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

vi Assessing HIV/AIDS Initiatives in China
Lack of Financial and Human Resources
A debilitated and dysfunctional public health system, particularly in rural areas where
HIV is hitting hardest, undermines an effective response to HIV/AIDS. The vast majority
of HIV-positive persons and those at highest risk of contracting HIV live in some of the
poorest and most remote regions of the country—such as in Yunnan, Guangxi, Sichuan,
Henan, Anhui, and Xinjiang provinces—further complicating an effective response.
Overall, resources and capacity are lacking at many levels. Medical professionals lack the
expertise and necessary incentives to treat HIV/AIDS patients, as well as the necessary
equipment and technologies to properly diagnose, counsel, treat, monitor, and care for
them. Ancillary treatment, counseling, and social services are not sufficiently available to
those in need.
Blood Supply: Better, but Still Question Marks
Since the mid-1990s, the government has stepped up its efforts to regulate the
commercial blood supply, a move that has reduced the threat of spreading HIV through
unsanitary blood collection methods. In addition, in certain parts of the country, the
government has suspended mandatory blood collection quotas. Relying on voluntary
donations will improve the chances of avoiding tainted blood supplies. Yet these
government efforts may have driven the practice of commercial blood donation
underground with potentially greater risks to donors and recipients. In March 2004, a
CCTV report exposed the mismanagement of a plasma collection station in Deqing
county, Guangdong, where techniques used were similar to those that caused the spread
of HIV in the early to mid-1990s in central China. Reports indicated that by 2003, 15
percent of the blood used in China was collected from sellers and that some 50 illegal
blood stations had to be closed down in late 2004.
HIV Education, Awareness, Prevention, and Testing Still Lag Behind
Greater emphasis is needed on HIV education, awareness, prevention, and testing. Stigma
associated with HIV/AIDS as well as with behaviors that spread HIV remains a major
barrier to successful implementation of many programs—including lingering stigma even
among health care workers.
Encouraging advances have been made in treating HIV/AIDS among rural farmers
who contracted HIV through plasma donation and in preventing the further spread of
HIV through illicit blood donation. However, the government remains poorly equipped to
deal with those who are most at risk of contracting and spreading HIV/AIDS, particularly
highly stigmatized and marginalized populations. HIV-testing capacity is severely
stretched.
Role of Nongovernmental Organizations and Civil Society
Nongovernmental organizations (NGOs), both domestic and international, continue to
walk a fine line in China and need to be constantly cautious and restrained in their
activities to avoid political, legal, and financial complications with local and central
authorities. Although there clearly are bright spots and encouraging preliminary results
from many pilot projects, few have “scaled up” or expanded to provide services to a
wider population.