done through the systematic collection of HIV prevalence data among selected populations like IDU, female sex workers and patients with sexually transmitted infections (STI). However, national scientifically valid data on current estimates and future trends remain incomplete. Since 1994, when the Chinese Government signed the Paris Declaration at the International AIDS Summit, some significant progress was made with regard toupdating national policies, laws and regulations in various areas pertaining to HIV/AIDS.

The future HIV tragedy is heralded by a most disquieting, albeit often hidden or unnoticed increase in factors underlying and facilitating the spread of HIV. The most frequent modes of HIV transmission in 2001 remain sharing of contaminated needles among injecting drug users (IDU) and unsanitary practices during paid plasma collection. However, the spread of HIV is quickly gaining momentum through sexual intercourse, both heterosexual and homosexual. Underlying vulnerability factors include the widespread lack of knowledge and protective life skills, huge internal labour migration, underprivileged minority communities, relative poverty, youth, and gender inequity.

However, many factors remain that hinder an effective AIDS response in China. These factors are often closely inter-related. They include insufficient political commitment and leadership at many levels of government, insufficient openness when dealing with the epidemic, insufficient resources both human and financial, scarcity of effective policies, lack of an enabling policy environment, and poor governance. AIDS awareness remains low among the public and decision makers.

Involvement by civil society and affected communities remains embryonic, while the overall AIDS response remains far too medical within a health care system in crisis. Several areas will need priority attention if a catastrophic AIDS epidemic is to be averted in China at the start of the new millennium:

• guidance for HIV/AIDS programmes needs to be sought from international consensus on best practices
• emphasis needs to be put on the great urgency for timely implementation of effective HIV/AIDS prevention
• strategic planning of AIDS programmes needs to be based on detailed and dynamic situation and response analyses
• the current chaotic situation in the STI care system needs to be addressed like a priority national disaster
• investment of human and financial resources into AIDS prevention needs to be markedly increased.
• Development of quality AIDS policies critically needs more government openness for acknowledging the seriousness and potential of the epidemic.
• The AIDS response at all levels needs to be widened, and involve multiple sectors beyond the purely medical sector.
• Improving AIDS awareness needs capacity building, training, information dissemination, and efforts at promoting life skills and healthy life styles among youth.
• Supportive policies need to be put into widespread action with respect to community care, treatment and safeguarding the rights of people living with HIV/AIDS.

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