Seize the Opportunity to Actively Explore so as to Comprehensively Press Forward in HIV/AIDS Prevention and Treatment Work

The world as a whole is facing a vital public health and social problem - the AIDS epidemic. The spread of HIV has greatly affected the physical health of the Chinese people as well as the economic and social development of the country. The party and the central government have paid great attention to this problem. The General Secretary Hu Jintao has pointed out that HIV/AIDS prevention and control is a matter of great importance for the prosperity of China. Party and political leaders of all levels should enhance their understanding, motivate the society as a whole to curb the spreading of the epidemic: starting with education and based on prevention. Premier Wen Jiabao mentioned that: The State Council has devoted much attention to HIV/AIDS prevention and control, and has drafted appropriate plans upon investigation. We must put into practice the assignment system, and enhance basic work related to: prevention and control programming, surveillance and inspection, personnel recruitment, technical measures, legal management, etc. At the same time we should learn from our successful experiences, and truly do an excellent job in this matter which is vital to the very basics of our national interests. During the 1990s, the State Council has: drafted the “Chinese National Medium-and Long-Term Strategic Plan for HIV/AIDS Prevention and Control (1998-2010)” as well as the “China's Action Plan for Reducing and Preventing the Spread of HIV/AIDS (2001-2005);” established the State Council STD/HIV prevention coordination meeting policies; made a series of important strategic decisions and employed several important measures regarding containment of the transmission and spread of the AIDS epidemic. Provinces and government departments have carefully implemented these decisions and plans made by the Party and the State Council. Under such guidance, they have: established leadership coordination system; developed prevention and control plans, implemented health education; adopted behavioral intervention mechanisms; carried out treatment and care programs, strengthened international cooperative efforts. Due to all of these efforts, we were able to make significant progress in HIV/AIDS prevention and control. However, in China, the AIDS epidemic situation is still quite serious. Furthermore, there have been found newly developed characteristics of viral spread and transmission. Thus, now is a time of great importance for HIV/AIDS prevention and control work. We must comprehensively and extensively implement HIV/AIDS prevention and control plans established by the Party and the State Council through: carefully analyzing the situation; researching prevention and control mechanisms; explore new effective methods; so as to timely enhance our prevention programs as well as effectively slow down the spread of the AIDS epidemic in our country.

I. Now Is a Crucial Time Period for HIV/AIDS Prevention and Control

Since the discovery and report of the first AIDS case in the year 1981, after merely twenty-or-so years, the total number of people infected by HIV globally has reached approximately 69 million, among which 27 million had died due to AIDS. For many years, populations infected by the virus have concentrated in Sub-Sahara regions of Africa. In recent years, however, Asia has become the area of the highest transmission rate. These data, along with analysis of other related situations, helped us conclude that now is a crucial period for HIV/AIDS prevention and control work in China. The reasons for such a statement are as follows:

1.           The HIV/AIDS Epidemic Situation Is Quite Severe

 According to epidemiological research results, in China there are about 840 thousand people infected with HIV/AIDS, among which 80 thousand has displayed active AIDS symptoms. Populations infected by the virus are spread out in all thirty-one of China’s provinces, autonomous regions, and municipals. Concentrated in the rural regions, the majority are youth and people between the age of 30 to 50. A few regions are now facing the high possibility of concentrated activations of AIDS symptoms and therefore deaths. According to the trends of transmission of HIV/AIDS, the epidemic situation in China has already reached the intermediate point where the virus is spreading from the high-risk population to the general population. Granted that the number of people infected by HIV in China is less than 0.1% of the total population and the rate of transmission is yet quite low, nevertheless, this is only so because China has such a large total population. In fact, China already has the second highest number of people infected with HIV in Asia, and fourteenth globally. Furthermore, in the recent years, the number of reported cases of reported HIV/AIDS infections has been increasing and routes of transmission still exists extensively within the society.   

2.             The Social and Economical Effects of the HIV/AIDS Epidemic have Become Apparent

Up till now, there is no known cure to HIV/AIDS. The transmission of HIV is closely related to the management of blood and blood products, sex work, injection drug use, as well as other social problems. Thus, the prevention and control of the epidemic is very difficult. Not only is HIV/AIDS harmful for the physical health of our people and pose as a hazard to the safety of their lives, it also severely threatens our economic development and social stability. Due to the AIDS epidemic, medical expenses for people infected by the virus and their families have increased drastically. Part of the infected population has lost part of all of their ability to work. Some have lost their jobs, been deprived of their education, and been unable to sell their produces because of social discrimination. Consequently, their incomes have been decreased severely, some families has become utterly destitute, others have, on top of the poverty, had their families broken up. The AIDS epidemic also has impeding effects on the economic developments of some of the regions: financial pressure from medical expenses used for treatment and care programs has been increasing, which caused huge amount of healthcare resources to be spent, which, consequently, created a serious financial burden for the local region. At the same time, the epidemic has also elicited a series of serious social problems such as social care and support for the patients, orphans, and the elderly, elimination of social hazards, and the maintenance of the physical well being of the general population. In December, 2003, I saw in Shangcai County of Henan Province that after the local farmers who had sold blood (to build houses and get married) have died from AIDS, the children and elderly of these families are left without anyone to take care of them. Such events have had severe effect on the financial development and social stability of the local region, and are very disheartening to see. The spread of HIV/AIDS has indeed caused great social and economical harm for our country.   

3.             We Have Learned and Publicized Internationally the Preliminary Information on the Epidemic Situation, So That Prevention and Control Work Would Be Motivated Both Domestically and Internationally

China has cooperated with UNAIDS, The World Health Organization, and other international organizations to make an assessment of the currently AIDS epidemic situation. This assessment was make based on investigation of the real situation, and using an internationally accepted method. The result of the assessment was publicized for the first time domestically as well as internationally. At the same time, on a high-ranking meeting held by the UN regarding HIV/AIDS, the Chinese government has made five promises to the international community regarding HIV/AIDS prevention and control. It could be said that HIV/AIDS prevention and control work is a demand and request of the Chinese people, and it is also closely watched by the international community. Under such a circumstance where prevention work is motivated both internally and externally, we must successfully implement HIV/AIDS prevention and control work through: having the courage to face the epidemic situation; understanding that we’re held responsible for the physical health and the safety of the lives of our people; communicating and cooperating more openly and efficiently with the internationally community.     

4.             The Fast Pace at Which the Routes of Transmission of HIV/AIDS are Changing Requires Us to Open Our Minds and Persistently Use Effective Intervention Mechanisms

Currently, the transmission of HIV/AIDS through blood transfusion is basically under control. Therefore, unsafe sexual contacts, injection drug use, and maternal transmission have become the main routes of transmission for the virus. In view of this new alteration, some regions have initiated activities promoting the use of condoms, providing methadone treatment as well as clean needle exchanges for injection drug users. Such activities have shown to be quite effective. However, these are only pilot projects with limited scope of influence, plus the general population’s understanding of such projects is still inconsistent. Therefore, there still exist many impediments, in terms of understanding and practicality, to the implementation of these behavioral intervention mechanisms. However, we must remain determined, open our minds, be practical and realistic, and unify our understanding and actions, so as to be steadfast in promoting and applying of these intervention mechanisms and prevent the further spread of the AIDS epidemic.     

5.            Urgent Need to Improve the Public Interest in and Recognition of the Importance of Prevention Work, in Order to Create a Positive Atmosphere for HIV/AIDS Prevention and Control

The State Council has, based on the STD/HIV prevention coordination meeting policies, established the national HIV/AIDS prevention and control committees. The goal of such an establishment is to strengthen leadership, reinforce the coordination and cooperation between each of the relative departments, and enhance coordination and cooperation within and between different regions, especially those of severe epidemic situation. The regional governments have gradually realized the harms involved with the AIDS epidemic and the urgency and importance of the prevention and control work. After years of practice, a few regions, especially those of severe epidemic situation, have gathered some experiences on prevention and control of the epidemic. However, the operating mechanisms of the HIV/AIDS prevention and control programs still need to be improved and perfected. Ignorant fear of the epidemic and discrimination against people living with HIV/AIDS still exist in society. Therefore, we must actively explore more effective prevention and control mechanisms, and try to create an atmosphere that is helpful for HIV/AIDS prevention and control work.  

To summarize, I believe, now is a crucial time for HIV/AIDS prevention and control work in China. If we can seize the opportunity, adopt effective measures, conscientiously strengthen our prevention and control programs, we can, without a doubt, contain the spread of the AIDS epidemic. If we ignore the shortcomings of our programs and lose this timely opportunity, the result will be detrimental. How to seize this opportunity to successfully accomplish this task, which is vital for the economic development, social stability, and national prosperity, is a challenged face by all governmental departments. In fact, the existing prevention and control programs seem hardly fit for the current need, some of problematic aspects include: underestimation of the severity and the scope of the spread of the AIDS epidemic; lack of understanding of the perniciousness of the epidemic, the long-term and difficult nature of the prevention work; lack of explorations for more effective prevention mechanisms, etc. Knowing that we are responsible for our people, our nation, and our national history, we should utilize successful experiences learned from fighting the SARS epidemic, be more practical and more willing to actively explore and learn, so that we could successfully improve and implement the HIV/AIDS prevention and control work. 

II.  Press for Extensive National Prevention and Intervention Programs

The key to containment of the AIDS epidemic is prevention. We need to widely and extensively develop publicizing educational programs, as well as adopting practical and effective prevention and intervention measures based on the main routes of transmission of the HIV/AIDS virus. 

1.        Widely and Extensively Develop Publicizing and Educational Programs

Publicizing and education is a key element in the prevention and control of HIV/AIDS. In the past few years we have done a lot of related work. However, the scope of the propaganda is not extensively enough, the target of the content is not obvious enough, and the format of such programs lacks variation.  In my opinion, education programs should focus in areas such as villages, communities, schools, regions and which have a high concentration of high-risk populations. These programs should help people eliminate the fear and hysteria that surround AIDS, increase the awareness of self-protection among the general public, mobilize the society to eliminate discrimination, provide care and support for people living with HIV/AIDS. Firstly, we should educate the public about the routes of transmission, epidemiological characteristics, and basic prevention information of HIV/AIDS. The general population should be taught what types of behavior would cause the transmission of HIV, and what types would not. We should also educate the entire society to actively join into the prevention and control of the epidemic, as well as provide care and support of people living with HIV/AIDS. Secondly, populations living with HIV/AIDS should be taught to respect and love themselves. They should be helped to acquire the confidence to fight against the virus and be victorious. They should also be encouraged to overcome difficulties, actively participate in and cooperate with the prevention and control programs, and do more things that will be beneficial to other people as well as society. Thirdly, governmental policies and measures regarding prevention and control of HIV/AIDS should be highly publicized so that the domestic population and the international community could learn our attitude towards the epidemic and the work we have done. Such understanding will bring more understanding and support. Lastly, we should encourage social organizations and corporations to actively participate in HIV/AIDS-related publicizing and educational programs, so as to increase the level of awareness. News agencies, departments of public healthcare, education, public security, agriculture, railroad, communications, civil aviation, labor union, the Communist Youth League, the women’s federation, along with other departments and organizations, should use the unique ability of each to conduct and promote HIV/AIDS related educational programs that are regular, systematic, easily-understandable, and multifaceted in nature. At the same time, we should encourage prevention and control program workers, public service workers, volunteers, and people living with HIV/AIDS to actively participate in and contribute to such programs.

2.        Rigorously Prevent HIV/AIDS Transmissions through Blood

HIV transmission through blood is the most dangerous route of transmission of the HIV virus. Through reinforcing the organization and management of blood collection stations, standardized blood-collecting behaviors, and strengthen the response against illegal blood selling and collection, the transmission of HIV through blood has been basically eliminated. However, in the recent years, this route of transmission still remains actively in certain regions. Illegal blood selling and collection organizations still exist in some of these regions. To completely eliminate transmission of HIV/AIDS through blood, we must reinforce further the organization and management of blood collection station, and standardize the management of these stations. Such reformations would be founded by funding from the national dept. In principle, in counties and regions below the county level, no blood collection stations should be setup, and in counties of especially severe epidemic situation, there should be no serum collection stations. We must improve the blood collection management mechanisms and clarify and define each management responsibility. We also need to implement monitoring and management measures regarding blood collection, rigorously overhaul and consolidate blood-collecting organizations, and perform periodic inspection and evaluations. We also must relentlessly crack down on illegal blood selling and collection activities. This year, the national leadership office for overhauling and standardizing market economy organization is going to organize an attack specifically on illegal blood selling and collection activities. This attach will rally the whole society so as to completely stop such illegal activities and punish people involved according to law.

At the same time, nosocomial transmission of HIV/AIDS is also a problem that is highly noteworthy. We need to promote the use of disposable needles and syringes, ensure safety of transfusion materials, improve work related to destroying disposable medical and health materials, and ensure sterilization of reused medical equipments. Blood used for medical procedures should also be examined closely so that nosocomial transmission of HIV would be completely eliminated. For work units that violate such regulations, people directly responsible as well as other related personnel will be punished according to law. There is also a need to promote and propagandize unpaid blood donation, people of appropriate age should be motivated to donate blood so as to increase the proportion of unpaid blood donation.  

3.        Steadfastly Implementing Intervention Measures

Injection drug use as well as whoring and prostitution is the most prominent routes of HIV/AIDS transmission. Actively developing intervention programs for high-risk behaviors such as injection drug use and prostitution is vital in the prevention and control of HIV/AIDS. According to relative Chinese policies, the use of narcotic drugs as well as whoring and prostitution are all illegal activities. The attitude of the Chinese government towards these behaviors has been very stern and determined. The law enforcement has been rigorous and active in their effort to crack down on these activities. All such measures taken by the government have contributed much to the prevention and control of HIV/AIDS. However, behaviors such as injection drug use and prostitution cannot be eliminated completely from society in the near future, therefore, to deal with these persistent ailments of society we must use a method that combines direct combat with prevention. On one hand, we need to be determined in our effort to crack down on illegal activities which include the dealing, selling, and ingestion of narcotic drugs as well as whoring and prostitution. On the other hand, we must adopt any necessary means by which we could decrease the spread of HIV/AIDS from these people with unhealthy behavior to the general public, and so to decrease their harmfulness to society. The Ministry of Health in cooperation with the World Health Organization had established in Hubei and Hunan pilot programs promoting the use of condoms. After a year of practice, this program has been able to drop the incidence of sexually transmitted diseases considerable. It has had a very positive effect on the prevention and control of HIV/AIDS and such experience should be learned and extended further. We must actively promote the use of condoms. In public areas where the high-risk populations are more concentrated, condoms should be distributed publicly or condom-distributing mechanisms should be setup. We should try as much as we can to eliminate the sexual transmission of the virus. In the resent years, in provinces (and autonomous regions) such as Guangxi and Yunnan, where injection drug use has been a very serious problem, cooperative efforts has been made by various international organization to establish pilot programs which promote clean needle exchange. These projects have shown to have very positive results. The Ministry of Health, Ministry of Public Security, and the Food and Drug Administration have setup pilot programs for methadone treatment for injection drug users in Zhejiang, Sichuan, Yunan, Guizhou, and Guangxi Provinces. In these projects, we need to learn from our experiences and gradually extend them further. We will try to eliminate the transmission of HIV/AIDS through intravenous drug use by these methadone treatments and needle exchange programs. The local governments and related departments should treat these intervention programs with practicality and reason. They should recognize that adopting necessary intervention measures and the crack down on illegal activities serve the same basic purpose. They should adopt effective and practical intervention programs based on whether it would contribute to the prevention and control of HIV/AIDS and whether it would have a positive effect on the physical well-being and safety of the general public.    

4.        Effective Put into Practice The Epidemic Situation Surveillance Mechanisms

The accessibility to timely, accurate, and comprehensive information regarding the epidemic situation and transmission trend of the AIDS epidemic is vital to the prevention and control of HIV/AIDS. We need to enhance the AIDS epidemic surveillance network, setup surveillance stations in medical service agencies, centers for disease control, and places of high high-risk population concentration. In these stations, we should develop policies and clarify the responsibilities, so as to be more efficient and extensive in the screening and examination of people living with HIV/AIDS. To ensure the efficiency of the surveillance system, the surveillance stations need to be: equipped with adequate surveillance and examine equipments and personnel; provided with necessary financial as well as other supports. In order to enhance the construction of the surveillance and reporting information network, we also need to implement policies regarding the reporting of epidemic situations. A timely and accurate report on the HIV/AIDS situation is requested, and to make available information on the epidemic according to relevant regulations. Individuals who deceive, underreport, or delay reporting on the epidemic will be punished severely. We must be persistent in our effort to establish a periodic epidemic surveillance and reporting program, so as to provide a firm basis for the research and development of more effective local HIV/AIDS prevention policies and thus make our prevention and control programs more effective.     

III.             Effectively Implement Treatment and Care Measures

Providing proper treatment and care for people living with HIV/AIDS not only could prolong their life, improve the quality of their lives, decrease the chance of transmission, but also is favorable for both solving the social problems brought by the AIDS epidemic as well as maintaining economic and social order.  

For many years, the Ministry of Health along with other departments have developed, based on detailed investigation and research, a series of policies and measures regarding providing treatment and care for people living with HIV/AIDS as well as their families. In the year 2002, China has started manufacturing domestic antiretroviral medications, and has been providing these free medications for the patients in Henan, Anhui, Hubei, and other regions of severe epidemic situations. In the year 2003, the Chinese government established the “Four Frees and One Care” policy, which says: the government will provide: free primary screening tests and counseling for people who voluntarily take the test; free ARV therapies for farmers and urban populations experiencing poverty; free education for children affected by HIV/AIDS; free HIV/AIDS counseling, screening, and ARV treatments for pregnant women; and federal care and support for underprivileged people living with HIV/AIDS and their families. In March of 2004, the State Council has issued “The Notice on Strengthening HIV/AIDS Prevention and Control”, and put forward a series of prevention and control measures. Each region has taken special care in implementing such decisions and plans made by the Party and the State Council. They have, under the combined support and cooperation of the Ministry of Health and the Ministry of Finance, actively developed ARV treatments for AIDS patients. In order to carry through with the treatments, they sent medical care team down to the villages. A series of care and support programs has been established to provide support for underprivileged families affected by HIV/AIDS through wavering of various fees from the overall financial need of the family as well as tuition money for the children, providing relief goods as well as funding, as well as other measures. Through works done by such treatment and care programs, we have had very positive results. I have seen in Shangcai County of Henan Province that many patients have regained their health through treatments and reclaimed their faith and confidence in life. Some of them even were able to go back to work. Through these changes, the social order of the local region has thus gotten back to normal. This represents perfectly how important providing treatment and care for people living with HIV/AIDS as well as their families is. We should recognize that the “Four Frees and One Care” policy is, at the present and for the near future, the most potent governmental measure for HIV/AIDS prevention and control work in China. To implement this policy, we must give prominence to being able to truly fulfill the program. When I went to Henan for investigation, I had separate informal discussions with the local patients, medical service personnel, researchers, and government officials. In these discussions, I have put forward over a dozen questions regarding the implementation of the “Four Frees and One Care” policy and asked the relative departments to investigate them. In the First State Council HIV/AIDS Prevention and Control Committee Meeting held not long ago, we concentrated on the problem of implementation. The Ministry of Finance, Ministry of Health and the Ministry of Civil Affairs will be coming up with specific regulations and policies. However, even with clearly stated policies and regulations as well as implementation methods, there are still many problems in carrying out this program. For example, how would we effectively hand out the free medications to the patients, and how would we ensure that they’re taking these medications properly? How would we provide treatments for the side effects caused by the ARV therapy? How should we actually provide care and support for people living with HIV/AIDS and their families? How should the targets and criteria of the care and support programs be defined? What types of adoption system should be setup for children and elderly affected by HIV/AIDS? How should we motivate the personnel working at the grassroots level, and how should their salaries be provided? How should we treat the premarital checkup problem in the regions of severe epidemic situation? Only when we have answered each of the questions clearly and find solutions for each can we truly implement these policies.

 The implementation of the “Four Frees and One Care” policies needs to be integrated into the China Comprehensive AIDS Response (China CARES). Since the year 2003, the Ministry of Health has setup 127 China CARES pilot sites which are focusing on providing community based education, consultation, treatment and care. In my opinion, this is a great platform for implementing the “Four Frees and One Care” policy. In constructing the pilot sites, we need to: firstly, we must actively develop comprehensive services related to personnel training, healthcare education, behavioral intervention, medical treatments, prevention of mother to child HIV transmission, and consultation and support. Only through these could we build a social environment that is favorable for the prevention and control of HIV/AIDS; secondly, we must educate the newly married population about HIV/AIDS prevention and provide for them free HIV testing. We also need to summarize the experiences we have accumulated in areas related to protection of children against the infection of HIV/AIDS; thirdly, we must keep on improving the treatment managing mechanism which combines therapy at the appointed hospital and community treatment, and for high-risk populations, we must continue on perfecting the behavioral intervention treatment managing mechanisms. In summary, we must explore to find the solutions to the real problems we have encountered while implementing the “Four Frees and One Care” policy, and thus provide useful information for prevention work in other regions within the country. In constructing the China CARES pilot sites, we must ensure the success of each. The emphasis is on the quality of these sites instead of the quantity.

 To implement the “Four Frees and One Care” policy, we also need to pay attention to the strengthening the construction of our HIV/AIDS prevention and control team. Presently, the HIV/AIDS prevention and control team in China is still not perfect. There is a lack of qualified personnel, there are very few that have the medical experiences that would make them competent for the grassroots level treatment and care work. The demand for such personnel has largely exceeded the supply. We need to adopt various methods to create a team of medical service workers who have the basic qualities to be competent for HIV/AIDS treatment and prevention work. To do so, we must vigorously develop HIV/AIDS prevention personnel training programs at all levels and of all types, so that a team that qualified for: participating in the newest scientific research, leading the prevention and control work at even the basic level, and handling the grassroots level HIV/AIDS prevention and control work. We must earnestly care about the HIV/AIDS prevention and control personnel, especially those working at the grassroots level: consider their needs in terms of policies and regulations; support them for their work; and care about their daily lives. During my investigation in Henan, I was deeply touched by how strenuous the work is, how difficult the conditions are, and how little the salaries are for people working for HIV/AIDS prevention programs, especially those working at the grassroots level. The amount of risk and danger that are involved in their job is usually not understood. However, these obstacles did not deter them. With their determination and love for life, they delivered medications to each of the patients so they can be relieved of their illness and pain. Such commitment is very moving and should be admired by everyone. Treating them with special care and respect would not only contribute to the stabilization and construction of our HIV/AIDS prevention team, but would also show the approval and encouragement which they deserve more than anyone else. In addition, we must pay special attention to those senior researchers and professionals who, in their work, embodies commitment, high morality, and superb mastery of the technical aspects of the prevention work. They are the core of our HIV/AIDS prevention and control work, and so we should create the best work environment for them. Each regional and related departments should ensure the exact and practical implementation of the “Four Frees and One Care” policy, so that it would: bring the concern of the Party and the Government to each of the person living with HIV/AIDS as well as their families; help them lessen the pain brought by the illness; aid them in building up the confidence to fight the illness; and assist to free them from poverty. Through the “Four Frees and One Care” Policy, we will continue on accumulating experiences that would be helpful in improving the level of our treatment and care work.

IV.     Actively Explore an Effective Prevention and Control Operating Mechanism which is Led By the Government and Participated by the Rest of Society

In the past dozen years or so, drawing on the experiences of foreign countries, and combining them with China’s unique situation, we have been vigorous in exploration of effective HIV/AIDS prevention and control mechanism, and have achieve some progress. In the past two years, we have accumulated valuable experience from our fight against the SARS epidemic. Such experiences suggest to us that as the economic society develops and evolves, we also need to actively explore new, more appropriate and effective prevention and control operating mechanisms that is lead by the government and participated by the rest of society. The leadership of the government is the key.

1.              Strengthen Leadership

We must insist on mainly having the officials in charge of the prevention and control work. HIV/AIDS prevention and control should be integrated into the routine government agenda as well as the national plan for economic and social development. The officials in charge must ensure that there are sufficient amount of human, financial, and material resources, and guarantee the adherence to responsibilities of tasks and implementation of actions. The HIV/AIDS prevention and control need to be integrated into the overall plans for construction of public health care system and rural cooperative medical care pilot projects. These programs will both provide relief for the patients and organize and motivate the patients to help each other. We should take “China’s National Medium and Long Term Strategic Plan for HIV/AIDS Prevention and Control (1998 – 2010),” “State Council Notice on China HIV/AIDS Containment, Prevention and Control Action Plan (2001 – 2005),” and “State Council Notice on Strengthening HIV/AIDS Prevention and Control” as the programmatic documents for HIV/AIDS prevention work in China at the present and in the near future, follow and implement them well.  

2.        Bring into Play the Roles of the Functional Departments

Each relative department should, based on the function of each, clarify and implement the responsibilities of each, act in close coordination. Together they should: research and develop policies and regulations related to HIV/AIDS prevention and control work; and strengthen the guidance and supervision to the actual prevention and control work. The member departments of HIV/AIDS prevention and control institutions especially should be conscientious in fulfilling their responsibilities, which include: reinforce the coordination among themselves, strengthen their guidance for local and grassroots level prevention work, successfully put into effect future plans, and exert themselves in researching, coordinating, and solving the major problems encountered in the HIV/AIDS prevention and control work. 

3.             Prevention and Control Mechanisms Should be in Conformity with Legal Provisions

We must use policies and laws to standardize prevention and control work as well as the behaviors of the general public. For regulations and policies such as the “China Communicable Disease Prevention and Control Law,” “China Mother and Child Healthcare Law,” and “China Blood Donation Law,” we need to, on one hand, continue on with the implementation of them, and on the other hand, amend and revise the parts that are no longer appropriate for the prevention and control work so as to ensure the consistency of the policies. At the same time, we need to keep on investigating those new situations and problems that we are encountering in practice and improve the policies according to these information. The goal is to develop specific and practicable measures and methods. We must strengthen the enforcement and supervision of the policies and extend the actual implementations of such policies into the practical aspects of the prevention and control work. We must strengthen the education in legality, raise the awareness of HIV/AIDS prevention and control in conformity with legal provisions, decrease the social hysteria and discrimination surrounding HIV/AIDS, and raise the legal awareness of people living with HIV/AIDS. We must, through unremitting efforts to reinforce the construction of the legal system, truly standardize the prevention and control activities, and create a legal environment that is favorable for HIV/AIDS prevention and control, and one that guarantees the prevention work would be progressing in a well-organized manner. We must punish the people who illegally provide medical services and those who sell counterfeit medications. These people do not act on a humanitarian basis and should be punished severely and vigorously cracked down.    

4.         Scientifically Carry Out the Prevention and Control Work

Whether it is the prevention or treatment of HIV/AIDS, science is always the focal point. We must be scientific in our practice. The scientific aspects of the prevention and control work should be involved as an important part of the content of the governmental guidance. The government should organize forces from various fields and engage in scientific researches. The emphases of the researches should be those that are applicable to enhancing the prevention and control work. For example, the contents of the researches could be: how to develop more effective ARV medications with less side-effects; how to improve the treatment method and raise the adherence among the patients to the therapy; how to control the development of drug-resistance; how to go about treating opportunistic infections, enhance the effects of the treatment, and decrease the harm done to the patients; and also how to make the surveillance and testing methods, education and propaganda strategies, and behavioral intervention policies more practical, efficient and effective. These are all scientific questions that require our attention and should be investigated and the solutions drafted. We must use scientific methods in developing the prevention and control programs as well as in evaluating the results of such programs. Upon such evaluations, we should strike to achieve better outcomes in the future. Through scientifically carrying out the prevention and control work, we must try our best to find, diagnose, and treat more people living with HIV/AIDS. We must continuously improve and strengthen HIV/AIDS prevention related scientific researches, so as to try as hard as we can to effectively prevent and contain the AIDS epidemic and eventually be victorious.

Emphasizing the leadership role of the government is necessary, however, this does not mean that the government is running the entire show. We must also make good use of other forces and resources from society, especially in the present where the economic and social environment has changed enormously. The socialist market economic system has evolved much and is changing toward a much more multifaceted society. People are becoming more likely and more capable financially to help the poor and destitute. Thus, while focusing on the leadership of the government, we also must motivate and guide the rest of the society to part take in the HIV/AIDS prevention and control work. This is not only the objective need of HIV/AIDS prevention and control work, but also the unavoidable trend of social economic development. First and foremost, we must motivate the whole society. Currently, the Communist Youth League, the Women’s Federation, STD/AIDS Prevention and Control Committee, and HIV/AIDS Foundations have all, according to the strength of each, developed care and support programs for people living with HIV/AIDS. Several enterprises, as well as international organizations have, through various means, participated in the HIV/AIDS prevention and control work. Volunteers have established schools, orphanages for children affected by HIV/AIDS. They have also been providing services for AIDS patients in hospitals, communities, and villages. We must preserve, guide, and expand these efforts. We should, through propaganda, education, as well as various other methods, try to guide medical service institutions of all levels, disease control and prevention institutions, enterprises, schools, social organizations, NGOs, private enterprises, volunteers, and even international organizations to participate in the HIV/AIDS prevention and control work. Secondly, we must explore and establish a multi-channeled input mechanism. In the recent years, China’s nonprofit organizations and institutions have been developing at an immense pace. We now have federally owned nonprofit institutions, developed a system of periodic donations, some enterprises and individuals has expressed their desire and capability to donate or provide funding, and also the State Council has issued the “Foundation Management Policies,” all of these combined have help created the condition for the developing the multi-channeled input system. We should actively explore, through setting up various foundations, ways to collect financial support from the society to be used for HIV/AIDS prevention and control work: setting up special budgets in non-profit foundations; developing donations that would involve the whole society; and setting up permanent stations or sites for receiving donations. We also need to truly use such financial resources to help the targets of the care and support programs. The government should, through making connections and setting up platforms, ensure the proper and efficient use of the social resources and founding. We need to strengthen the training of the social forces so that they would master the skills needed to provide proper services for the targets of the care and support programs. We must also strengthen our management of the funding and reduce the number of intermediate links for the target population to use this fund. We must encourage more social forces and funding to enter the community, villages, and pilot sites where the people living with HIV/AIDS reside. Care and support should be provided to the target population through establishing “home of love and care,” schools, orphanages, voluntary services, and organizing peer assistance and consultation. Through such activities, the target population will be able to experience the care from the government as well as the entire society, and consequently will help them acquire the confidence to fight against the disease. In short, we must fully mobilize the available social forces and resources and create an effective HIV/AIDS prevention and control system that involves the entire society. I hope that all the regional related departments would open up their minds, broaden their outlook, and be courageous in their efforts to explore, amend, and revise relative policies and regulations, so as to create a favorable environment and positive conditions which would encourage the society’s participation into HIV/AIDS prevention and control work. They should also reinforce the leadership and guidance, be bold in putting plans into actual practices, and do whatever they could to make HIV/AIDS prevention and control work successful.

The comprehensive advancement of HIV/AIDS prevention and control work is vital to out people’s physical health and the safety of their lives. It is an urgent mission that would influence significantly the social and economic stability and development of China. We must be persistent in implementing the orders and plans made by the Party and the State Council, comprehensively carry out each of the HIV/AIDS prevention and control measures, do our best in exploring new effective prevention and control mechanisms and raise the HIV/AIDS prevention and control work in China to another level.

**unofficial translation**