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　　At the International AIDS Conference, China showcases its progress in dealing with the disease
　　Twenty-five years after the first report of what has become known as AIDS, representatives of the global AIDS community gathered in Toronto, Canada, to reaffirm their commitments to fight this deadly epidemic.
　　
　　Over 26,000 scientists, clinicians, policymakers, people living with HIV/AIDS, community leaders and caregivers from more than 170 countries and regions attended the biennial International AIDS Conference on August 13-18. On the speakers list were such high-profile figures as former U.S. President Bill Clinton and Microsoft co-founder Bill Gates. The latter named stopping AIDS as the “top priority of the Gates Foundation,” a charity he founded with his wife, Melinda Gates.
　　Themed “Time to Deliver,” the conference featured the presentation of more than 4,500 abstracts and an array of community and cultural activities. Participants addressed a wide range of issues, including the search for a vaccine, the stigma around HIV (human immunodeficiency virus) and AIDS (acquired immune deficiency syndrome) and circumcision as a form of prevention, calling for an accelerated pace on HIV prevention, care and treatment programs in resource-limited settings.
　　
　　Taking the initiative
　　
　　Despite persistent efforts made over the past quarter of a century, experts said the global anti-AIDS campaign, which has somewhat slowed the epidemic, is still beset with difficulties.
　　Shanghai-based Jiefang Daily identified three major challenges in a recent article. The first is the shortage of funds. Last year, $8 billion was pumped into the fight against the epidemic around the world. However, the United Nations Program on HIV/AIDS (UNAIDS) estimated that at least $15 billion is still needed to treat the disease.
　　Weak awareness about AIDS prevention among “key groups” also poses a challenge. The newspaper quoted experts as saying priority should be given to educating females and male homosexuals about AIDS, but that has not happened.
　　In addition, the article pointed out that developed countries have been slow in honoring their commitments to offering financial assistance to countries where the disease is prevalent.
　　According to UNAIDS, at the end of 2005, an estimated 39 million people worldwide were living with HIV/AIDS, the vast majority in developing countries. Last year, 4.1 million people became newly infected with the virus, and 2.8 million died of AIDS-related illnesses.
　　Of the 6.8 million people living with HIV in low- and middle-income countries who are in need of antiretroviral medication, only 24 percent or 1.6 million have access. The treatment access gap is even greater for children under 15. Treatment is available only to 8-13 percent of the 800,000 HIV-infected children. Only 4-16 percent of people at high risk for infection have access to effective prevention.
　　In China, the rate of HIV infection is low, but given its large population, a daunting picture might emerge in terms of raw numbers, experts say.
　　Official statistics released by China’s Ministry of Health early this year show that China had an estimated 650,000 people living with the HIV virus by the end of 2005, including 75,000 AIDS patients. In 2005, some 70,000 were newly infected, nearly half of whom caught the virus through unsafe sex. The majority of the other new cases involved drug abusers.
　　“The Chinese Government is strongly committed to fighting HIV/AIDS,” Wu Zunyou, Director of the National Center for AIDS/STD Control and Prevention at the Chinese Center for Disease Control and Prevention, declared in a speech at the conference. “Our goal is that by 2010, China will limit the number of people living with HIV/AIDS to no more than 1.5 million.”
　　In 2003, the government started the “four frees and one care” program, meaning to offer free antiretroviral treatment, free prevention of mother-to-child transmission, free voluntary counseling and testing, free schooling for children orphaned by AIDS, and care and economic assistance to affected households. Even free condoms, methadone and clean syringes have been made available to high-risk groups.
　　Li Dun, a professor at Tsinghua University and a prominent AIDS expert, said the Chinese Government has intensified its campaign against AIDS year by year. “No other disease in China has ever attracted such a large amount of investment,” he said.
　　President Hu Jintao visited AIDS patients in Beijing in December 2004. The following year, Premier Wen Jiabao spent the Spring Festival with AIDS patients and their families in central China’s Henan Province. These symbolic moves are believed to speak of the government’s concern for those who live with HIV/AIDS.
　　The nongovernmental sector is also encouraged to take part. Chen Xiaohong, Vice Minister of Health, told a nongovernmental organization (NGO) forum during the International AIDS Conference that beginning from 2002, the state allocates some 6 million yuan annually to sponsor NGOs and the general public to conduct AIDS prevention and control through a social mobilization program under the HIV/AIDS Prevention and Control Committee of the State Council.
　　To date, 231 projects have been approved and more than 20 million yuan has been granted. These projects are carried out in over 150 counties in China’s 30 provinces, municipalities and autonomous regions.
　　At the same time, the Chinese Government used the $3.75 million it received from the Global Fund’s anti-AIDS program in China to support 72 Chinese NGOs. These organizations are working on such areas as providing care and treatment to HIV-infected people and AIDS patients as well as their families, helping to enhance the work capacity of HIV-infected people, organizing health promotion and behavioral communication activities among migrants, young people and drug users and dispelling the fear of and discrimination against AIDS in society.
　　However, Chen said China’s NGOs are still lagging and therefore need to go through capacity building and expand their scope of work. The Ministry of Health will establish a collaborative mechanism with the NGOs to give them new impetus. At the same time, cooperation with Chinese organizations in other countries and regions will also be encouraged to explore ways of controlling AIDS at the community level.
　　
　　World recognition
　　
　　China was commended by top officials at the International AIDS Conference for its strong political commitments and action in the fight against HIV/AIDS.
　　“The Chinese Government and the people of the country have, in a short period of time, demonstrated a real commitment to fighting HIV/AIDS, and the resources that they have mobilized over the last couple of years are very impressive,” Helene Gayle, President of the International AIDS Society, told Xinhua News Agency.
　　Gayle, also co-chair of the conference, said China has done a good job, compared with many countries where the mobilization of resources takes a long time.
　　However, China’s approach toward HIV/AIDS has not been static. According to Li from Tsinghua University, there have been four major policy shifts over the past 20 years.
　　When AIDS was first discovered in China, the government believed it was a social vice from foreign countries. It tightened the entry examination in an attempt to prevent the disease from spreading to China.
　　Later, as more AIDS cases were reported in the country, the government responded by launching a crackdown on drug use and prostitution, believing this policy would curb the spread of the disease.
　　In the mid-1990s, when many people contacted HIV from selling blood, the government enacted the Blood Donation Law and a series of regulations for blood centers. At that time, the thinking went, as long as blood was properly managed, the disease would be held at bay.
　　The latest policy change took place in 2003 with the unveiling of the “four frees and one care” program. Also, the AIDS Prevention and Treatment Regulations, issued by the State Council, came into force in March this year.
　　Li noted that apart from the changing perception of HIV/AIDS among the Chinese, the external influence of the UN and foreign governments has played a remarkable role in shaping China’s policy toward HIV/AIDS. However, this influence is not always positive.
　　He pointed out that almost all AIDS-control programs in China are devised by foreign experts. Many officials in charge of AIDS control in international organizations working in China do not speak Chinese and cannot communicate effectively with the Chinese. Their programs can be detached from reality, he noted, adding that the insubstantial programs hardly bring any real benefits to the disadvantaged high-risk groups.
　　He called on Chinese volunteers and NGOs to establish good governance and lessen their dependency on foreign foundations. “Old operational modes in international cooperation projects and government-sponsored projects should be dumped,” he asserted. “At least 40 percent of the investment should go to the grassroots.”

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