China urged to “Close the Gap” on World AIDS Day
WHO applauds China’s progress on HIV and AIDS, yet calls for new approaches
BEIJING, 28 November 2014 - China’s national HIV and AIDS response has continued to improve as a result of strong government leadership in the last decade. Top-level commitment to controlling the HIV and AIDS epidemic includes world-best practices including clinics for injecting drug users. But more needs to be done to end the epidemic in China by 2030.
“Progressive and rapid actions in China have helped lessen the infection rate of HIV, the virus that can lead to AIDS,” said Dr Bernhard Schwartländer, the World Health Organization (WHO) Representative in China. “We already see decreased transmission rates from HIV-positive mothers to their babies, and lower infection rates among injecting drug users who have access to more than 700 harm-reduction clinics across China.”
China’s policies for reducing HIV infections among injecting drug users are world’s best practice. From just eight clinics in 2004, there are now 763 methadone clinics which provide harm-reduction services including methadone substitution therapy. These measures also improve health of this most vulnerable population in many other health aspects, including by reducing the risks of Hepatitis C infection.
HIV transmission rates in the children of HIV-positive mothers have also decreased significantly. The number of sites providing services to HIV-positive pregnant women has trebled from around 500 in 2009, to more than 1500 today – drastically reducing the rate of HIV infection among children born to HIV-positive mothers, from 35% in 2009 to 7% in 2012.
“We have seen remarkable progress in some areas, but we cannot stop now. This year’s World AIDS Day focuses on ‘Closing the Gap’ – the gap in widespread availability of preventative services, and the gap that currently exists in access to HIV prevention and treatment between what is needed, and what is actually available in the community,” said Dr Schwartländer.
“But there are still many challenges that China faces in preventing new infections, and in ensuring equitable access to healthcare and treatment for all who need it,” Dr Schwartländer said.
In particular, HIV infections continue to increase among men who have sex with men (MSM). A study published in Clinical Infectious Diseases in 2013 showed that the HIV epidemic among MSM is expanding rapidly across all parts of China. Compounding the problem, many MSM remain unaware of their status given the low rates of HIV testing among this population.
Around the world, there were around 35 million people living with HIV in 2013, and 2.1 million people becoming newly infected. There were an estimated 4.8 million people living with HIV across the Asia-Pacific region in 2013, including around 800,000 people in China.
“China can accelerate action on several fronts. First, a stronger push on prevention – for instance, promoting safer sex through 100% condom use. Second, make rapid HIV testing available at the community-level, particularly for populations who are stigmatized and discriminated against – sex workers, men who have sex with men, and drug users,” said Dr Schwartländer.
“And third, for those people who are living with HIV, we need to make antiretroviral treatment available sooner, and in a simpler form using fixed dose combinations – one pill per day. Virtually all countries in Africa, including some of the poorest nations in the world, base their treatment programmes on these simple and highly effective fixed dose combinations. This increases uptake, keeps people healthy and productive, and reduces the number of new infections. China is really lagging behind here,” Dr Schwartländer said.
“The goal is clear: ending the AIDS epidemic by 2030. There are still challenges in China and every other country in the world. However, we have the tools, and with China’s track record in innovation and pragmatism, I have no doubt that we can achieve this goal,” Dr Schwartländer concluded.
World AIDS Day, observed on 1 December every year, is dedicated to raising awareness of the AIDS epidemic caused by the spread of HIV infection.
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