HIV This Week

Wu Z, Sullivan SG, Wang Y, Rotheram-Borus MJ, Detels R. Evolution of China’s response to HIV/AIDS. Lancet 2007;369:679-90.

Four factors have driven China’s response to the HIV pandemic: (1) existing government structures and networks of relationships; (2) increasing scientific information; (3) external influences that underscored the potential consequences of an HIV pandemic and thus accelerated strategic planning; and (4) increasing political commitment at the highest levels. China’s response culminated in legislation to control HIV -the AIDS Prevention and Control Regulations. Three major initiatives are being scaled up concurrently. First, the government has prioritised interventions to control the epidemic in injection drug users, sex workers, men who have sex with men, and plasma donors. Second, routine HIV testing is being implemented in populations at high risk of infection. Third, the government is providing treatment for infected individuals. These bold programmes have emerged from a process of gradual and prolonged dialogue and collaboration between officials at every level of government, researchers, service providers, policymakers, and politicians, and have led to decisive action.

Editors’ note : In the wake of SARS, China has shown tremendous resolve in responding to HIV decisively and matching programming to the dynamics of its epidemic. When China decides to move forward, it commits to deliver. The speed at which antiretroviral treatment access can be increased; the extent to which key populations can be reached with tailored programmes; and whether the voluntariness of HIV testing, combined with anti-stigma and antidiscrimination measures, can be ensured so that knowledge of serostatus will be sought by people are all key to achieving an effective and sustained result.