Assessing HIV/AIDS Initiatives in China - Center for Strategic and ...

Bates Gill 33
organizations can play a critical role in providing much-needed services such as
counseling, harm-reduction activities, in-home treatment and health care, and job
training.
Second, the comprehensive, full-spectrum approach requires a broader range of
expertise than any single government agency or major international NGO can deliver.
This approach will bring in the coordinated expertise of peer educators, social welfare
specialists, counselors, medical laboratory technicians, doctors, nurses, employment
counselors, foreign experts, public security personnel, hospital and clinical staff, poverty
alleviation specialists, and local government officials as well as vendors who can provide
the necessary training in many of these areas. This approach will also require significant
project management skills at the local level to provide oversight and guidance and to
assure overall success.
As such, the Chinese government and international NGOs need to consider how to
effectively and acceptably increase the participation of NGOs in a comprehensive anti-
HIV strategy. This approach could include an increase in government funding for privatesector
implementers and the outsourcing of non-core activities to organizations that have
core expertise, such as microfinance and animal husbandry. At a minimum, such an
approach calls for a major expansion in the use of peer educators and counselors for
IDUs, CSWs, MSM, and people living with HIV and AIDS.
• DEEPEN COORDINATION ACROSS GOVERNMENT AGENCIES AND KEY ACTORS.
This more strategic and comprehensive approach, drawing together and gaining
synergies from a greater range of inputs and actors, will absolutely require a far greater
degree of coordination across government agencies and among key actors than has been
the case.
Because the needs of high-risk individuals, particularly IDUs, are high, and because
such individuals are outside of the formal social and economic systems, they often fall
between the lines of responsibility of individual government agencies or NGOs. Drug
users who are HIV positive face significant life challenges, often due to deteriorating
health, little or no regular income, and the pressures of supporting families and
maintaining expensive drug habits. In order to successfully address one need, other needs
must also be considered and addressed to ensure the success of any individual program.
Unfortunately, different agencies and initiatives tasked with providing distinct
services to at-risk populations fail to coordinate or comprehensively link their activities,
and as a result, marginalized individuals do not receive the support that they need,
ultimately undermining effective HIV/AIDS treatment and prevention. Poor coordination
and weak cooperation is not limited to different bureaucracies or xitongs. Disconnects are
evident between different elements of the health system, particularly the gap between the
government-funded public health system, including the Center for Disease Control and
Prevention and antiepidemic stations, and the increasingly privatized medical system of
hospitals, local clinics, and doctors’ practices.
Coordination between NGOs is often lacking, which undermines the very purposes
and goals that like-minded organizations seek to achieve. In one case, an outlet that sells
condoms reported a significant drop in sales due to another NGO opening operations in
the area and distributing large numbers of free condoms. Additionally, many international