State Council Notice on Strengthening HIV/AIDS Prevention and Control

Provinces, autonomous regions, municipalities, ministries and  institutes attached to the State Council：

Since the first AIDS case was reported in 1985 in China, provinces and government departments have under the leadership of the Party and the State Council studied, developed and implemented HIV/AIDS prevention plans, clarified HIV/AIDS policies, implemented health education, strengthened treatment, and, achieved progress on HIV/AIDS prevention and control.

In general, the HIV/AIDS epidemic is however still spreading rapidly in China. In certain regions and sectors of society there is lack of coverage and awareness of HIV/AIDS education and interventions, down-to-earth surveillance of HIV/AIDS, rigorous laws and regulations that are conducive to work on HIV/AIDS, technical capacities for HIV/AIDS prevention and control, and, awareness of the importance to contain the epidemic.

Strengthening HIV/AIDS prevention and control is necessary in seven areas:

                       I.      Strengthen leadership and clarify roles and responsibilities [A1] 

                    II.      Adhere to the principle of prevention and implement comprehensive prevention and management

                 III.      Strengthen HIV/AIDS surveillance and standardize epidemic reporting

                 IV.      Implement treatment and support policies and facilitate the provision of anti-retroviral drugs

                    V.      Strengthen investments and ensure availability of funding

                 VI.      Provide care and support and strengthen the management of AIDS patients

              VII.      Conduct international cooperation and improve the prevention and treatment capacities

I.    Strengthen leadership and clarify roles and responsibilities

HIV/AIDS prevention and control is linked to economic development, social stability, and national security and prosperity. Long-term commitment to respond to HIV/AIDS is hence necessary. In order to respond to and contain HIV/AIDS in China, local governments must: realize the importance and urgent need for prevention and control; integrate HIV/AIDS into the routine government agenda as an important item; strengthen the leadership, streamline and coordinate efforts; and, urgently and effectively respond to and contain HIV/AIDS, which is a priority linked to the interest and benefit of China and its people.

Local governments are required t develop detailed HIV prevention plans and objectives; implement accountability mechanisms for work on HIV prevention; and, integrate HIV/AIDS into government performance evaluation. The following should be taken into consideration: China’s National Mid and Long-Term Strategic Plan for HIV/AIDS Prevention and Control, 1998-2010 (State Council Document, 1998, No. 38) and State Council Notice on China HIV/AIDS Containment, Prevention and Control Action Plan, 2001-2005, (State Council General Office Document. 2001, No. 40).

In provinces, autonomous regions and municipalities with advanced HIV/AIDS epidemics, HIV/AIDS prevention and control working committees are requested to be established. The committees should be led by the chief government leader and composed of leaders from relevant government sectors. When necessary, other areas should also establish or improve the HIV/AIDS prevention and control coordinating mechanism, implement HIV/AIDS policies and measures, address urgent and unique HIV/AIDS problems, and make sure of responsibility of tasks and implementation of actions. 

The State Council HIV/AIDS Prevention and Control Committee will organize and conduct national supervision of HIV prevention activities annually. Individuals with assigned responsibilities with regard to HIV/AIDS will be strictly punished if they do not: perform according to set standards and identified objectives; take appropriate measures to respond to HIV/AIDS; portray accurately the scale and challenge of HIV/AIDS; or, prevent the continuing spread of HIV/AIDS.

II.   Adhere to the principle of prevention and implement comprehensive prevention and management

1.      Health education and behavioral interventions on large scale

As a principle, health education and HIV/AIDS awareness and knowledge campaigns among the general population and the rural population should be conducted and promoted. The general population needs to learn about and understand HIV/AIDS transmission routes and prevention messages in order to protect themselves from HIV infection. The general population also need to learn about how to pursue healthy life styles, fight and mitigate the impacts of stigma and discrimination against people living with and affected by HIV/AIDS.

The role should be prominent within the government, schools, enterprises, and civil society. Full use should be made of media like broadcast, television, newspapers, internet, etc. The media and publicity departments at central and local government levels are required to prioritize and promote: education on HIV prevention; development and implementation of specific HIV/AIDS publicity plans; and, unpaid blood donation. The media and publicity departments also need to regularly broadcast and publish non-profit advertisements about HIV/AIDS prevention and unpaid blood donation. Central and local governments and publicity departments are required to strengthen HIV/AIDS prevention education, guidance and supervision.

Agriculture departments are required to make full use of “Three Approaches Downward to Rural Community” to spread knowledge on HIV prevention and promote unpaid blood donation in rural areas. Agriculture departments are also required to cooperate with health departments to compile and print education materials that are appropriate for rural populations in order to achieve the goal of: every township being equipped with HIV/AIDS education materials; every village having posters with HIV/AIDS prevention messages; and, every family having HIV/AIDS brochures. Townships and villages in areas with severe HIV/AIDS epidemics should be supported to establish education boards on HIV prevention and promotion of unpaid blood donation. Agriculture departments are required to cooperate with relevant departments in order to make full use of opportunities to promote HIV/AIDS education messages and unpaid blood donation during rural trade markets and holidays, where large groups of people gather.

Education departments are required to integrate HIV/AIDS education and unpaid blood donation into the education plan of general middle schools, vocational middle schools, and colleges and universities. These learning institutions are required to teach HIV prevention and promote unpaid blood donation persistently and continuously.

Departments such as Railways, Communications, Civil Aviation, Quality Supervision, Inspection and Quarantine are required to promote HIV prevention knowledge and unpaid blood donation among passengers in waiting halls of bus stations, railways, ports, and airports. Border areas and areas with advanced HIV/AIDS epidemics are required to set up education boards on HIV/AIDS prevention knowledge, promote unpaid blood donation, and distribute health education materials. Messages on HIV/AIDS prevention and unpaid blood donation are required to be broadcast (where necessary technology is available) during appropriate hours.

Culture and Industrial and Commercial Administrative departments are required to strengthen the management of entertainment settings. Entertainment settings are required to display posters and make available education materials on HIV/AIDS, and actively cooperate with relevant departments to carry out HIV prevention education. Civil society and mass organizations, such as the Labor Union, Youth League, and Women’s Federation, etc., are required to actively develop HIV prevention education.

Health departments are required to cooperate with bureaus of Public Security and Food and Drug Administration to conduct pilot programs on AIDS treatment and drug adherence, needle and syringing exchange, and social marketing of condoms in areas with high HIV prevalence among injecting drug users.

Technical institutes where medical and family planning services are provided are required to provide counseling to their patients, and distribute materials on: health education, HIV prevention and cure, and condom use. Managers of public settings are required to promote condoms, for instance, by setting up condom vending machines. Enterprises and companies that produce and sell condoms are allowed to use commercial network, and networks of the Center for Diseases Control and Family Planning to promote condom use. Relevant departments are required to fully support condom promotion for HIV prevention, and actively organize and implement public advertisements on the role of condoms in HIV prevention.

2.      Law enforcement, strengthened monitoring and supervision

The Health sector is required to strengthen the management of unpaid blood donation according to “China Blood Donation Law” and “Regulation on Blood Products Management”. The Health sector is required to cooperate with civil society and mass organizations such as the Red Cross to mobilize people of appropriate age to donate blood in order to increase the proportion of unpaid blood donation. The Health sector is also required to cooperate with bureaus of Food and Drug Administration and Public Security t strengthen the management of blood collection institutions; strengthen the response against illegal blood selling and collection; punish those who break the law; and stop HIV transmission through blood. In order to prevent nosocomial transmission of HIV, the health sector is required t promote the use of disposable needles and syringes; ensure safety of transfusion materials; improve work related to destroying disposable medical and health materials; and, ensure sterilization of reused medical equipment so as to prevent iatrogenic transmission of HIV.

Public Security bureaus are required to severely crack down on illegal activities such as sex work, drug trafficking, and drug abuse. Public Security bureaus are required to strengthen HIV/AIDS education for drug users who undergo detoxification, sex workers in re-education centers, and urban flowing populations. Bureaus of public security and justice are required to cooperate with relevant sectors in order to conduct HIV/AIDS testing, screening, treatment and education among people detained and within prison settings. The necessary measures required should be taken in order to establish special arrangements for detained or imprisoned people living with HIV/AIDS and patients. 

The Health sector and Legislation departments are required to cooperate with relevant departments t conduct HIV/AIDS research and surveys; review relevant laws and regulations; and, revise sections that do not support HIV/AIDS prevention and control. Special research and drafting of HIV/AIDS prevention legislation need to be initiated. Each region is required to improve its regional legislation on HIV prevention according to the local context.

3.      Implementation of pilot activities on comprehensive HIV/AIDS prevention

Provinces, autonomous regions and municipalities with severe HIV/AIDS epidemics have been selected to implement community-based comprehensive HIV/AIDS prevention, treatment and care pilot projects. People living with HIV/AIDS in the communities of the pilot projects will receive treatment and care from their communities and families. The prevention work in the pilot projects will mainly be based on community needs and provide: HIV/AIDS knowledge and training; health education; behavior change intervention; medical care; and, counseling. The target populations of the pilot projects are all populations, including people living with HIV/AIDS, and other STIs and high risk groups. These populations should be able to receive regular and convenient information and services. A supportive social environment conducive to HIV/AIDS prevention and control as well as to patients and people living with HIV/AIDS should be established. Relevant departments and regions are required to strengthen the organization, technical guidance, supervision and evaluation of the comprehensive pilot project areas. Appropriate adjustments measures will be based on the progress and quality of HIV/AIDS prevention efforts.

The Government will provide free: counseling, screening tests, and anti-retroviral treatment to HIV positive pregnant women to reduce the risk of mother-to-child HIV transmission. Maternal care and health institutes at each level and relevant health providers are required to promote prevention of mother-to-child HIV transmission.

III. Strengthen HIV/AIDS surveillance and standardize epidemic reporting

The Government will provide free voluntary HIV blood testing (screening) and counseling. Institutions for Disease Prevention and Control and Supervision, Inspection and Quarantine departments at national, provincial, autonomous regional, and municipal levels, are required t strengthen HIV/AIDS surveillance; conduct epidemiological surveys among high risk populations in order to identify the number of people living with HIV/AIDS and patients; and to conduct periodic assessments of the HIV/AIDS situation and trends. The Ministry of Health is required to cooperate with the Ministry of Finance to develop and implement the detailed measures necessary in order to provide free HIV blood testing (screening) and counseling.

According to the “China Communicable Diseases Prevention and Control Law”, the governments and health administrative departments at different levels are required to strictly report on HIV/AIDS. A timely and accurate report on the HIV/AIDS situation is requested, and information on the epidemic according to relevant regulations should be made available. Individuals who deceive, underreport or delay reporting on the epidemic will be punished severely.

IV. Implement treatment and support policies and facilitate the provision of anti-retroviral drugs

The Government will include anti-retroviral drugs into the drug list of the basic Medical Insurance for the urban population, and the new Cooperative Medical Scheme for the rural population and the Medical Financial Assistance for both the rural and urban populations. AIDS patients in rural areas and in urban areas with economic difficulties will receive free anti-retroviral drugs, and treatment of opportunistic infections to a reduced price. Treatment of AIDS patients will mainly be conducted in designated hospitals at the local level. Migrant AIDS patients are encouraged to receive treatment in their hometowns. The Labor and Social Security Department and the Ministry of Health are required to develop a drug list of anti-retroviral treatment for AIDS and integrate it into the basic Medical Insurance for the urban population, the new Cooperative Medical Scheme for the rural population, and ensure the progress of these efforts.

It is required to strengthen research on and production of anti-retroviral drugs for AIDS treatment. The Food and Drug Administration departments are required t support AIDS treatment drugs research and development; accelerate the approval process for AIDS treatment drugs; and, promote safe and effective drugs for AIDS treatment. Anti-retroviral drugs for AIDS are required to be manufactured in designated sites. Unified procurement is required, and so are integration into national drug storage to ensure unified allocation and appropriate distribution through the national diseases prevention and control network. Health institutes at all levels are required to implement: “Standard for HIV/AIDS Anti-retroviral Drugs Project Management “(pilot), issued by the Ministry of Health, and “Standard for Implementation of HIV/AIDS Anti-retroviral Drugs Project “(pilot), issued by the Chinese Centers for Diseases Control. Health institutes are required to standardize the utilization of anti-retroviral drugs for AIDS. Health administrative department are required t supervise the distribution and usage of anti-retroviral drugs for AIDS; strengthen the professional and ethical education of medical staff; improve the quality and capacity of medical services; and, provide timely and effective treatment and support to AIDS patients.

V. Strengthen investments and ensure availability of funding

Finance departments are required to increase the HIV/AIDS prevention and control budget and ensure availability of funds for: necessary anti-retroviral drug procurement; health education; personnel training; epidemic situation surveillance; establishment of pilot projects; and, capacity building for prevention, treatment and care. In areas with advanced HIV/AIDS epidemics, local finance departments are required to establish special HIV prevention budgets. The central finance department is required to provide financial support for procurement of anti-retroviral drugs and etc., to areas with economic difficulties and severe HIV/AIDS epidemics through special disbursements. The central finance department is required to conduct the supervision and evaluation of the management and usage of HIV prevention budgets in order to ensure the proper usage of the special funds and improvement of the efficacy of the funds.

The prevention budget is required to be arranged properly in order to strengthen HIV/AIDS prevention and control. It is required to actively support relevant medical institutes to improve the infrastructure for HIV/AIDS prevention and control, and to actively implement staff training on HIV prevention in order to improve their technical capacities. It is required to pay attention to the health of medical staff and avoid the risk of professional exposure infection. Local governments can provide certain allowances to HIV/AIDS prevention and treatment staff according to the local financial capacity.

VI. Provide care and support and strengthen the management of AIDS patients

The Government at different levels is required to integrate poor AIDS patients and their families into the subsidy plan of the Government, and provide them with living subsidies according to relevant social aid policies. Free school education should be provided to AIDS orphans through different mechanisms and channels. Relevant departments should actively support people living with HIV/AIDS and improve their productivity by supporting income generating activities.

According to “Opinion on Management of People Living with HIV/AIDS” issued by the Ministry of Health, work pertaining to people living with HIV/AIDS needs to be strengthened and social discrimination needs to be eliminated, through measures such as the provision of medical services, community-based services, and social and family support. It is required to further support the role of civil society organizations such as the Red Cross, and provide care and support to people living with HIV/AIDS and HIV/AIDS patients. It’s required to strengthen legal and moral education of people living with HIV/AIDS and patients. People living with HIV/AIDS and patients who transmit HIV deliberately to others will be punished severely.

VII. Conduct international cooperation and improve the prevention and treatment capacities

International communication and cooperation needs to be further strengthened, and financial and technical support from foreign governments and international organizations is needed as is their active participation in international HIV/AIDS prevention and control activities. With regard to HIV/AIDS prevention and control, it is required t make full use of international best practices; continuously summarize domestic best practices; actively implement mechanisms that are appropriate to the Chinese socio-economic context; and, further enhance the nation’s efforts on HIV/AIDS prevention and control.

The Governments and sectors at different levels are required to consider HIV/AIDS prevention and control in light of “Three Representatives” and the spirit of the sixteenth Congress of the Communist Party and be responsible to the party, nation and people. They should effectively protect the health and life of the people, maintain the nation’s development and social stability, and contribute to the realization of the objective of the “well-off society” and the great renaissance of the Chinese nation.

Seal of the State Council of P. R. China

Issued on March 16, 2004

Keywords: health, diseases, disease prevention, notice

Cc.:

Central Party Sectors, People’s Government of Special Economic Municipalities, General Office of Central Committee of the Liberation Army

Headquarters of military sectors, military categories and military regions

General Office of the Standing Committee of the People’s Congress

General Office of the People’s Political Consultative Conference

Supreme People’s Court

Supreme Prosecuting Court

Central offices of the democratic parties

Printed and distributed by the Secretary Department of the General Office of State Council

March 17, 2004