British medical journal The Lancet has credited China with a major about-face in its attitudes and policies toward its HIV/AIDS epidemic. The journal's summary of China's current approach toward the disease is one of the most significant positive assessments of the country's HIV/AIDS strategy to date.
In the paper 'Evolution of China's response to HIV/AIDS' by Professors Wu Zunyou MD, Sheena G Sullivan MPH, Wang Yu MD, Mary Jane Rotheram-Borus PhD and Roger Detels MD, the authors describe the evolution of China's attitude toward HIV/AIDS:
"After a slow start and reluctance to recognise the existence of risk activities in its population and of the HIV epidemic, China has responded to international influences, media coverage, and scientific evidence to take bold steps to control the epidemic, using scientifically validated strategies. The country now faces the challenge of scaling up these programmes and of convincing all levels of government to implement these innovative strategies and policies. This vigorous response, incorporating research findings into policy formulation, can be informative to other countries that face similar challenges in responding to the HIV/AIDS epidemic."
China's first AIDS case was a dying tourist in 1985, its first indigenous cases of AIDS were recorded in 1989, a result of an outbreak among 146 heroin users in Yunnan province. Since then, the disease has spread to all of China's administrative regions, not only through intravenous drug use, but also through plasma donation in the 1990s and through heterosexual and homosexual intercourse. By 2005, an estimated 650,000 Chinese were HIV-positive.
Like most countries, there was an initial reluctance in China to admit the seriousness of HIV/AIDS within its own borders. The Lancet cited several initiatives taken by the Chinese government to curb the disease's spread including needle exchange programs, methadone treatment programs, prevention programs targeting commercial sex workers and other programs as having a significant impact on slowing the disease's spread. Domestic and international media coverage was also credited with raising awareness of and destigmatizing HIV/AIDS among the general public.
Interestingly, China's severe acute respiratory syndrome (SARS) outbreak in 2003 is also credited with raising awareness among Chinese officials of the socially and economically destabilizing potential of infectious diseases. In the wake of SARS, China's relationships with international organizations including the World Health Organization have improved as has the country's ability to collect real-time data pertaining to infections.
The Lancet report said one of China's biggest challenges for scaling up and enhancing its HIV/AIDS prevention strategy was getting provincial and other local governments onboard. The report singled out Yunnan for praise, saying that the province "has shown strong support for implementation and advocacy of harm-reduction strategies that reduce HIV transmission in its many drug users".