China leads fight against AIDS

China leads fight against AIDS

World AIDS Day is a time when people around the world remember, rejoice and recommit to fighting for a cause. In China, many people, institutions, organisations and communities will do the same. On World AIDS Day, observed on Dec 1 every year, we remember the millions of people who have lost their lives to AIDS.

But we can also rejoice at the incredible progress we have made together. Thanks to our joint efforts, new HIV infections globally have dropped almost 40 per cent since 2001, and AIDS-related deaths have fallen by 35 per cent since their peak in 2005.

Now, some 30 years since the virus first made headlines, we are making news of a different sort. There is growing consensus that we can end the AIDS epidemic as a public health threat by 2030 by scaling up interventions which have proved highly effective.

If we act with speed, focus and determination we can avert 28 million new HIV infections and 21 million AIDS-related deaths by 2030.

This new hope makes it all the more important for countries and communities to recommit and redouble their efforts to eradicate this epidemic which has devastated so many lives. China as a world leader can lead the way.

China's influence is increasingly seen in many areas, including economics, politics, culture and development cooperation.

The country is an innovator when it comes to health, making large investments in infrastructure and providing crucial services to the most remote areas of the country and even halfway around the globe in several African countries.

More than a decade ago, China began extending universal healthcare to its citizens, and free HIV testing and treatment very soon became part of the package. The approach to inclusion and leaving no one behind is speeding up social transformation in the country and helping African countries to do the same.

Over the years, HIV programming has responded to the epidemic by investing significant financial and human resources in all regions of China, resulting in better health for everyone. Efforts to address HIV transmission through blood and blood products have been successful.

Last year, 110 million people tested for HIV. In addition, millions of condoms were distributed among key groups, including female sex workers and their clients, and men who have sex with men.

China's antiretroviral therapy programme for people living with HIV/AIDS has been significantly scaled up with more than a quarter of a million people currently on treatment.

And the country has pioneered the innovative "Test and Treat" programme for key groups which makes treatment available to people who test HIV positive as soon as possible, regardless of their immune status.

The widespread availability of antiretroviral treatment for HIV positive people has led to a decrease in mortality and a reduction in mother-to-child transmission rates.

But, to quote Nelson Mandela, "After climbing a great hill, we find that there are many more hills to climb."

In spite of the hard work that has gone into the programming, data tell us that China still has lots more to do.

As in a lot of other countries, HIV services in China still do not consistently reach some people. Key groups including gay men and other men who have sex with men, transgender people, and people who buy and sell sex are at higher risk of contracting HIV and need to access effective prevention and treatment services.

While China has used its public health infrastructure effectively in delivering services to some of its most populous cities and some of the furthest regions, there is a need to tailor the services to meet the needs of key groups and expand community-based testing and treatment approaches.

Health workers and public officials need to create an environment that encourages people who are hard to reach and their families to voluntarily access key services.

Strong commitment from China's top leadership has led to a big expansion in the domestic funding for AIDS response and the country has moved into a position of complete self-sufficiency. However, it is clear that health financing is no longer just about money.

China needs to increasingly go beyond its initial success in the roll-out of large-scale HIV programs and focus on "how" to reach people who are currently falling through the cracks and all too often not accessing life-saving prevention, treatment and care services.

China's reflections on how to reduce costs and innovations in its health system will benefit many people, and the country can demonstrate how strategic approaches to spending can move the world toward ending the AIDS epidemic.

UNAIDS vision for ending AIDS as a public health threat by 2030 can be a reality in China and the lessons learnt from China can re-engineer HIV efforts across the world.

The author is UNAIDS country director, China.

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