PANOS London - Monday, 20 January 1997.
Yuan Ye & Li Nu'er

Although the incidence of Human Immunodeficiency Virus (HIV) infection is low for China (relative to its population of 1.2 billion), the Ministry of Public Health (MPH) has announced a national medium- and long-term plan of action for HIV/AIDS prevention and control.

The aim is to control the spread of the disease before the year 2000.

"Now is the prime time for prevention and control of HIV infection in 97 it could be the last chance," warned Prof. Chen Minzhang, the minister. "We have no time to waste."

At the core of the plan will be the establishment, by the end of the century, of a nationwide HIV/AIDS monitoring network with some 400 clinics. Also set up will be an advanced national HIV/AIDS laboratory along with modern laboratories in all provinces, autonomous regions and municipalities.

Under the ambitious plan:-

* Central and provincial government departments responsible for budgets, education, scientific research, media campaigns and law enforcement will participate;

* AIDS awareness will be promoted through the government-controlled mass media and by special agencies in schools and among ordinary people, particularly youths and high-risk groups such as prostitutes and drug addicts;

* Methods used by other countries in curbing HIV infection, including greater condom use, will be promoted in China; and

* Law enforcement departments will be made responsible for cracking down on the illegal blood supply business, drug abuse and prostitution. These are the main channels of HIV transmission in China.

Fears that an AIDS explosion might occur in China in the absence of strong steps were voiced last October at a national conference on HIV/AIDS prevention and control held in Beijing last October. It was attended by Chinese AIDS experts and government officials and representatives of multilateral donors.

"Experts fear that the next battleground for HIV/AIDS after Africa may include China, even though China is still a low-incidence country in terms of reported cases of HIV/AIDS," said Arthur Holcombe of the United Nations Development Programme (UNDP).

The first AIDS case identified in China was a foreign tourist in 1985. By the end of August 1996, health authorities had uncovered 4,305 HIV-positive cases, including 131 with full-blown AIDS.

But some experts say that inadequate detection methods mean the actual number of HIV-positive people in China could be substantially higher - anywhere, in fact, between 50,000 and 100,000.

They point out that all but two of China's 30 provinces, autonomous regions and municipalities have reported HIV/AIDS cases.

A UNDP study on the economic implications of HIV/AIDS in Asian countries estimates that the cost to China in terms of health care and lost labour could be two billion dollars annually by the year 2000.

"General ignorance about HIV/AIDS, drug abuse, prostitution, illegal blood supply and sexually transmitted diseases (STDs) may fuel the epidemic,"said Dai Zhicheng, director of the Department of Disease Control in the Public Health Ministry.

The current number of STD patients alone may have reached three million, and will keep rising in the next 20 years, experts predicted.

Although the situation is critical, both experts and officials are optimistic about the future of HIV/AIDS control in China.

They pointed out that in addition to the screening clinics and test laboratories across the country, three regional prevention and treatment centres for HIV and STDs have been set up in the provinces of Guangdong, Yunnan and Jiangsu.

According to a report released by the Department of Disease Control, China's 42 monitoring centres in big cities conduct tests twice annually on four high-risk target groups: people attending STD clinics, prostitutes, drug addicts and long-distance truck drivers.

However, experts are urging the establishment of similar facilities in the country's vast rural areas and smaller and medium-sized cities, which are also vulnerable to the spread of HIV/AIDS.

Research work on AIDS medicine has been carried out by Chinese pharmacologists. Although the prospect seems bleak at present, experts hope that breakthroughs will be made in developing traditional Chinese herbal medicines for the treatment of AIDS.

"However, what we can do now - surely the most effective way - is to educate the public about the social and medical ills caused by prostitution and drug abuse," said Ye Shunkai, director of the National STDs and Leprosy Control Centre.

The services of government institutions, nongovernmental organisations, press and media have been enlisted in large anti-AIDS publicity campaigns in recent years, particularly around World AIDS Day on December one.

Meanwhile, financial and technological support from multilateral donors is playing an important role in China's AIDS research and prevention.

Donors have committed a total of $17.4 million in support of China's HIV/AIDS awareness and control efforts. The country has benefited from UN assistance, which is intended to help increase China's understanding of the experience of other countries in combating HIV/AIDS and to support services to HIV/AIDS victims.

"Unlike India and Thailand, China still has the opportunity to stop the spread of HIV/AIDS," said Holcombe of UNDP. But he warned against complacency, saying "We must not lose valuable time."

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