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

The current HIV surveillance system in China appears to have improved in its timeliness and effectiveness for providing useful HIV disease information and regular behavioural monitoring of at-risk populations in China. However, under-utilisation and lack of transparency of information outside certain authorised channels are possibly the greatest hindrances to optimal use of the current system. Since accessibility to health data in China is largely limited to a small group of authorised personnel at the top of the administrative hierarchy, it often requires extensive bargaining and bureaucratic procedures to obtain epidemiological and behavioural indicators that are commonly accessibly in other countries. Hence, large amount of surveillance data remains in CISDCP and cannot be utilised widely for the purpose of HIV public health research, broader program evaluation and planning of control strategies. A transparent HIV surveillance system across all stakeholders, including policy makers, health officials, community health organisation leaders and HIV researchers, is beneficial for the entire HIV sector in the evaluation and implementation of HIV prevention and intervention strategies [34] . To understand barriers to optimal utilisation of available systems it is essential to first understand the political structure in China and its influences on surveillance. Although HIV surveillance is considered as a purely public health issue in many countries, issues related to HIV in China are highly sensitive and politically motivated [13, 35, 36] .