In the response to HIV, the protection of the rights of those vulnerable to, and living with the infection, is critical. The UN considers that through continued efforts to expand access to HIV prevention and treatment services, efforts to combat stigma and discrimination, and efforts to protect the rights of those affected and infected, China will be able to make significant progress toward Millennium Development Goal 6 (MDG6).
Almost 25 years have passed since the first case of HIV was discovered in China. Over those 25 years, China's response to HIV has grown and become increasingly effective - preventing many new infections and saving the lives of many thousands of Chinese citizens living with HIV.
As we move into the second decade of the 21st century, it is important that China's response to HIV is further intensified, for despite China's progress, the reality is that the epidemic is still exacting an unacceptable human toll - in 2009 some 48,000 people were estimated to be infected with HIV and some 26,000 people died of AIDS in China.
As China's HIV response has matured, it has become clear that increased attention to protecting the rights of people living with, or at risk of HIV, will be critical for success. As in many other countries, one of the greatest challenges is to stop new HIV infections by scaling up prevention services among people most at risk of HIV infection, particularly sex workers and their clients, injecting drug users and men who have sex with men (MSM). Another challenge is to ensure that people living with HIV who need treatment are accessing it, thereby saving lives and preventing new HIV infections, including from mother to child.
The epidemic among MSM is a particular concern as HIV infection rates among this population are high and rising rapidly. In the city of Chongqing, for example, HIV prevalence among MSM has almost doubled between 2006 and 2009 (from 10.4 percent to 19.2 percent), and almost one-third of all new infections estimated in China in 2009 are among MSM. It is critical that the MSM response is rapidly upscaled if the epidemic is to be halted, and action to prevent stigma and discrimination will be necessary for this to be achieved.
Key to achieving such scale-up will be the prioritization of efforts to protect the rights of the most-at-risk groups and ensure that they are not subjected to discrimination. Equal rights of people living with HIV to confidentiality, work, education and medical treatment must be guaranteed and protected by laws and policies which are fully enforced.
Action must be taken to combat stigma and discrimination, from their family, from the public and service providers. Also key to sustainable changes in awareness and attitudes will be empowering young people with non-discriminatory values and sex education.
Fear of rights violations, and stigma and discrimination make people reluctant to seek or accept HIV prevention and treatment services. It is therefore critical that the protection of rights and prevention of stigma and discrimination are given emphasis in the next Five-Year National Action Plan to Control HIV/AIDS.
Also key to success will be the increasing involvement of civil society organizations in the HIV response. Grassroots organizations are better able to reach the hard-to-reach populations and stigmatized groups which are reluctant to seek or accept services from government. However, if civil society is to play a full role in China's AIDS response, steps need to be taken to ensure that these organizations can legally register, seek funding and work within a legal framework. Civil society organizations can also play an important role not just in service provision, but also in giving voice to and representing the needs and concerns of people living with HIV and at-risk populations.
Achieving the scale-up required to halt and reverse the HIV epidemic in China will not be easy, but it is something which China has the capability and resources to do. As China is now preparing its next Five-Year National Action Plan to Control HIV/AIDS, this is the time to review the targets and the priorities as well as to allocate the resources to realize the Chinese government's promise to achieve the MDGs by 2015. The United Nations Country Team in China will continue supporting China to deliver on its MDG commitment and encourages the government and people of China to push aggressively to achieve the UN vision of zero new HIV infections, zero AIDS deaths and zero AIDS-related discrimination.
The author is the chair of the UN Theme Group on HIV in China. The HIV Theme Group in China comprises UNDP, UNFPA, WHO, UNICEF, UNESCO, ILO, UNODC, UNIFEM, and the UNAIDS secretariat.
(China Daily 12/01/2010 page9)