Hunger Strike for AIDS (11): China summary information concerning the current HIV/AIDs situation

空腹健身运动 

Hunger Strike for AIDS

Hunger Strike for AIDS (11):

China summary information concerning the current HIV/AIDs situation

HungerStrikeforAIDS.org Published on 2008, Nov, 25th：.

December 1st 2008, this year’s World’s AIDS Day, HIV/AIDs activists and supporters from around the world will be carrying out “Hunger Strike for AIDS” for a period of 24 hours. The theme this year is: the second “Hunger Strike for AIDS”, focusing on caring for China AIDS NGOs and activists, and starting a donation drive to set up the “China Non-governmental Red Ribbon Award”. We’ll be engaging in a four-week long activities in the hopes to collecting 4000USD for this Award. Please support and participate in this effort with us. Please visit the relevant website: www.HungerStrikeforAIDS.org

Up to 2008, November 25^th, we have collected registration from 64 individuals from 12 countries. Collected donations include 50 USD and 1600RMB.

We are very sorry , and thank you very much for our volunteers who have organized so perfect information in the limited period of time.

Brief overview:

The people’s republic of China is one of the most populous nations in the world, with an estimated population of 1.328 billion[1].

The first HIV/AIDS case was discovered in China in 1985, from a foreign tourist who later developed AIDS-related complications and died in a local hospital. During the early stages of the AIDS epidemic the Health Ministry concentrated its prevention efforts on the risk of infection from abroad. In 1986 it announced that it planned to test all foreign students for AIDS who had been in the country for more than a year, and students entering China would require a certificate from their country of origin testifying that they were not infected with HIV⁸. Although a National Program for AIDS Prevention and Control was set up in 1987, the Public Health Authorities reported that AIDS would not become established as homosexuality and “abnormal” sexuality – thought to be the main causes of the spread of HIV – were a “limited” problem[2].

By the end of 1989, there were 172 identified case of HIV/AIDs, most of which came from the population of drug-users. These cases signaled the official beginning of a HIV/AIDs epidemic in China[3]. By 2007, the international estimate of individuals living with HIV/AIDs in China amounts to 700 000, or 0.1% if the total population. This number includes 690,000 adults over 15yrs and approximately 10,000 children. Of the adult population, 200,000 of which are female[4]. In 2007, 39,000 adults and children are estimated to have died from AIDs related complications, while there exist no reliable estimates available on the number of orphaned AIDs children in the country[5]. Although UNAIDS reports that China’s HIV epidemic remains one of low prevalence overall (0.1%), there are pockets of high infection among specific sub-populations and there is danger of the epidemic spreading further into the general population[6].

In the Chinese HIV/AIDs epidemic, the main routes of infection occur via: heterosexual intercourse, injected-drug users, contamination of blood and sero-products and an increasing number of MSM infections in recent years. In 2007, there were 50,000 new cases of infection identified, and HIV/AIDs caused deaths were numbered at 20,000. Of the 50,000 new incidences, the percentage breakdowns according to method of infection are as follows: heterosexual relationships (44.7%), MSM (12.2%), injected-drug use (42%) and vertical mother-infant infection (1.1%). The general trend of infection by geographical regions indicates a distinct pattern between urban and rural residents, with a heavier concentration of infected individuals from the rural areas of China. Moreover, there is a disproportionate number of injecting drug users who are infected with HIV/AIDs, the percentage reach over 40% in injecting drug users in the provinces of Yunan and Xinjiang.

Coverage of anti-retroviral drugs:

As of the end of 2007, there are an estimated 19% of the total population living with HIV/AIDs in China receive coverage of anti-retroviral therapy. Of the number of infected expecting mothers, only approximately 9% of them receive anti-retroviral therapy for the prevention of mother-to-child transmission[7].

Government solutions:

There was a notable shift in government response to the epidemic in the new millennium. On World AIDS Day 2001, stories and testimonials of those infected with HIV alongside a television drama about AIDS reflected a far greater willingness to discuss the emerging epidemic. The same year, the “China Plan of Action to Contain, Prevent and Control HIV/AIDS (2001-2005)” was published, which included plans to screen all blood for clinical use for HIV.

In 2003, the Health Minister’s change in attitude was evident, it is widely felt that the 2003 SARS epidemic prompted the change as it demonstrated to the government the impact public health could have on social and economic stability. He described the fight against AIDS as a “long-term war” and, as well as showing a new willingness to accept overseas assistance, requested that China’s AIDS budget of US$12.5 million be doubled. On World AIDS Day 2003, Wen Jiabao became the first Chinese premier to shake hands with an HIV-positive person.

According to the Ministry of Health, between 2003 and 2007, China provided free antiretroviral therapy to 37,497 people living with AIDS including 771 HIV positive children⁸¹. The WHO estimated that in 2007 China was supplying 19% of those in need of treatment with antiretroviral therapy. In reality, although the treatment itself is free, patients often have to pay for associated clinical tests.

Funding for treatment programmes comes from central and national programmes, as well as international donors. In 2003, the Global Fund to Fight AIDS, Tuberculosis and Malaria awarded China a five-year grant to strengthen the operational system of the free antiretroviral treatment programme. Funding from central government increased from very little in 2000 to US$185 in 2006.

Challenges:

Amongst the most affected groups, 45% of IDUs and 25% of sex workers were receiving HIV/AIDS treatment in 2006. Challenges in treating these populations remain and include stigma and discrimination in the community and in the health care system, migratory work patterns, and commonly chaotic social circumstances. Additionally many IDUs spend time in drug detention centres where antiretroviral therapy is currently not available. This means that those people that are already receiving anti-retrovirals risk interruption of their therapy and consequent resistance if they are incarcerated or otherwise detained.

Migrant workers have been identified as a population who are under-served by treatment program, as people are only usually allowed to access medical care in their official area of residency.

Another challenge to treating those with HIV in China is the weakening health system, which suffers from inadequate human and physical resources. Since the late 1970s government funding for health service providers has decreased with less money going to local providers. Local governments are mandated to support medical care for HIV/ADS patients, but inadequate funding discourages local governments from identifying and treating HIV/AIDS patients, as the more patients they identify the more expenditure they have.

[1] WHO Country epidemiological report (2008), accessed through UNAIDS on 11/11/2008. http://www.unaids.org/en/KnowledgeCentre/HIVData/Epidemiology/epifactsheets.asp#C

[2] http://www.avert.org/aidschina.htm

[3] Accessed through: http://zh.wikipedia.org/

[4] WHO Country epidemiological report (2008), accessed through UNAIDS on 11/11/2008. http://www.unaids.org/en/KnowledgeCentre/HIVData/Epidemiology/epifactsheets.asp#C

[5] WHO Country epidemiological report (2008), accessed through UNAIDS on 11/11/2008. http://www.unaids.org/en/KnowledgeCentre/HIVData/Epidemiology/epifactsheets.asp#C

[6] http://www.avert.org/aidschina.htm

[7] WHO Country epidemiological report (2008), accessed through UNAIDS on 11/11/2008. http://www.unaids.org/en/KnowledgeCentre/HIVData/Epidemiology/epifactsheets.asp#C