China fighting out HIV/AIDS
China is playing a great role in fighting AIDS. International public health experts are praising China for a new openness that will be key to effective control of HIV/AIDS. Despite a recent downward revision of its HIV/AIDS estimates, China faces a growing epidemic. Its ambitious public health plans include free HIV testing and AIDS treatment and a nationwide rollout of methadone therapy to help drug users lower their risk of contracting HIV.
China has prevented the spread of HIV through blood transfusions, with nearly zero cases of infection recorded through this channel and through using other blood products. However, sexual intercourse is the main channel for contracting HIV in China. Around every nine in 10,000 people are living with HIV/AIDS in China, a low rate compared to other countries, according to the National Health Commission (NHC).
The HIV transmission through injective drug use has also come under control, with reported cases of HIV contraction via drug injection in 2017 seeing a 44.5 per cent decrease compared to 2012. Meanwhile, the rate of mother-to-child transmission also declined from 7.1 per cent in 2012 to 4.9 per cent in 2017.
According to a joint evaluation by the Chinese Center for Disease Control and Prevention, UNAIDS and the World Health Organization, there are around 1.25 million people living with HIV/AIDS in China by the end of 2018, and 80,000 newly-infected people every year.
Some 80.4 per cent of people living with HIV/ AIDS in China received anti-virus treatment in 2017, with the treatment success rate standing at more than 90 per cent. A total of 200 million people in China had HIV tests last year, double that in 2012.
Figures from NHC showed that by the end of
June, a total of 253,031 people in China had died of the virus ever since it was first discovered, but the number of HIV infections caused by blood transfusions had essentially been reduced to zero. In the second quarter of 2018 alone, 40,104 cases of people living with HIV/AIDS were newly reported, with about 93.1 per cent having contracted the virus through sex.
China has established an initial network for HIV/AIDS prevention and testing, covering both urban and rural areas. The NHC has been stepping up efforts in HIV testing and discovering HIVinfected people. As HIV/AIDS prevention and treatment is still arduous, the NHC will strengthen efforts in warning and educating people at risk of contracting HIV, promoting one-stop services for testing, consultation, diagnosis and treatment, and mobilizing social forces, including enterprises, funding bodies, health organizations and volunteers, to participate in the fight against the disease.
According to the China AIDS Fund for NonGovernmental Organizations (CAFNGO), about
157 million yuan ($22.6 million) has been allocated to AIDS control projects by nongovernmental organizations (NGOs) in the past three years.
The money has gone to more than 1,700 projects operated by nearly 1,000 NGOs across China. From 2016 to June 2018, about 820,000 people were persuaded by the NGO projects to take HIV tests, which led to the identification of about 23,000 new carriers. The CAFNGO, initiated by the government in July 2015, receives 50 million yuan from the central budget annually and also takes in private donations.
China also has made breakthroughs in key technology related to AIDS in the past decade, significantly reducing their spread and lowering their mortality rate to the level in developed countries. China was able to produce its own potent HIV screening agent, reducing the waiting time for results from 28 days to seven. New domestic drugs and prevention methods have cut the cost of AIDS treatment by 79 per cent, and reduced the spread of HIV between spouses by 62 per cent.
In addition to taking preventive measures, China Food and Drug Administration (FDA) has approved the sale of a new drug for the treatment of HIV-1 infection. Aikening, or albuvirtide for injection (ABT), can be used with other antiretroviral drugs to treat infected patients who have been treated with antiviral drugs but still suffer from viral replication, according to Frontier Biotech, a pharmaceutical company based in the east Chinese city of Nanjing.
According to Frontier Biotech,The company said “Data from clinical trials showed that Aikening was effective against major strains of HIV, including resistant viruses, and the efficacy was long-acting. Patients who used Aikening didn’t show severe symptoms of side-effects, and they only have to take one injection every week. As a long-acting injectable drug with a new mechanism of action,
ABT has the potential to be a significant addition and improvement to the currently all oral drug regimen.”
“China is playing a great role in fighting AIDS,” said Michel Sidibe, Executive Director, UNAIDS on June 12 at the United Nations headquarters after his report on the latest progress of the agency’s struggle against AIDS. UNAIDS signed an MoU with Xinhua News Agency, one of the leading media groups in the world, in 2010 and unrolled joint media campaigns on fighting AIDS ever since. The UN agency has also strengthened ties with the Chinese government in combating the epidemic in China and beyond.
According to AVERT, a UK-based organisation that has been working at the forefront of HIV education for the past 30 years, China has made substantial progress in tackling its HIV epidemic. China’s HIV history has been anything but steady, with national negligence a critical factor in the spread of HIV in the early 1990s. However, significant progress in the last decade and increased national response have stemmed the epidemic across the country as well as increasing the quality of life for people living with HIV.
The HIV epidemic in China is largely characterised by low national prevalence at 0.037 per cent, with certain regions having higher and more severe HIV prevalence rates. China is also faced with
the increasing challenge of providing more targeted prevention programmes to key affected populations such as men who have sex with men, people who inject drugs and young people. Greater effort will be required for providing more targeted interventions that adequately and effectively support these groups. Greater coordination between community level HIV organisations and national level services will also be crucial for curbing the HIV epidemic in China in the future.
Treatment, care and support challenges prevail in China. However, progress in reducing motherto-child transmission rates is still regarded as slow. Progress has also been slow in addressing the high levels of stigma and discrimination people living with HIV experience across the country.
China has a relatively low national HIV prevalence rate. However, the HIV epidemic is still a major concern for some of the key affected populations within the country. Targeted prevention strategies are critical to curb the epidemic amongst these vulnerable groups as well as addressing the stigma and discrimination many people from key populations face on a daily basis, preventing them from accessing vital HIV services.
The Chinese government has made a serious commitment to the HIV epidemic across the country by funding 99 per cent of its response from domestic sources. However, increased financing will be needed as HIV testing and treatment continues to be scaledup. Without this, drug and resource shortages may occur, preventing those most in need of treatment to access it.
China’s multi-sectoral approach to HIV, which engages the government, civil society and the private sector and draws on comprehensive national data, can provide important lessons for many countries in Asia and the Pacific and beyond.
National Center for AIDS STD Control and Prevention (NCAIDS)