HanMengjie

The HIV/AIDS Epidemic and Response in China: 

The HIV/AIDS Epidemic and Response in China Han Mengjie Deputy Director National Center for AIDS/STD Control and Prevention January 20,2005

Annual Reported HIV/AIDS Cases in China (1985－2004.09): 

Annual Reported HIV/AIDS Cases in China (1985－2004.09)

Brief Statistics on the HIV/AIDS Epidemic in China: 

Brief Statistics on the HIV/AIDS Epidemic in China By the end of September 2004, Cumulative reported HIV infections: 89,067 Cumulative reported AIDS cases: 20,786 Cumulative reported AIDS deaths: 5,024 China CDC and WHO estimated: People Living with HIV/AIDS: 840,000 AIDS patients: 80,000

Geographic Distribution of Cumulative Reported HIV Infections in China (1985-2004.9): 

Geographic Distribution of Cumulative Reported HIV Infections in China (1985-2004.9)

Distribution of HIV Infections by Age: 

Distribution of HIV Infections by Age

Features of the HIV/AIDS Epidemic in China: 

Features of the HIV/AIDS Epidemic in China The epidemic is characterized by a wide disparity between high and low prevalence regions The epidemic is becoming more severe The main HIV transmission route is through injecting drug use. The number of AIDS-related deaths is increasing HIV is spreading from high risk groups to the general population The proportion of female HIV cases are increasing

Stronger Central Government Commitment: 

Stronger Central Government Commitment Chinese President Hu Jintao stated explicitly, “HIV/AIDS prevention, care and treatment is a major issue pertinent to the quality and prosperity of the Chinese nation. The party and government leaders at all levels need to deepen their understanding of the issue and motivate the whole society to deal with it. Starting with education and focusing on prevention, we should be determined to contain the spread of HIV/AIDS.” Premier Wen Jiabao is also very concerned about the HIV/AIDS issue and has repeatedly given instructions to relevant ministries to improve HIV/AIDS prevention and treatment, “…dealing with HIV/AIDS is an urgent and major issue, which is related to the fundamental interests of the whole Chinese nation”.

Slide8: 

Chinese President Hu Jintao shakes hands with an AIDS patient in a Beijing hospital on Nov. 30, 2004.

Slide9: 

On December 1st 2003, Premier Wen Jiabao and Vice Premier Wu Yi went to Beijing Ditan Hospital to meet AIDS patients and health workers

“Four Frees and Care”: 

“Four Frees and Care” Free ARV drugs to AIDS patients who are rural residents or people with financial difficulties living in urban areas; Free Voluntary Counseling and Testing (VCT); Free drugs to HIV infected pregnant women to prevent mother-to-child transmission, and HIV testing of newborn babies; Free schooling for children orphaned by AIDS; Care and economic assistance to the households of people living with HIV/AIDS.

Slide11: 

In July, Premier Wen Jiabao signed an important proclamation "Joint Efforts for Effective Prevention and Control of HIV/AIDS" outlining the Chinese Government's new initiatives in response to HIV/AIDS.

Slide12: 

China’s Medium-and Long-Term Program for the Prevention and Control of AIDS (1998-2010). State Council, 1998 China 5 Year Action Plan to Control HIV/AIDS (2001-2005), 2001 State Council’s Call for Intensifying HIV/AIDS Control Programs, 2004 Three National Strategic Policy Plans

Slide13: 

Director ：Wu Yi (Vice Premier of the State Council) Deputy Director：Gao Qiang (Executive Vice Health Minister) Xu Shaoshi (Deputy Secretary-General, State Council） Members：23 Vice Ministers from relevant ministries and organizations and 7 provincial governors The Office is located in the MOH: Director of the Office: Wang Longde, Vice Health Minister Deputy Director of the Office: Qi Xiaoqiu (MOH) Shen Jie (China CDC) State Council AIDS Committee （State Council Office 2004）

National AIDS ConferenceApril 6th – 7th, 2004: 

National AIDS Conference April 6th – 7th, 2004 Vice Premier Wu Yi, gave the meeting strong guiding statements at the opening of the meeting with her new ideas for HIV/AIDS control in China Conference attendees： Vice Governors from 31 Provinces, Autonomous Regions and Municipalities The Ministers of all relevant ministries Directors of all Provincial Health, Finance, Police, and Civil Affairs Bureaus National HIV/AIDS Expert Panel WHO, UNAIDS, and UNICEF

Seven Requirements in State Council’s Call: 

Seven Requirements in State Council’s Call 1. To strengthen government leadership and clarify responsibilities 2. To emphasize prevention as a top priority and implement comprehensive programs 3. To improve surveillance and standardize case reporting

Seven Requirements in State Council’s Call: 

Seven Requirements in State Council’s Call 4. To implement the policy of social relief and ensure the supply of medicines 5. To increase and ensure the dedication of funds for HIV/AIDS programs 6. To improve treatment and care for patients with HIV/AIDS and to provide social supports for them 7. To facilitate international cooperation and enhance the capacity to respond to the epidemic

National HIV/AIDS Policy initiatives in 2004: 

National HIV/AIDS Policy initiatives in 2004 Notice on HIV/ADIS Prevention IEC Guidelines 2004-2008(State Council AIDS Working Committee Office) Notice on Key Messages on HIV/AIDS Prevention and Control( Publicity Department of the central Committee of the Chinese Communist Party and Ministry of Health) Notice on Free Voluntary Counseling and Testing( Ministry of Health and Ministry of Finance) Notice on ARV Treatment Management (Ministry of Health and State Administration of Traditional Chinese Medicine)

National HIV/AIDS Policy initiatives in 2004: 

National HIV/AIDS Policy initiatives in 2004 Notice on Implementing the Policy on ARV Treatment (Ministry of Labour and Social Security) Notice on Strengthening Assistance to Poor People Living with HIV/AIDS (PLWHA), Families of PLWHA and Orphans (Ministry of Labour and Social Affairs) Notice on Establishing a Task Force on Interventions among High Risk Groups by Centres of Disease Control at All Levels (Ministry of Health) Implementation Guidelines on Condom Promotion for Preventing HIV/AIDS (Ministry of Health and Five Other National Departments)

National HIV/AIDS Policy initiatives in 2004: 

National HIV/AIDS Policy initiatives in 2004 Notice on Directive Principles of Protecting Medical Staff from Occupational Exposure to HIV/AIDS (Ministry of Health) Notice on Professional Training on Infectious Diseases, including HIV/AIDS for Medical Staff (Ministry of Health) Notice on Strengthening HIV/AIDS Prevention and Control in All Places for Re-education through Labour (Ministry of Justice and Ministry of Health)

Slide20: 

The Ministry of Finance provided specific financial support for HIV/AIDS Control Programs in Zhumadian Prefecture, Henan and Dehong Prefecture, Yunnan. MOH【2004】49 The Ministry of Finance provided specific financial support for HIV/AIDS Control Programs in 15 provinces（MOH and Ministry of Finance 【2004】87） Increased Central Government Financial Support to Local Provinces for HIV/AIDS Control

Slide21: 

The Ministry of Health and the Ministry of Finance together issued the “Regulation of Free Voluntary, Counseling and Testing for HIV/AIDS” and the “Measures for Management of Drug Treatment of HIV/AIDS and Common OIs at No/Reduced Charge” These regulations specified the responsibilities and mission of the relevant institutional actors for programmatic implementation, organization, management, technical supervision, monitoring and evaluation of VCT and ARV therapy. Development, Publication and Distribution of Regulations on ARV Treatment and Voluntary Counseling and Testing （MOH & CDC 2004）

China Comprehensive AIDS RESponse- China CARES: 

China Comprehensive AIDS RESponse - China CARES Components: First phase designates 51 counties in 11 provinces initiated in 2003 Second phase designates 76 counties in 23 provinces initiated in 2004 There are in total 127 counties in 28 provinces covered by the program

Slide23: 

Education: HIV/AIDS awareness is still low and stigma is a serious barrier to prevention and treatment programs VCT: Among 840,000 HIV infected, only 89,067 were reportedaround 90% of infected individuals are unknown on their status and continue to transmit HIV to their sexual partners or needle sharing partners potentially Treatment: Among 80,000 AIDS cases, and 10,388 are in ARV treatment program; Adherence issues Drug Resistance issues Issues with ARV treatment for high risk groups (drug users and sex workers) Intervention: Successful pilots in collaboration with the World Bank, WHO, etcetera Scale-up issue Challenges

Need for International Collaboration: 

Need for International Collaboration Strategic planning, technical assistance, and protocols to make policy into effective action Training for public health managers and medical workers Scientific monitoring and evaluation to ensure cost efficacy and movement in the right direction

Slide25: 

Thank you