|
- 现金
- 62111 元
- 精华
- 26
- 帖子
- 30437
- 注册时间
- 2009-10-5
- 最后登录
- 2022-12-28
|
http://www.nature.com/news/2011/110715/full/news.2011.422.html?WT.ec_id=NEWS-20110719
China steps up to AIDS challenges Nation set to tackle epidemic through community groups and cooperation with other developing countries. Jane Qiu
 Michel Sidibé.MARTIAL TREZZINI/epa/Corbis
Michel Sidibé, executive director of the Joint United Nations Programme on HIV/AIDS (UNAIDS), made a whirlwind visit to China this week — meeting the vice-premier and health minister, attending the launch of a programme to address the country's growing HIV epidemic among men who have sex with men (MSM) and participating in the first ministerial summit on global health with officials from Brazil, Russia, India, China and South Africa (BRICS).
He talks to Nature about the challenges that China faces in tackling AIDS, and why it is crucial for BRICS countries to join forces on global public health.
China launched its HIV/AIDS-response programmes almost a decade ago. How would you assess the efforts?
China has made serious progress. Funding has more than quadrupled since 2003 and AIDS-related deaths have been reduced by 64%. The country no longer has major problems with the safety of blood transfusions. It has established one of the biggest methadone-treatment and needle-exchange programmes in the world. It has lifted travel restrictions for foreigners with HIV and AIDS and is the first country to develop a five-year plan based on UNAIDS' 'Getting to Zero' strategy — which aims for zero new HIV infections, zero discrimination and zero AIDS-related deaths worldwide.
There are still major gaps on stigma and discrimination, high-risk populations — especially MSM — and support for community-based organizations. But I see attitudes changing, and the top leaders are willing to tackle these issues.
China is stepping up its detection programme, including mandatory HIV testing in hospitals and among high-risk populations. What's your view on the initiative?
The major failure of our AIDS programme today is people's lack of knowledge of their HIV status. If we start people on treatment early, we can reduce transmission by 96%. The strategy of dedicated voluntary counselling and testing centres is not always effective, because people often don't come forward for fear of stigma and discrimination.
We're now shifting towards routine testing in hospitals and clinics, but testing must always be confidential and voluntary, with the right counselling. The danger of mandatory testing is that people could be discriminated against and go underground.
One in three new HIV infections in China is among MSM. What steps need to be taken to tackle this problem?
The first step is to know the scale of the epidemic and come up with a targeted strategy to focus on areas where infection is highest. The government also needs to take a stronger stance to ensure that there is zero tolerance for discrimination against homosexuality, especially in health-care settings.
The engagement of the MSM community is absolutely essential. Here, community-based organizations also have a crucial role. I was in Chengdu a few days ago and I was very impressed with the partnership between community-based organizations and the government to reach MSM. The city has just launched a five-year programme. Instead of working separately, they have mapped out areas where they can reach MSM and will coordinate efforts in delivering testing services systemically across the city. They are also looking at how this programme can be scaled up nationwide.
Non-governmental organizations (NGOs) in China suffer from a lack of legal status and limited funding. How could this jeopardize the country's continuing efforts in HIV/AIDS prevention, treatment and care?
If NGOs are to have a more meaningful role in China's response to HIV, they need to be able to register freely for legal status. Otherwise, they will find it very difficult to access funds, have long-term plans or achieve sufficient scaling-up of services. Every time I come to China, I raise the same issue with leaders, particularly the vice-premier.
I think things are changing. The leaders have begun to realize the importance of community-based organizations in the AIDS response. They have decided to remove the dual-registration requirement [in which NGOs are required to find a government or party sponsor for registration] for AIDS-related organizations. In Chengdu, such organizations are already able to register freely, even before the national policy is in place.
The Global Fund to Fight AIDS, Tuberculosis and Malaria delayed grant payments to China in May because of concerns over the lack of support for NGOs and potential misuse of funds. What are your thoughts on this?
It would be a big mistake for the fund to withdraw, because it is clearly important for China to tackle the epidemic, especially among the most at-risk populations. The Global Fund should have discussions with the Chinese government, to find out what's working and what's not working, and to set conditions for continuing collaboration.
Why is it important for BRICS countries to collaborate on health-related issues, including HIV/AIDS?
BRICS countries constitute more than 40% of the world's population, what happens in those countries is important for the global public-health agenda. They also shoulder nearly one-third of the global AIDS epidemic and their leadership will be key to achieving the goals of universal access [to HIV prevention, treatment, care and support] and the Getting to Zero strategy.
The BRICS countries are a new voice, with a new perspective and new solutions to today's global challenges. It's a voice with incredible economic and innovative strength, intimately connected to the needs and interests of the developing world.
|
|
发表于 2011-7-20 11:50
