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All-around effort needed against AIDS
( 2003-11-15 11:22) (China Daily)

More media coverage is being paid to the HIV/AIDS situation in China, especially after a gathering of leading officials, scientists, medical workers and activists in the field occurred in Beijing this week.

Coupled with the speech given by Gao Qiang, executive deputy minister of health on the same topic at an international economic forum held in Beijing on November 6, it seems a high-profile campaign by the Chinese Government on this issue is now under way.

By official estimates, China has 840,000 people carrying HIV, the virus that causes AIDS, and about 80,000 AIDS patients.

Despite the fairly large groups of HIV carriers and AIDS patients, the epidemic is mostly confined to high-risk groups, such as drug users, sex workers and users of blood products. And it has yet to spread widely in the rest of the nation, according to reports.

But China only has a window of opportunity that could disappear within two or three years to prevent the deadly epidemic, said Ray Yip, an official from the Global AIDS Programme in China with the US Centre for Disease Control and Prevention.

His point of view finds support in the projected number of 10 million HIV carriers or more by 2010 offered by David Ho, a leading world researcher on AIDS treatment. Ho provided that estimate at the AIDS and SARS Summit on November 10.

The Chinese Government is well aware of such perspectives, and the central and local governments have allocated 6.8 billion yuan (US$850 million) to establish and improve disease prevention and control mechanisms in provinces. Each year a special fund of more than 200 million yuan (US$24 million) is channeled into HIV/AIDS prevention, care and treatment.

Since April, free medicine to poor AIDS patients has been delivered in regions hit hardest by the virus.

But the project witnessed a dropout rate as high as 20 per cent through the end of October due to a lack of trained medical workers, inadequate varieties of available regimens and the patients' fear of side-effects of the drugs, said Zhang Fujie, director of treatment from the National AIDS Control Centre.

From the several reasons singled out by Zhang and many other reasons, it is easy to see that only government funding and its efforts cannot solve the AIDS problem effectively.

Just as the impacts of AIDS reaches social and economic fields of society, effective prevention also requires united efforts from virtually all sectors.

Key factors needed include public education, affordable drugs, medical training for healthcare workers in hospitals and the public health system, monitoring and evaluation, care for orphans, measures to stop mother-to-child transmission, a comprehensive care framework and research into vaccines and a cure.

None of these things can be achieved with the single hand of any institution -- not health officials, not medical workers or the government.

Some experts took China's success in fight against SARS early this year as a example, suggesting a similar system adopted in prevention and treatment in AIDS.

The suggestion makes some sense, given the that patients without treatment will die and severe losses in economic and social terms are caused by the two epidemics.

But AIDS is a long-wave epidemic whose aftermath is not as instant as SARS, and hence appears less alarming.

Taking place in the long run, its influence has a chronic poisoning on the nation, which depends heavily on checkups and curbing on a regular basis, rather than as an acute crisis.

So, only a mechanism incorporated into the everyday social scheme can be an effective treatment against AIDS.

Also, when the solution to the AIDS problem is being explored, this nation's special background has to be considered.

First, economic progress, at the core of the nation's endeavours for development in the last two decades, overwhelms investment in public departments, like health care system, costing the country a buffer against shock from the epidemic.

Second, China's rural population is in a relatively disadvantaged position both economically and socially, which makes them vulnerable or even helpless once attacked by an epidemic like AIDS.

Third, the non-government organizations (NGOs) have been underdeveloped during the decades of planned economies, and therefore are not as reliable when confronted with big challenges.

These characteristics, only a few of many unique to China, must be considered when a strategy against the epidemic is being sought.

As a result, a to-the-point treatment to AIDS could be led by a high-ranking commission or even the highest leaders to call on nation-wide vigilance and to motivate available resources against the disease, which is the mode adopted in the fight against SARS.

More important, a multisectoral mechanism should be built under the commission involving the government, NGOs, media, academics, educators, medical workers, the private sector and the victims.

This mechanism should operate on a platform, like a network of secretariats in all levels of government, on which every party can interact with one another.

The combat against HIV/AIDS requires the participation of as many parties as possible.

As the country nurtures with a market-orientated economy and a profound reform in some social fields, many problems are being solved. Topping the agenda are the unbalanced development in rural and urban areas, and the healthcare system and deregulation.

The campaign under way may not bear instant fruit, but at least, it could serve as a part of public education.

As former US President Bill Clinton said as a co-chair of the advisory board of International AIDS Trust, the AIDS problem is "manageable and preventable'' though we must wage it on all fronts with tenuous determination, utmost patience and tactful skills.

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