Describing the Chinese HIV Surveillance System and the Influences of Political Structures and Social Stigma

Zhang, Lei; Fung Chow, Eric Pui; Zhang, Jun; Jing, Jun; Wilson, David P

Improving from the previous step-wise hierarchical reporting framework, the new web-based reporting system provided the ability for direct reporting of diagnosed HIV cases from the grassroot hospitals to the centralised database in Chinese MOH through CISDCP (Fig. 1) . That is, once disease cases are entered into the system, all levels of CDC can acquire the data 'live' according to their assigned access privileges [19] . This substantially reduced the average reporting period from 7-8 days to less than 2 days. In addition to their assumed responsibility for authenticating the HIV disease information in their administrative regions, municipal and provincial CDCs are required to report to their corresponding Department of Health (DOHs) and Bureau of Health (BOHs) and to form networks with local research bodies, universities and other health organisations. At the top of the hierarchy, the National Center for HIV/AIDS Prevention and Control (NCAIDS) of China CDC is the overseeing organisation for assembling and analysing all HIV disease information and then presenting a final report to China MOH. China MOH remains the only legitimate office to disseminate HIV/AIDS-related information to the public, but provincial and municipal CDCs are also authorised to release information under the supervision and approval of China MOH [20, 21] . China MOH enacts health policies, designs prevention guidelines and intervention strategies based on the surveillance reports provided by NCAIDS, once a consensus agreement is established between MOH and the Chinese government, feedback recommendations and policies are issued to all lower levels of MOH for execution. Since the feedback information does not go through the webbased information pool, hospitals at grassroots level may have to wait for a considerable period of time to receive recommendations and guidelines from China MOH.