Executive Summary

Over the past two years, the response to HIV/AIDS across China has intensified, and the Chinese government has strengthened leadership on HIV/AIDS. Effective measures have been launched in each key area of HIV/AIDS prevention, treatment and care work, and the environment for comprehensive work in these areas has improved considerably. This report was jointly prepared by the Ministry of Health of the Peoples Republic o China, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO) to describe the current status of Chinas HIV/AIDS epidemic, progress mad over the past year in Chinas HIV/AIDS response, and ke challenges that need to be addressed to stop the spread of AIDS.

1.Characteristics of Chinas HIV/AIDS Epidemic

In 2003, it was estimated that there were 840,000 people living with HIV/AIDS in China. Since then, the Chinese government has collected more representative data on HIV/AIDS, better estimates of the most at-risk populations have been generated, and improved estimation methods have become available. The latest estimation results indicate that as of the end of 2005, there are approximately 650,000 people currently living with HIV/AIDS in China (range: 540,000 to 760,000). Among these 650,000, there are an estimated 75,000 people living with AIDS (range: 65,000 to 85,000). In 2005, there were an estimated 70,000 new HIV infections (range: 60,000 to 80,000), and there were an estimated 25,000 AIDS deaths (range: 20,000 to 30,000).

Although the 2005 estimate of people living with HIV/AIDS in China is lower than the 2003 estimate, there is no room for complacency. The latest national estimates indicate that HIV/ AIDS remains on the rise in China. New HIV cases are being transmitted primarily through injection drug use (IDU) and sex. More people are developing clinical AIDS, and AIDS-related deaths are on the rise. The epidemic is spreading from high- risk groups to the general population, and there is a potential risk that the epidemic will spread further.

2.Progress in Chinas HIV/AIDS Prevention, Treatment and Care Response
The Chinese government has laid the foundation for a government-led HIV/AIDS prevention, treatment and care response involving multisectoral support and strong societal participation. President Hu Jintao, Premier Wen Jiabao, Vice Premier Wu Yi and other national leaders have visited with AIDS patients in hospitals and in their homes, and have toured highly affected areas, leading by example to raise awareness of HIV/AIDS. The State Council has outlined 9 key measures for HIV/AIDS prevention, treatment and care work. Each level of government has established prevention, treatment and care coordinating mechanisms, and mobilized strong societal and multisectoral support for the HIV/AIDS response.

National HIV/AIDS surveillance and testing efforts have been strengthened, and a web-based disease reporting system has been established. The number of HIV sentinel surveillance sites has been expanded, and improvements have been made to the laboratory screening and free voluntary counseling and testing (VCT) systems. Mass screening has been carried out among key populations, through which many HIV and AIDS cases have been detected.

Across China, a broad range of mass media education activities have been instituted to reduce the social stigma associated with HIV/AIDS. Over 120 million HIV/AIDS information, education and communication (IEC) materials have been distributed, and 34.9 million people have received HIV/AIDS information and face-to-face education. Condom promotion programs have been widely implemented, and 128 methadone clinics and 91 needle and syringe exchange pilot sites have been established. In from voluntary clinical settings, the proportion of blood coming  blood donors has risen from 22% in 1998 to 94.5%  in 2005. Pilot programs for the prevention of mother-to-child transmission of HIV are now underway in 271 counties within 28 provinces and autonomous regions.

Clinical treatment and care are now being actively provided for AIDS patients, and preliminary steps have been taken to address problems around the production and supply of antiretroviral (ARV) drugs. Currently, 20,453 AIDS patients are receiving antiretroviral therapy in 605 counties within 28 provinces. In high HIV prevalence areas, the death rate is beginning to fall as a result. Free education for children made orphans by AIDS and a series of other prevention and care policies are being progressively expanded in accordance with national policy.

Funding from the central government for HIV/AIDS prevention, treatment and care has risen to 800 million RMB ( US $100 million) annually, and local investment has risen to 280 million RMB (US $34.7 million) annually. NGO participation in prevention, treatment and care work is progressively increasing, and international cooperation has been further strengthened.

   3.Challenges and Responses

China is now facing a number of key challenges in HIV/AIDS prevention, treatment and care. In some prefectures and within some government departments, leaders still do not understand enough about the dangers of HIV/AIDS. Implementation of the policy remains uneven. The majority Four Frees and One Care of people living with HIV do not know their status. Mass media education has not been adequate in scope and effectiveness. Coverage of targeted interventions remains low. There are also significant difficulties in implementing policy measures among the migrant population.

Next steps in the HIV/AIDS prevention, treatment and care response include:

 Strengthen HIV/AIDS prevention, treatment and care training for local leaders, formulate prevention, treatment and care work
plans, and implement prevention, treatment and care work according to assigned responsibility

 Ramp up implementation of the Four Frees and One Care policy, disseminate experiences from China CARES , expand The Four Frees and One Care effective prevention, treatment and care interventions …

More details see: 2005 Update on the HIV/AIDS Epidemic and Response in China