Joint Efforts for Effective Prevention and Control of HIV/AIDS

   Wen Jiabao, Premier of the State Council

The International AIDS Conference to be held in Thailand highlights the great importance attached by the international community to HIV/AIDS epidemic, prevention and treatment. As a major developing country, China has the responsibility and obligation to make its due contribution to HIV/AIDS prevention and treatment in Asia and the world at large.

I. Governments at all levels and the whole society should give high priority to HIV/AIDS prevention and treatment.

HIV/AIDS is both a major public health issue and a social issue of global significance. With its rapid spreading, high mortality and devastating effect on the economy and the society, HIV/AIDS has posed a serious threat to the existence and development of mankind. In 1985, China reported its first HIV/AIDS case. Last year, with the technical support from UNAIDS and WHO, the Chinese Ministry of Health conducted an epidemiological survey which showed that in China’s mainland, there are about 840,000 HIV infected people including 80,000 or so AIDS patients, most of whom live in the rural areas. In recent years, HIV/AIDS epidemic has been spreading at increased speed and on extended scale. In some areas, the epidemic is already quite serious and it is spreading from the high-risk groups to the general population. The serious impact of HIV/AIDS epidemic on the development of the local economy and society is increasingly felt in some areas. It is a crucial moment for China’s HIV/AIDS prevention and treatment work.

The Chinese government gives high priority to HIV/AIDS prevention and treatment. It lists HIV/AIDS one of the three main infectious diseases in the prevention and treatment efforts and works out a series of policies and measures. With years of efforts, HIV/AIDS prevention and control in China has made remarkable progress. Many AIDS patients have gained access to medical treatment and care. HIV infected people and AIDS patient families have received assistance. The epidemic has, to some extent, been contained. However, there are many problems in HIV/AIDS prevention and treatment waiting to be solved. They are: insufficient public awareness and education, underdeveloped epidemic surveillance system and limited technical strength and prevention and treatment capacity. Moreover, China’s large population, imbalanced economic and social development, inadequate health care facilities in rural areas and low public awareness of health and rule of law have made our prevention and control work more difficult. HIV/AIDS prevention and control ,which is an arduous task in China ,is faced with severe challenges. 

China is a socialist country. Our government serves the general public and should always put people’s health and life security above anything else. As China is entering into a new development stage of building a moderately prosperous society in an all-round way, it is our important objective to improve the ethical standards, education level and health quality of the whole nation. We should be fully aware that HIV/AIDS prevention and control has great bearing on the strength of the Chinese nation and the fate of the country. To do a good job in HIV/AIDS prevention and control will demonstrate that we are working to implement the important idea of the “Three Represents” and consistently run the government to serve the people, and that our efforts are always people-oriented and we are putting into practice the scientific outlook of development. It is also a specific demonstration of a responsible Chinese government to the international community and to the existence and development of mankind. The governments at all levels must work, in the spirit of being highly responsible for the country, the nation and the people, to integrate HIV/AIDS prevention and control into their important work agenda, mobilize and organize all social forces, conduct the prevention and treatment in a down-to-earth manner and firmly curb the prevalence and spread of HIV/AIDS in China.

II. HIV/AIDS prevention and treatment should be carried out under correct guiding principles.

In the light of the national conditions and experience obtained from the local efforts, we need to bear in mind and adhere to the following four points to make the prevention and treatment successful.

(1) Adhere to the principles of putting prevention first, integrating prevention with treatment and conducting comprehensive management. “Putting prevention first” has been a long-term and general principle of China’s public health work. It is also a fundamental measure to control the spread of HIV/AIDS. The principle of “integrating prevention with treatment” means we should make prevention efforts and at the same time improve the treatment. The principle of “conducting comprehensive management” means we should work to alleviate the symptoms and at the same time to effect a permanent cure ,that is to say not only bring about a temporary solution but also get at the root of this problem; work to conduct necessary behavior intervention to the high-risk groups and at the same time to disseminate prevention knowledge among the public; work to firmly prevent blood-source transmission and at the same time to effectively control other transmission channels like injecting drug use, sexual contact and mother-to-child transmission; and work to strengthen medical treatment and at the same time to comprehensively put into effect all prevention and treatment measures. 

(2) Adhere to the principles of government guidance, multi-department cooperation and social participation. Government leadership and organization is a fundamental guarantee to the success of HIV/AIDS prevention and treatment. The government should play the leading role, mobilize sufficient resources and forces for prevention and treatment and strive to solve this major public health problem. HIV/AIDS prevention involves many sectors. Departments concerned should perform their own functions, do their own duty, make joint efforts and work in coordination. HIV/AIDS threatens every individual and every household. It is a common responsibility of the whole society for HIV/AIDS prevention and control. It is therefore essential to guide all social forces for comprehensive participation and create a favorable environment for the whole society to work jointly in HIV/AIDS prevention and control.

(3) Adhere to the principles of scientific prevention and control in accordance with laws and regulations.  The law and science are the fundamental guarantee to the success of HIV/AIDS prevention and treatment. We must constantly revise the relevant laws and regulations, promote people’s awareness of HIV/AIDS prevention and control in accordance with the law, strengthen supervision of law enforcement and incorporate HIV/AIDS prevention and control efforts into the legal system so as to ensure the orderly development of the work. Science and technology is the ultimate key to conquer HIV/AIDS. Hence in HIV/AIDS prevention and control we must apply science and technology and adopt scientific methods to conduct active prevention, new drug development and research and regimen optimization so as to enhance the efficiency and effectiveness of prevention and control.

(4) Adhere to the principles of highlighting the focuses, categorizing guidance and emphasizing the effect. Adherence to these principles is required by China’s real national conditions, the national strength and the characteristics of HIV/AIDS epidemic in China. The spread of HIV/AIDS varies greatly among different regions in China. The principle of “highlighting the focuses” means to do a good job on those key links, key groups and key areas of HIV/AIDS epidemic. The principle of “categorizing guidance” means to work in the light of the specific local situations and take corresponding policies, methods and measures in different regions. And the principle of “emphasizing the effect” means to work in a down-to-earth manner, stress implementation, make efforts to reduce infection rate, morbidity rate and mortality rate and improve the health status and living standards of people in key affected areas.

III. Key tasks in HIV/AIDS prevention and treatment

 HIV/AIDS prevention and treatment is a long-term and arduous task and at the same time, a socially systematical program. We need to strengthen the efforts in every aspect such as prevention and surveillance, medical treatment and support, care and assistance and education and awareness promotion.

Firstly, strengthen epidemic surveillance and have timely, accurate and full HIV/AIDS epidemic information and its prevalence trends. These are the basis and prerequisite of HIV/AIDS prevention and control and also the best protection for the healthy people. We should further strengthen the development of HIV/AIDS surveillance network and put in place the necessary testing equipment and personnel. It is necessary to intensify HIV/AIDS epidemic surveillance and conduct epidemiological surveys among the high-risk groups so as to get the number of HIV infected people and AIDS patients as accurate as possible. There should be stringent epidemic reporting system under which local HIV/AIDS epidemic information is reported timely and accurately and released to the public according to the prescribed requirements. 

Secondly, strengthen the propaganda and education and disseminate the knowledge of HIV/AIDS prevention and control. A fundamental solution in HIV/AIDS prevention and control is to make people know about HIV/AIDS prevention and treatment and cultivate good and healthy lifestyle. We should integrate regular awareness promotion and education campaigns with the target campaigns. Villages, communities, schools and public places where high-risk groups concentrate are the key areas for comprehensive awareness promotion and education work. The public and every household should be well informed of the HIV/AIDS transmission channels, features of prevalence, protection and prevention methods and relevant laws, regulations and policy measures. In particular, we should strengthen education for the youth, and provide them with guidance for healthy behavior and for resistance to bad habits like reading or watching pornographic products, gambling and taking drugs. With wide scale awareness promotion and education, officials at all levels will realize the harm of HIV/AIDS and never treat it lightly; the general pubic will understand that HIV/AIDS can be prevented, controlled and treated so as to avoid unnecessary panic; and the whole society will have a correct attitude towards HIV infected people and AIDS patients, offering them more care and not discriminating against them.

Thirdly, strengthen behavior intervention and comprehensive prevention and treatment to improve the effectiveness of HIV/AIDS prevention and treatment. Effective measures should be taken to cut the key transmission channels of HIV/AIDS. It is necessary to take reference from successful experience of other countries, review the experience learned from the domestic pilot projects, severely crack down according to law on vile social evils like drug trafficking, drug taking and prostitution and, at the same time, adopt necessary measures of behavior intervention in the key groups so as to reduce their chances of spreading or being infected with HIV/AIDS. Construction and management of blood stations should be strengthened. Illegal blood collection and supply must be suppressed to ensure blood and blood products safety. In key areas, we should establish model bases of comprehensive HIV/AIDS prevention and treatment, which will focus on providing treatment, care and assistance, and explore working models that are appropriate for China and can have effective HIV/AIDS prevention and treatment.

Fourthly, strengthen treatment and care for people living with HIV/AIDS (PLWHA) and guarantee their legitimate rights and interests. The “4 frees and 1 care” policy established by the central government should be further implemented, which is to provide free ARV drugs to AIDS patients who are rural residents or people with financial difficulties in urban areas, free VCT to people who voluntarily want to receive HIV testing, free drugs to HIV infected pregnant women to stop mother-to-child transmission, free schooling fees for orphans of AIDS patients and economic assistance to PLWHA households. HIV/AIDS treatment and medical service system should be developed and efforts should be made to organize professional training and ethics education among healthcare workers so as to optimize HIV/AIDS treatment and tending. Medical services, community services and social and family care should be integrated to help HIV infected people and AIDS patients establish their confidence in conquering the disease, work, study and live like others and feel the warmth in the big family of socialism. Legal education, ethical education and management for HIV infected people and AIDS patients should be strengthened to raise their awareness of abiding by the law and the sense of social responsibility.

Fifthly, increase financial input and build capacity in HIV/AIDS prevention and treatment. To meet the needs of HIV/AIDS prevention and control we should increase government input, improve facilities and conditions and guarantee the necessary funding for epidemic surveillance, drug procurement, patient treatment, health education and personnel training. In recent years, the central budget for HIV/AIDS prevention and treatment has been increased year by year. The government also earmarked funds to accelerate the development of centers for diseases prevention and control at all levels. Local governments have also increased their funding for prevention and treatment. In the future, input in this aspect should be further increased. It is necessary to establish and improve a funding mechanism in which the government input is dominant, all levels of the government have their own obligations and there exist multiple funding channels. In particular, support for scientific research should be intensified to accelerate the research and development of HIV vaccines and treatment drugs, trying to produce a few safe and effective drugs. We should study and explore treatment methods that integrate traditional Chinese medicine (TCM) with the Western medicine and have TCM play its role in HIV/AIDS prevention and treatment.

Sixthly, strengthen international exchanges and cooperation and improve the effectiveness of HIV/AIDS prevention and treatment. For many years, China’s HIV/AIDS prevention and treatment has been receiving attention and support from the international community. One after another, more than 20 international organizations and countries have cooperated with China successfully in HIV/AIDS prevention and treatment. In the future, we will work in a more open and pragmatic manner, further strengthen international exchanges and cooperation and actively participate international activities of HIV/AIDS prevention and treatment. We will also take reference from and absorb the advanced experience of other countries and conduct information and technical exchanges of HIV/AIDS prevention and treatment. HIV/AIDS is a common enemy of mankind. The Chinese people will join the international community in the common efforts to fight against HIV/AIDS and protect the world, the mankind and ourselves.

The Chinese government and the Chinese people have full confidence and capacity to effectively prevent and control HIV/AIDS and make greater contribution to the ultimate victory of mankind over HIV/AIDS.