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6 Combat HIV/AIDS, malaria and other diseases
Where we are?
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. The prevalence of tuberculosis (TB) in China reduced to 0.66 in every thousand, 61 percent lower than the figure of 2000. This meant that the MDG indicator for TB control had been achieved ahead of schedule. The actual malaria incidences decreased from 14,140 in 2009 to 2,716 in 2012.
Target 6A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS, and Target 6B: Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it
The Ministry of Health of the People’s Republic of China, UNAIDS and the World Health Organization conducted an estimation of HIV/AIDS epidemic conditions. By the end of 2011, there were approximately 780,000 people living with HIV in China, among whom women account for 28.6 percent. Currently, China’s HIV epidemic shows the following characteristics: firstly, although the rate continues to expand, the rate has slowed down; secondly, sexual transmission continues to be the primary mode of transmission, with homosexual transmission taking an obviously increasing share; thirdly, China’s HIV epidemic remains one of low prevalence overall, but with pockets of high infection in some localities; fourthly more people living with HIV are entering the period of onset and the number of deaths is increasing.
The HIV/AIDS awareness rate has reached 75 percent and 84 percent among Chinese rural and urban residents respectively. In terms of prevention and control, 17,083 HIV screening labs and 377 HIV confirmatory labs have been established by the end of 2012.
The government has comprehensively advanced the implementation of various HIV/AIDS prevention and control measures, including the expansion of the coverage of publicity and education, monitoring and testing, mother-to-child transmission prevention, comprehensive intervention, and antiretroviral therapy, as well as strengthening blood management health security, care and aid, protection of rights and interests, organizational leadership, and team building. After the launch of pilot projects, the government is now building six hospitals dedicated to infectious diseases in areas of high AIDS prevalence. Care has been increased for those with AIDS and for AIDS orphans. With the support of government, around 1,000 social organizations are active in this area, while China has sound bilateral cooperation with countries such as the UK, USA and Australia.
Challenges remain in relation to preventing and treating the illness, since sexual transmission is the main mode of transmission, which is harder to detect. Fewer than 50 percent of HIV carriers realize their status and so do not realize the risk of further spreading. P39.3.3 The HIV prevention and control measures provided for migrants and sex workers, particularly for low income sex workers, are insufficient. People living with HIV have gradually entered the stage of attack and the number of those requiring antiretroviral treatment has significantly increased. There are also more drug resistant cases, increasing pressures and difficulty for treatment. Discrimination against people living with HIV widely exists; there are no effective measures to protect employment and treatment rights of people living with HIV and AIDS.
Target 6C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases
China how has 4.99 million TB patients, ranking second in the world. In addition, there are about 1 million new TB cases emerging every year. Since 2001, it has launched the WHO-recommended modern TB control strategy (DOTS) at all levels. Since 2005, the geographic coverage of DOTS has remained at 100 percent and the cure rate for smear-positive TB cases has increased from 76.3 percent in 1991 to 93.8 percent in 2012. The upwards trend of TB prevalence has been curbed effectively and the Chinese Government has achieved its commitments to the international community on TB control at this stage.
The malaria rate has decreased from 30 million in 1949 to 2,716 cases in 2012. In that year only 14 deaths occurred. 2,473 of the cases were imported, while the remaining local cases were scattered in some areas of Yunnan, Anhui, Hubei, Tibet and Guangxi. Judging from the current situation, China has fully achieved the commitments concerning malaria control in the MDGs.
The government has attached high importance to TB prevention and treatment, providing RMB 1.4 billion in 2012. The Chinese Government has also made vigorous efforts to incorporate multi-drug resistant TB into the major disease insurance of the New Cooperative Medical Scheme in Rural China.
Regarding malaria, the government has a target to eliminate it from the country by 2020. The strategy is one of prevention and control as well as education.
Challenges remain in relation to multi-drug resistant TB, to TB patients being unable to afford medication, and to prevention and control capacities being too low in some local areas. The soaring social and economic development has caused the number of people leaving China to increase, causing a growth in imported malaria cases.
Targets for MDG6
- 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
- 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
- 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