The Central Communist Party School (CCPS) Launched HIV/AIDS Policy Training among Leading Cadres

People’s understanding towards AIDS has gone through a process from seeing it as a pure medical problem to as a public health issue and later as a social issue. The knowledge of AIDS among general public needs someone to advocate and promote, so does the case of middle- and high-level officials who make decisions.  The training on AIDS policy for the leaders at middle- and high-level held by the central communist party school (CCPS) played an active and driving role in mobilizing the government sectors at all levels to participate in the AIDS control and prevention with very good effect. This article starts from the causes of the policy advocacy and described the causes, process and problems of the project, especially the setbacks and changes in thought of the leading cadres on the issue of AIDS. Since the project had got some effect, the relevant sectors applyed the training pattern of CCPS to various provincial and municipal party schools to train more leaders at prefecture and county level to promote the development of the local AIDS control and prevention.
—— Editor

Founded in Yan-an The Central communist Party School,  is the most prestigious institute where the CPC trains and cultivates its leading cadres. In late November, 2001, the CCPS held a reporting conference titled “We Are Facing AIDS —— Situation and Policy” and a symposium  titled “Policy Makers and Policy on HIV/AIDS Prevention and Control.” This is the first time in history that the CCPS has held a reporting conference and symposium for a public health problem or for a certain disease.

1. Rationale

In the spring of 2001, the China-UK HIV/AIDS Prevention and Care Project (HAPAC), in conjunction with the Tsinghua University Public Policy Institute, held the First Symposium on Social Science and HIV/AIDS Prevention and Control. At that time, though AIDS had raged in China for more than ten years, this problem had not yet drawn attention from the social science society owing to the insufficient exchange between the social science society and the public health & medical circle. Except for a few specialists and scholars, most people believed that AIDS was only a medical problem, a research field for medical specialists and public health specialists only. The purpose of this symposium was to wake up the awareness of the social science society on this problem and brought the strength of social science to curb the spread of AIDS into full play.

The social scientists participating in the symposium were mainly scholars of anthropology and sociology. At the symposium, the description made by public health specialists on the rapid spread of AIDS in China and the challenge encountered in the course of prevention and control had deeply stirred these social science scholars. After the brainstorming, They began to think: “What can we do?”
If it can be concluded that this symposium has mobilized humanities & social sciences scholars theoretically, the funds supplied by the China-UK HIV/AIDS prevention and Care Project subsequently has paved the way for social science society to participate. The Project “AIDS Policy Training among Leading Cadres” launched by the Central communist Party School is just one of activities which materialize such participation.

In China, the prevention and control of HIV/AIDS are mainly led by the government. The Central Government has not only exerted great effort in making related policy, establishing related institution and appropriating funds, but also explicitly stipulated the policy of “Taking Prevention First, Integrating Prevention with Control” and the principle of “Joint Participation and Collective Effort by Government and Whole Society.” If the leading cadres at various levels have no idea about the HIV/AIDS situation in China and are unaware of their duties, it will be difficult to actualize the government-led prevention and control of AIDS, let alone the multi-sectoral cooperation and the participation by the whole society. The realization of government-led prevention and control of AIDS depends on the efforts of government officials, especially those middle and high-ranking officials. Therefore, it is very necessary to carry out training and education among leading cadres, and the highest priority has been given to the AIDS policy training among middle and high-ranking officials in the Central communist Party School.

2. Target Population

Some specialists at home and abroad believe that the target population for HIV/AIDS prevention is the population who are susceptible to AIDS. In our opinion, however, in current China leading cadres are the important target population for HIV/AIDS prevention whom we should focus the advocacy and education relating to AIDS prevention on. The reasons lie in the following two facts: Firstly, leading cadres are the commanders of the war against AIDS in China; as the maker and implementioner of HIV/AIDS Prevention and Control related policies, they will play an important role in mobilizing common people, allocating resources and taking measures. As a result, the universal, development and advocacy of AIDS policy among leading cadres at various levels are of overriding importance.

One class attendee points out: “It is really delightful that the matter relating to prevention and control of HIV/AIDS can be talked about within such a wide scope and has drawn so much attention from all walks of life. Not too long before we just avoided discussing AIDS, but now this problem is talked about everywhere by every person, from common people to the CPC central committee, from ordinary universities to the Central communist Party School. This is the first step to succeed, and a step of great importance. All works relating to HIV/AIDS Prevention and Control are pushed by the government, and this is the most important guarantee and the foundation of our work. As long as we stick to this guideline and mode, it is very hopeful that AIDS will be brought under control in China (Record of symposium of the Central Party School in Dec. 2003).

Secondly, some leading cadres, because of some reasons, are not very familiar with the situation of AIDS, the knowledge relating to HIV/AIDS Prevention and Control as well as the AIDS policy made by the State, Nor are they aware of their duties or the arduousness of the task. If their awareness has not been fully woken up, it is impossible for them to lead the people through the war against AIDS and win the battle. Therefore, they should be firstly deemed as the target population for work relating to HIV/AIDS Prevention and Control.

The survey among class attendees of the Central Party School reveals that: Leading cadres have no clear idea about the epidemic situation of AIDS (more than 40% of them deny the situation judgment that “AIDS is spreading rapidly within China and poses a threat to the economic growth and the national security”); owing to insufficient knowledge about AIDS, they bear some misconceptions, such as unnecessary worry and fear (24.8%, 34.1% and 40.3% among them believe that a person may get HIV/AIDS by sharing food or public facility with an infected person or through mosquito bites) buton the other hand they slacken their vigilance against some possible transmission routes (34.6% among them have no idea that a person may get infected with AIDS through dental disease treatment and 17.8% among them have no idea about the risk of iatrogenic transmission); they always take discriminatory attitude towards AIDS patients (35% among them holds that only those people who are not serious toward sex and drug abusers may get infected with AIDS; 36.2% among them agree to restrict the rights of People living with HIV/AIDS), and they are unconcerned with AIDS-related works (32.4% among them believe that HIV/AIDS Prevention and Control have nothing to do with their duty), and make decisions on the basis of their own understanding on AIDS (34.7% among them answer that they will prevent and control AIDS in an secret way if AIDS is found spreading in the area where they work).

If the major leaders of our party and the government believe that there is no relationship between HIV/AIDS prevention & control and their work or they don’t know what relationship exists, how can the national system for HIV/AIDS Prevention and Control be established? The Chinese government is the core strength to mobilize common people, and only after all leading cadres get aware of the seriousness of the problem can the people’s war against AIDS be launched with enough human resources and material resources invested and stop AIDS.

3. Action

Since 2001, heated debate over AIDS always occurs within the yard of the Central Communist Party School. Before those cadres at prefecture level come to the CCPS, they never though that they will face problem relating to AIDS. The symposium “Policy Maker and Policy on HIV/AIDS Prevention and Control” makes these policy makers realize promptly that the work relating to HIV/AIDS Prevention and Control has been listed as an important content in the training curriculum by the CCPS (An extract from Southern Weekly, June 23, 2005).

The first obstacle encountered is the old concept of these leading cadres. Some people worry that, if asked to discuss AIDS-related problem, these leading cadres will wonder whether the party is doubt of their moral character. Some leading cadres believe that nowadays there are many major realistic problems in China, and AIDS-related problem is only a trivia and is unworthy of being discussed in the class of the CCPS.

With the support from leaders of the Social Development Research Institute, CCPS, near 2000 prefecture-level cadres studying in the Party School participated in the Project “Policy on HIV/AIDS Prevention and Control” from 2001 to 2004.

In the CCPS, the activities are carried out in the following forms: Reporting conference, symposium, lecture and questionnaire-based survey. Among these forms, reporting conference at which relevant leaders and specialists give reports is taken as the main training method. The symposium is titled as “Policy-Maker and Policy on HIV/AIDS Prevention and Control,” at which relevant specialists make keynote speeches and the trainees discuss toghter. In April 2004, another lecture course titled “Public Health and Social Crisis” was set up, and since then this lecture course has been offered once a semester. In addition, questionnaire-based surveys on base line and effect assessment are conducted before and after every training activity, and more than 1100 survey samples have been obtained by now. For the purpose of overcoming the difficulty that there are no teaching materials, a group of public health specialists and social scientists are organized to compile a series of training materials including Policy on HIV/AIDS Prevention and Control —— Reading Book for Cadres, China Faces Up to AIDS —— Strategy and Policy Making.

The activities held by the CCPS have drawn much attention from society. More than 20 media at home and abroad have reported upon the fact that the CCPS launch training on policies relating to HIV/AIDS Prevention and Control as well as the achievements of such training. The presence of AIDS problem at the symposium held by the CCPS makes high and middle ranking cadres in China pay more attention and attach more importance to HIV/AIDS Prevention and Control.
 
4. Key Person

The regulation of “No Prohibited Area for Research, with a Strictly Disciplined Advocacy” made by the CCPS always limits the minds of class attendees. The launching of the Project “Policy on HIV/AIDS Prevention and Control” owes to one key person, namely Li Junru, the deputy principal of the CCPS in charge of scientific research.

When learning that this project has been launched with a low key, Mr. Li Junru said: “AIDS is not only a medical problem, but also a major social problem and a strategic problem. It is necessary for all high and middle ranking leaders of our party to get acquainted with AIDS, a disease which affects the future and destiny of human being.” He also said: “It is very important to carry out AIDS policy training among leading cadres. At present, many cadres, including many leaders are unaware of the pressing of this problem. Therefore, we should persist in this work and keep patient. Whenever we complete a round of training, we make one more step towards the success.” Mr. Li Junru also communicated with the main leaders of the Social Development Research Institute for the purpose of obtaining more help and support from them.

Wang Weiguang, the deputy principal of the CCPS is another key person for this project. Acting as the director of the HIV/AIDS prevention & Control Leading Group under the Central Party School, he has given a lot of help and support to this project.
In 2003, the State Council AIDS/STIs Coordination Meeting Office (Now State Council AIDS Working Committee Office) appropriated RMB100 thousand to the CCPS for carrying out AIDS policy among leading cadres. Mr. Wang Weiguang, the director of the HIV/AIDS prevention & Control Leading Group under the Central Party School, offered encouragement and support to the planning and summing-up of each activity.

With the direct help and support from leaders of the CCPS such as Li Junru, Wang Weiguang who have insight and strategic thoughts, activities of this project have been carried out and promoted in the CCPS..

5. Setback
Although this project is supported by the leaders of the CCPS and the Social Development Research Institute, it is still unavoidable that debate over thoughts and ideas occurs.

At a symposium held in 2003, a class attendee insisted that a nation-wide HIV screening should be carried out and all HIV positive people found through such screening should be ‘marked’ so as to ‘protect the public health right’. Another specialist participating in the symposium held that the right of all persons including People living with HIV/AIDS should be protected. Therefore, a tit-for-tat debate happened between them. The class attendee said: “If the privacy right of People living with HIV/AIDS are protected, it will be impossible to protect the life right of healthy persons.” The specialist said: “AIDS is not a disease that is easily transmitted.. If the two persons are irrelevant in behaviors, the AIDS won’t be transmitted. But if they have unsafe sexual behavior and one of them is an AIDS patient, the other must be responsible for his or her action.” They disputed drastically. The opinion of this class attendee is typical and majority of class attendees hold the view that the AIDS patients and HIV infected peoples must be separated to protect the health of majority.   

In fact, debate over thoughts and ideas is normal. The emergence of AIDS gets the moralities, ethics, laws and systems of every country in the world challenged. The training on AIDS policy among leading cadres is neither a cramming process nor a single-way transfusion, but an exchange of thoughts and transmission of information to realize the focusing on AIDS and thinking of the establishing and implemention of HIV/AIDS prevention policies. But the setbacks on views sometimes are not always understood. After the debate, some class attendees reported to relative sectors of CCPS: “There is something wrong in the seminar of HIV/AIDS prevention policies. They even distributed condoms to us, what do they think we are?” Some problems are reflected by the questionnaires and the three most typical are: lack of knowledge and information, the out-of-date views and the bais in policy choice. Over half of the class attendees chose “Let him be and he has only himself to blame”. Meanwhile, over half of the class attendees chose “Segregation” when their friends or relatives are found infected with HIV. According to the questionnaire, the knowledge and opinions of the class attendees have changed greatly through special report meeting and seminar.
 
6. Effect

The obvious effect of this project is beyond the expectation of its organizers.
When the first report meeting was over in 2001, one of the class attendees represented: I got a lot today. The successful experience of reducing infection and decreasing harm such as generalization of 100% condoms, methadone maintenance therapy(MMT) and sterile needles exchange is very useful. In the past, this special group was hidden as we adopted heavy blow method. It is very disadvantaggeous to AIDS prevention and control. As such phenomena as  sexual transaction and drug addiction can not be eliminated immediately, to control the disease by another method may be more effective.” He said that he would take all relative materials to his working unit and organize the cadres to study and discuss so that they will change their working method.  

The interactions among the class attendees are more valuable. One of the class attendees proposed: We may organize all AIDS patients and HIV infected people together and convey them to an isolated island and they can make a living by themselves by knitting and sewing gunny bags. Thus social wealth is created and Meanwhile, the AIDS spreading is avoided. His proposal was objected by another class attendee. He thought this method is neither humanism nor realistic. “If we conduct mandatory testing, the social horror will be caused. If the purpose of testing is separation, the infected patients will go into hiding to avoid being detected. Moreover, more hospitals and wards and doctors and nurses will be needed to separate the infected patients. Can we afford that by our financial resources?” The first class attendee insisted: “We will have to do that in spite of the high cost. The separation will work. We built up a Leper Village in 1950’s and by that we successfully controlled the spreading of leper.” The latter class attendee objected again: “It was Due to the invention of medicine and the accurate prevention method for leper that we controlled the leper. It should not be owed to the Leper Village.”

According to the questionnaire, the training and seminar has influenced the class attendees by the following aspects:

First, the awareness has been raised. Before training, 64.5% of class attendees have heard of but never seen the HIV/AIDS prevention policies, 22.7% of them knew nothing about these policies, and only 12.7% of them have ever seen the policies. The seminar “forced” them to read relative policies and documents and their understanding of AIDS have been improved greatly. Before training, 24.8% of them though that AIDS would be transmitted by eating together, 34.1% of them thought it would be transmitted by sharing public facilities and 40.3% of them thought AIDS would be transmitted through mosquito bites. Meanwhile, a few of them thought that even shaking hands and talking would cause transmission of AIDS. After training, the percentages have been decreased by 17%, 26.8% and 36.7% respectively as a result of awareness level of HIV/AIDS knowledge improved and revelent fear eliminated.

Second, the belief and attitude have been changed. Before the implementation of project, 32.4% of the class attendees thought that the HIV/AIDS prevention had nothing to do with them, 34.4% of them thought that only people with depraved behaviors such as sexual swingers and drug users would be infected with HIV; 36.2% thought that people living with HIV/AIDS should be confined of work; 38.6 % thought that the PLWHA should be isolated, 64.5% thought that the family members of PLWHA should be isolated and 60.1% thought they would do nothing about subordinate PLWHA . According to investigation, the discriminative and disregarded attitude have changed greatly after the implementation of project. The percentages have been decreased by 6.2%, 19.2%, 18,8% and 6.4% respectively.

Third, the decision-making action has been influenced. According to the questionnaire, the project has changed the decision-making action of the class attendees. The percentage of choosing “Talking about AIDS in public and strengthening prevention effort” has increased by 23.6%, the percentage of agreeing on “ to Confront pornographic and drug issues as well as strengthen management can be good way of preventing AIDS spreading” has increased by 24.9%; And the percentage of agreeing on “To set up the mechanism of government-led prevention,treatment and care response with multi-sectoral cooperation and strong societal participation is the key of preventing and controlling AIDS” has increased by 16.8%.

One of the class attendees has talked about his three ideas: First, it is unexpected that the HIV/AIDS prevention policies can be talked about in the CCPS; Second, the discussion on HIV/AIDS prevention policies in the CCPS indicates that the HIV/AIDS prevention issues should be attached importance to; Third, the development of education on HIV/AIDS prevention policies in the CCPS indicates that the central government leaders have thought much about this issue. So, as local leaders, we should pay much attention to this issue and have confidence in solving this issue. “Any problem will be solved as long as the CCP has determined to solve it!”  
        
The effect of the project has extended out of the class. One officer of the HIV/AIDS prevention project interviewed a deputy governor when he was working in a minority area with severe epidemic situation. This deputy governor expressed understanding of and cooperation with the HIV/AIDS prevention actively. He represented: This task is very important! If we can not prevent its spreading timely, the nationality will be on the verge of perdition!” The officer was surprised as he had never thought that he would meet a governor with sufficient understanding of HIV/AIDS prevention. The deputy governor explained, ‘I have attended the class of HIV/AIDS prevention in CCPS.”   

7. Promotion

In June 2005, a new attempt has been conducted in CCPS after half a year’s pause. On the seminar of “Facing AIDS World-wide” held on June 15, 2005, the training attendees had been replaced by relative leaders and key teachers of Party Schools at provincial level. 10 units of courses of HIV/AIDS prevention policies were included in the curriculam for the “Scientific Socialism and Contemporary Reality” training class for teachers. Domestic well-known experts instructed the AIDS epidemic situation in China, decision makers and the HIV/AIDS prevention, AIDS and public policy, sexual behavior in the era of AIDS, etc. To visit the Beijing detoxificaion Center and Home of Love Caring of Beijing You-an Hospital were also admitted in course list. It aimed to transplant the training mode in CCPS to party schools at provincial level to train more officials at municipal level and county level.

However, the prevention efforts of leaders at different levels are to be strengthened due to the restriction from various factors. The achievement check indicators for leaders only consist of “GDP, social stability and population control” and human development indexes such as public helth, life expectancy and average educational level have not been listed in achievement check system, so it is no wonder that the AIDS issue remains a “Blind Point” or“ Dead Angle” of the work for quite a number of leaders. In addition, AIDS information is still scarce for the whole Chinese society, so there is broad prospects for the media organs strengthening HIV/AIDS prevention advocacy The advocacy and education should not only be implemented around 1st of December each year, but also at ordinary times, not only to the masses but also include the leaders.     
The Party School is a mature training system for leaders. When the leaders and cadres attend in advanced studies or training, they will go to the party school at corresponding level. If the training and discussion of HIV/AIDS prevention policies can be activated in party schools at different levels by the radiation and driving of CCPS, it has nothing different with a powerful “Politics Mobilization”! More leaders will realize the severity of AIDS circumstance in China through study and discussion and will think about the solving method.

(Jin Wei  from Central Party School )