6 Combat HIV/AIDS, malaria and other diseases

Where we are

 HIV positive meeting

The Chinese Government has endeavoured to improve people’s health and made significant progress in disease control and mortality reduction. By 2010, China had achieved the goals set in the National Action Plan (2006–2010) for AIDS Containment, Prevention and Care, succeeding in keeping the number of HIV carriers below 1.5 million. Despite many challenges ahead, China is making steady progress towards the MDGs concerning the control of HIV/AIDS.

Highlights

  • In 2014, 104,000 new cases of HIV/AIDS were found. The prevalence of epidemics has been kept at a low level. The primary mode of transmission has changed from blood transmission ten years ago to sexual transmission.
  • China has established a fully functional network for AIDS prevention and treatment covering both urban and rural areas. It has practically realized self-sufficiency in antiviral drugs. Over 80% of people that meet treatment standards have received standardized antiviral treatment. The fatality rate has been reduced to 6.6%.
  • In 2014, China saw 889,400 new cases of tuberculosis, a decline for six consecutive years since 2008. In 2014, China saw 3,149 new cases of malaria, 97.7% of which were imported cases. China is working hard to eradicate malaria nationwide.

Goal 6: Combat HIV/AIDS, malaria and other diseases

Target 6A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS

Basically met*

 

Target 6B: Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it

Basically met**

 

Target 6C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases

Basically met***

 

*In 2014, there were 104,000 newly reported cases of HIV/AIDS infected people and patients, with an annual growth of 14.8%. The epidemic was generally controlled at a low level and the trend of fast growth of incidence was curbed. The mortality rate of HIV/AIDS patients who meet treatment standard declined from 33.1% in 2003 to 6.6% in 2013.

**China started to offer free voluntary HIV/AIDS consultation and check in 2004, and put in place an HIV/AIDS prevention and treatment service network covering the urban and rural areas in 2014

***The upward trend of tuberculosis has been effectively controlled. The incidence of malaria has been reduced notably. But the incidence of chronic diseases has presented an upward trend in recent years.


Target 6A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS

 

The prevalence of HIV/AIDS epidemics has been generally kept at a low level, with the momentum of fast-rising incidences reversed. By the end of 2014, there were 501,000 people living with HIV, of whom 205,000 were AIDS patients. Thanks to improved policies and financial inputs from both the central and local governments, the annual growth rate of AIDS incidence has begun to slow down since 2012. For example, in 2014 the cases of mother-to-child transmission of HIV/AIDS had been reduced from 1.5% in 2004 to 0.7%, declined by 55%. HIV/AIDS through mother-to-child transmission on children under the age of five has always been small in number, kept between 300-500 people.


Target 6B: Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need

 

China has established a relatively full-fledged service system for AIDS prevention and treatment, with free testing covering most regions of the country. So far, China has set up 25,000 preliminary screening labs for HIV/ AIDS, 446 confirmation labs, over 9,000 voluntary consultation and testing clinics, over 1,800 AIDS monitoring posts, 766 methadone maintenance treatment clinics, 3,923 designated agencies for antiviral treatment, 163 Chinese medicine treatment clinics and 3,281 designated hospitals for comprehensive AIDS treatment, thus forming a full-functional HIV/AIDS prevention and treatment network that has rational layout and covers both urban and rural areas. In 2012, 87% of people living with HIV/AIDS eligible for treatment received antiviral therapy. By the end of 2014, 295,000 people living with HIV/AIDS were receiving antiviral therapy, 15,000 patients were receiving traditional Chinese medicine treatment, and 184,000 drug users were receiving methadone maintenance treatment. Intervention rates on women sex workers and male homosexuals stood at 81.0% and 72.3% respectively. AIDS treatment capacity is rising continuously with falling fatality rate. By the end of 2011, China had realized basic self-sufficiency in free antiviral drugs. The fatality rate of children under antiviral therapy has been kept under 2.31%. Methadone maintenance treatment was recognized as the best practice to be spread widely by UNAIDS and other international organizations.


Target 6C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases

 

China has successfully reversed the rising trend of tuberculosis (TB) incidence, with the recovery rate remarkably increased. The Chinese government has always attached great importance to TB prevention and treatment. In 2014, new cases of TB patients stood at 889,400, with an incidence rate of 65/100,000, a reduction for six consecutive years since 2008. The recovery rate for smear-positive TB patients had risen from 76.3% in 1991 to 93.0% in 2013. In 2010, the incidence for smear positive TB patients was 66/100,000, and the fatality rate of TB was 3.9/100,000, which amounted to a decrease of 51% and 79.5% respectively compared with 1990, thus realizing relevant target of the MDGs ahead of schedule. China has made tremendous progress in malaria prevention and treatment. The number of newly infected malaria patients has been reduced from around 100,000 every year in the early 1990’s to 3,000 now, with the incidence rate reduced to 0.2/100,000. Over 90% of new cases are imported cases. Judging from the current situation, China has fully realized the relevant targets on malaria in the MDGs.

Challenges Ahead

The task for prevention is still arduous. Although the national information system for comprehensive prevention and treatment of AIDS has been established, there are still about 40% of people living with HIV/ AIDS that have not been discovered, making effective prevention services hard to provide, with the risks of further transmission. Social discrimination against people living with HIV/AIDS is still prevalent. The services and management of grassroots medical and health care institutions also needs improvement with departmental coordination and social participation further strengthened.

Imported malaria cases have increased with 97.7% of reported malaria cases being imported cases. As the population mobility has increased markedly with people going abroad for business, tourism or work, imported malaria cases have been on the rise year on year, bringing new challenges to malaria eradication in China. 

Targets for MDG6
  1. Halt and begin to reverse the spread of HIV/AIDS
    • HIV prevalence among population aged 15-24 years
    • Condom use at last high-risk sex
    • Proportion of population aged 15-24 years with comprehensive correct knowledge of HIV/AIDS
    • Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years
  2. Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it
    • Proportion of population with advanced HIV infection with access to antiretroviral drugs
  3. Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases
    • Incidence and death rates associated with malaria
    • Proportion of children under 5 sleeping under insecticide-treated bednets
    • Proportion of children under 5 with fever who are treated with appropriate anti-malarial drugs
    • Incidence, prevalence and death rates associated with tuberculosis
    • Proportion of tuberculosis cases detected and cured under directly observed treatment short course