Evolution of information-driven HIV/AIDS policies in China

Sun, Xinhua; Lu, Fan; Wu, Zunyou; Poundstone, Katharine; Zeng, Gang; Xu, Peng; Zhang, Dapeng; Liu, Kangmai; Liau, Adrian

Since 1995, HIV spread more quickly throughout China. 10 By 1998, all 31 provinces, municipalities and autonomous regions in Mainland China reported HIV cases. 10 To respond to the changing HIV/AIDS epidemic, several key ministries, including health, finance, public security, justice, and the development commission, met to discuss instituting supportive policies for condom promotion, needle exchange and methadone maintenance programmes. The language of early documents was carefully selected to avoid condoning 'social evils', such as prostitution and drug use. Terms such as condom social marketing, needle social marketing and community-clinic-based therapeutic treatment for drug users were used to describe HIV prevention measures that were incorporated into China's first 5-year action plan (2001-05). 16 China's first 5-year action plan was a policy milestone in terms of supporting effective policies for condom promotion, methadone maintenance and needle exchange. One of most important policy directions laid out in the first 5-year action plan was pilot testing of harm reduction strategies, including methadone maintenance treatment (MMT) and needle exchange programmes. 30, 31 However, implementation of the plan was not adequately budgeted, weakening its impact, particularly in the first 3 years, between 2001 and 2003. After the Severe Acute Respiratory Syndrome outbreak in 2003, public health rose to the top of China's policy agenda, and funding for the HIV/AIDS 5-year action plan increased. 18 China's second 5-year action plan (2006-10) was drafted in a more supportive political environment in which public health was given a higher priority. First, there was much stronger political commitment and financial commitment for controlling HIV/AIDS from Chinese Central Government. In 2003, a new administration led by President Hu Jintao, Premier Wen Jiabao and Vice Premier and the then Health Minister Wu Yi put the implementation of evidence-based HIV policies high on the national agenda. 18 Secondly, China's 'Four Frees and One Care' policy to increase access to anti-retroviral therapy (ART) was announced in late 2003 and had greatly facilitated implementation of HIV prevention, treatment and care and support.