China

The guidebooks call it ‘remote’, ‘undiscovered’ – China’s south-western province of Guizhou is home to some examples of extreme natural beauty including China’s largest waterfall, the ‘Huangguoshu’ and the Zhijin Caves, famous for their massive-scale stalagmite stone pillars.

But despite its remote location and idyllic surroundings, the province, like every other in China, is increasingly affected by HIV. From a few individual reported cases in 1993, it is currently estimated that about 37,000 people in Guizhou are living with HIV. There are signs of the epidemic becoming progressively generalized and increasingly women are becoming infected.

With hope and help – A self-help group for people living with HIV in Guizhou

A joint HIV prevention and care project, run by Guizhou provincial authorities, and UNAIDS` Cosponsor UNICEF is making some headway towards tackling the growing figures and at the same time involving people and groups from all sectors in the AIDS response. Established in 2001, the project focuses particularly on young people, tackling the often difficult issue of injecting drug use and its crossover with HIV, as well as providing care and support for people living with HIV.

“The initiative contains three key areas – development of a strategic plan on AIDS involving high-level advocacy and media mobilization; HIV prevention among children and young people in and out of school and within drug rehabilitation centres; and care and support to children living with HIV and their families,” said Christian Voumard, UNICEF Representative and chairman of the UN theme group on AIDS in China.

The project aims to build and involve all key officials and provincial groups in the AIDS response. Vice Provincial Governor of Guizhou Wu Jiafu underlines how the initiative has helped bring people together. “As government officials, we now know how we can work together with multiple sectors to confront AIDS and support people living with and affected by HIV. This network is now implementing the national policies and local policies to support young people, people living with HIV and their families to fight against the disease and its social impact,” he said. 

“Though the resources here are very limited, we’re confident that we can get ahead of the HIV epidemic with the participation of all these young people and people infected and affected,” he added.

Results so far have been extremely encouraging. Provincial policies on HIV have been put in place and training sessions with authorities and project managers are already underway. Since the project’s inception, 45 high schools have developed curriculum on HIV and drug use prevention in eight of the province’s prefectures, reaching more than 70,000 children and young people.

Voluntary testing and counselling services have been set up within seven drug rehabilitation centres across the province. 

“By knowing my HIV status and with all the knowledge of prevention of HIV, I will stop sharing needles with my friends and engaging in high risk sex,” said one young man at the Tongren prefecture drug rehabilitation centre.

Through the initiative, gradually people living with HIV are being brought to the forefront of the response in the province. A number of self-help groups of people living with HIV have been developed with the participation of 50 people living with HIV. More than 100 family members and 26 children and their families participated in care and support campaigns in the prefectures of Guiyang and Tongren, receiving community based care for family life and schooling.

“I never imagined it could be possible that authorities and big organizations would care about us –people living with HIV—and our children,” said one man living with HIV from Tongren prefecture who has been involved in the programme. “I lost my hope because of the pain of disease, social discrimination and poverty, but this is helping to restore the hope by supporting me and my children.”

UNICEF was the first major donor on AIDS in Guizhou province and provided some of the ground work for other donors’ work in the area. Programmes supported by the US Center for Disease Control and the Global Fund to Fight AIDS, TB and Malaria (Round 4) have since benefited from this in their support to Guizhou.

UNICEF will continue to support the project in their new 2006-2010 programme and activities will be expanded to include prevention of mother to child transmission of HIV (PMTCT) and increasing care and support for children affected by AIDS.

The joint project in Guizhou is focusing particularly on young people

“This programme has been an example of bringing together a variety of different groups within the AIDS response – and crucially invovles young people and people living with HIV,” said UNAIDS Country Coordinator for China, Joel Rehnstrom.

“We are seeing the project help reduce numbers of new infections, as well as break down the barriers and taboos of involving people living with HIV – which in turn is breaking down stigma and discrimination related to HIV.”

UNAIDS Executive Director Peter Piot is visiting China from 7 – 12 September to encourage continued leadership and commitment and to mobilize a truly multi-sectoral response to AIDS in China. As part of his visit, Dr Piot is participating in a three-day mission to Guizhou, visiting the Hui Long community and Zhijing County. Dr Piot will meet with representatives of provincial government and city leaders and visit various key sites that focusing on HIV and drug use.

Related links
UNICEF China website
More on China

Wenli Jiang won China’s highly-revered ‘Flying Goddess Award’ for Best TV Actress in 1999. Her husband, Changwei Gu, is a cinematographer-turned-director, who won the Silver Bear at 2005 Berlin International Film Festival with Peacock. They have a 5 year-old son.
Photo by Xinhua.

The first time Chinese TV star Wenli Jiang took part in a public HIV prevention and awareness raising event, in 2003, she was decidedly nervous.

Standing on a temporary stage set up in the most popular shopping section in Beijing, she looked out at the shoppers, holding a sheaf of condoms in her hand.

Crowds started to form as passers by recognized Jiang, who shot to fame in China through a TV series called “Holding Hands” where she played a modern housewife disillusioned with her marriage.

“I felt quite embarrassed that first day,” said Jiang, “but the more I participated in these kinds of events, the more I got used to them and felt comfortable.”  So much so that in 2004, Jiang handed out 6,000 condoms in one hour in Bangkok’s red-light district with fellow Chinese actor Cunxin Pu.

A Leadership Council member of the UNAIDS-led Global Coalition on Women and AIDS – and the first female spokesperson in China’s HIV prevention campaign – Jiang explains why she is so committed to fighting AIDS and the stigma surrounding it.

“I feel a sense of responsibility to help people living with HIV, and call for the elimination of misunderstanding and discrimination against them,” said Jiang. She is especially interested in promoting the recognition of women and children’s rights.

Her interest in the AIDS response began in 2002 when she made a TV spot with a young boy living with HIV. “The first time I met the little boy living with HIV I felt so shocked and sympathetic. I had a strong desire to do something to make a difference.”

Now, Jiang is well-known for promoting awareness about HIV prevention in China. Her face can be found on HIV prevention posters in subway stations and along main streets in many Chinese cities, including the capital Beijing.

In February, 2004, Jiang joined fellow actress Emma Thompson and other celebrities and leading figures working to reduce the impact of AIDS on women and girls at the London launch of the UNAIDS-initiated Global Coalition on Women and AIDS.

“The London meeting was my turning point,” said Jiang, “I was captivated by the passion of the UNAIDS staff and other delegates from other 24 countries. I realized that besides just attending meetings and events, I could really move my commitment forward.”

In 2005, Jiang invited an 11-year-old child living with HIV from the Anhui province, to live with her family for a number of days. “I wish all children living with HIV could be free to go anywhere and do anything that they want without being discriminated against,” Jiang said.

UNAIDS Country Coordinator for China Joel Rehnstrom underlines the importance of Wenli Jiang’s involvement in the fight against AIDS for the country. "Celebrities such as actress Wenli Jiang play an important role in China in raising awareness about AIDS. By appearing in public with a person living with HIV, Wenli Jiang helps reduce fear, shame and stigma related to AIDS," he said

Wenli Jiang’s first book, entitled Wenli Talks about AIDS was published last December. All profits from this book will be donated to AIDS related organizations, said Jiang. “The book introduces basic information about AIDS, and shares my experiences as an HIV prevention activist with readers,” Jiang said. “I want to make readers aware – and then ignorance of AIDS cannot be used as an excuse.”

“My dream would be for everyone in China to volunteer as an AIDS activist,” said Jiang, “Please do tell your friends and relatives to keep away from drugs, use condoms and lead a healthy life,”

“My objective this year is to shoot a documentary about AIDS in China. Everything is being planned now,” she said excitedly, “it will be my directorial debut.”

China calls for shared responsibility in achieving zero new HIV infections, zero discrimination, zero AIDS-related deaths

UNAIDS Executive Director Michel Sidibé and China’s Premier H.E. Wen Jiabao at a World AIDS Day event in Beijing.

BEIJING/GENEVA, 1 December 2011—China has pledged to fill its HIV resource gap by increasing domestic investments. This pledge was made China’s Premier H.E. Wen Jiabao at a World AIDS Day event in Beijing. The Premier also called on the international community to fully meet its commitments and achieve a world with zero new HIV infections, zero discrimination and zero AIDS-related deaths.

“I see no reason for the Global Fund to withdraw its support to China,” said Premier Wen Jiabao at the AIDS roundtable in Beijing. “I have asked the Minister of Finance to close the gap left by the Global Fund. We will rely on our own efforts.”

This new commitment from China comes at a crucial moment as resources for AIDS are declining and the Global Fund to Fight AIDS, Tuberculosis, and Malaria is facing a major setback in resource mobilization, leading to the cancellation of its next call for country proposals (Round 11), putting millions of lives at risk. 

"China's voice could not have come at a more critical time in the AIDS response. We are in a period of high risk and welcome this bold decision," said Michel Sidibé, Executive Director of UNAIDS, when thanking the Premier of China. "I am confident that a new socially sustainable agenda can be forged that promotes country ownership and shared responsibility.”

More than 6.6 million people are on HIV treatment in low- and middle-income countries and rates of new HIV infections have fallen in most parts of the world. Domestic investments have steadily increased, but the magnitude of the epidemic in Africa means that continued international solidarity and investments are vital.

“Getting Round 11 back on track is a top priority especially as Africa is leading the world in reducing new HIV infections and AIDS-related deaths. Its international partners must come forward and help countries multiply their success,” said Mr Sidibé. “This call is not just about shared responsibility but also of shared values.”

China has scaled up its AIDS response in a short timespan, including its evidence-informed HIV prevention services. By rapidly scaling up access to drug substitution therapies, it has reduced new HIV infections among people using these services to close to zero. China has also made important advances in its anti-discrimination programmes and support for civil society organizations. 

“To defeat AIDS, it will take the whole society,” said Premier Wen Jiabao. “China is willing to play its part.” China’s rapid scale up model can be replicated in other countries—especially in strengthening the capacity of community health workers to deliver HIV services. In addition, China can provide vital technology transfer in key areas of innovation of HIV treatment, including development of new antiretroviral medicines, investing in research and development, telecommunications, e-health infrastructure and supply chain management.

World leaders call on South-South cooperation to reverse the AIDS epidemic and lead an integrated approach to accelerate progress towards the Millennium Development Goals

NEW YORK, 22 September 2010—World leaders gathered at the United Nations called for a new model of partnership to strengthen the AIDS response and achieve broader health and development outcomes. Without synergy between AIDS and other health and development initiatives, the leaders agreed sustainable progress towards global goals to end poverty and ensuring healthy societies will not be achieved.

A high-level meeting co-hosted by China, South Africa, Nigeria, Ethiopia and UNAIDS brought together world leaders including the Premier of China, the Prime Minister of Ethiopia and Ministers from South Africa, Nigeria, Burundi, Democratic Republic of Congo, Kenya, and Rwanda. They were joined by heads of international organizations and civil society.

"The era of health and development programmes operating in isolation is over,” said Mr Michel Sidibé, UNAIDS Executive Director, who chaired the meeting. “We have to work together to make this one movement—we cannot afford to have a fragmented approach to health and development. This Africa-China partnership can be the engine that accelerates progress towards the MDGs.”

Developing countries are joining hands to push for a combined approach to health and development and giving communities a strong voice in defining their health needs. The new South-South partnership will promote innovation, local solutions that make a difference, sharing of technology, and building local capacities.

The AIDS epidemic is stabilizing globally and new infections are steadily declining around most of the world. This has been possible as the international community has made significant progress in achieving goals towards universal access to HIV prevention, treatment, care and support.

"We cannot turn a deaf ear to the call of life, and we must not be slow in reaching out,” said H.E. Wen Jiabao, Premier of China. “We should redouble our effort to advance the global campaign against HIV/AIDS and ensure that the related MDGs be met on schedule. China has been actively involved in the international cooperation on HIV/AIDS prevention and treatment."

Endorsing the UNAIDS approach of “AIDS plus MDGs”, the leaders called for the AIDS movement to take the lead in bringing about integration and innovation.

“The ‘AIDS plus MDGs’ approach seeks to bring about change that will create a new dimension of performance. Not just in the response to AIDS, but also in efforts to achieve other MDGs, accelerating progress on those that are trailing behind,” said Dr Asha-Rose Migiro, UN Deputy Secretary-General. “Progress towards reversing the HIV epidemic is therefore central to the broad international development agenda.”

Investments in AIDS have contributed to strengthening health systems and primary health care as well as better access to social welfare programmes in many countries. In Ethiopia, a strong, results-driven alliance between the Ethiopian Government and its key development partners is producing win-win results by channelling more than US$ 300 million of AIDS resources to strengthen the county’s health systems.

“Ethiopia’s strategy to integrate AIDS and health issues has not only decreased the burden on health facilities, but it has also enabled the health system to reach the vulnerable and poor,” said H.E. Meles Zenawi, Prime Minister of Ethiopia. “Community ownership of development has helped us achieve progress that is sustainable over time.”

South Africa has integrated HIV and TB services under one roof, reducing both AIDS and Tuberculosis-related deaths. Under its ambitious programme to test 15 million people for HIV, it is offering comprehensive health checkups for women and girls. In 2009, nearly 90% of all pregnant women were able to access treatment to protect their babies from being born with HIV.

“We have to strengthen primary health care services that integrate HIV, maternal and child health, sexual and reproductive health into development,” said Dr. Aaron Motsoaledi, Health Minister of South Africa. “Communities must own the health agenda which is at the centre of their own development.”

However, HIV continues to hamper progress in reducing maternal and child mortality in many sub-Saharan countries. More than 40% of all maternal mortality in countries such as Botswana (77%), Swaziland (75%), Lesotho (59%) and Zimbabwe (53%), Namibia (50%), South Africa (43%) is attributable to HIV.  Where health services are integrated, the results have been spectacular. In Pampaida, Nigeria, a Millennium Development Village in Kaduna state, there have been very few maternal deaths or children born with HIV in recent years, thanks to an integrated approach to health care delivery.

“We are saving mothers and children by strengthening the health system,” said Professor Onyebuchi Chukwu, Health Minister of Nigeria. “We are investing in health using resources from debt relief because access to good quality health care is a necessity and a basic human right, not a luxury.”

In 2000, world leaders adopted the Millennium Declaration. This milestone in international cooperation inspired development efforts that have improved the lives of hundreds of millions of people globally. Five years remain to move forward to meet the eight Millennium Development Goals by 2015.

Calls for 51 remaining countries with such “travel restrictions” to take action towards their removal

VIENNA, 20 July 2010 — UNAIDS Executive Director Michel Sidibé applauded today the leadership displayed by China, Namibia and the United States of America to lift their travel restrictions for people living with HIV, while calling for similar action in all countries that continue to employ such discriminatory measures.

Namibia is the most recent of the three countries to remove HIV-related restrictions on entry, stay and residence.  Its reforms—which took effect on 1 July—also remove such restrictions against people living with other contagious diseases.  "Namibia is very pleased to lift travel restrictions,” said Hon. Richard Kamwi, the Namibian Minister of Health, speaking at a press conference at the International AIDS Conference in Vienna. “With this move we have formally removed this discrimination. There is no way we will make headway without people living with HIV playing a vital role."

Mr Sidibé underlined that restrictions that limit mobility and migration based on HIV-positive status violate human rights. There is no evidence that such restrictions prevent HIV transmission or protect public health. Furthermore, HIV-related travel restrictions have no economic justification, as people living with HIV can lead long and productive working lives.  “Travel restrictions for people living with HIV serve no purpose other than to fuel stigma and discrimination,” said Mr Sidibé. “I urge all other countries with such restrictions to remove them.”

Last year, President Obama announced that the United States would lift its long-standing HIV-related travel restrictions, overturning a policy that had been in place since 1987. "The lifting of the HIV-specific U.S. entry ban is a sign of a renewed commitment to global health,” said Dr. Howard K. Koh, Assistant Secretary for Health, U.S. Department of Health and Human Services.  "With this announcement, the U.S. looks forward to hosting the 2012 International AIDS Conference in Washington, DC."

Restricting the mobility of people living with HIV is one example of the many forms of laws, policies and practices that undermine the AIDS response.  A new document launched at this week’s Vienna conference by UNAIDS, the Global Network of People Living with HIV (GNP+), the International Harm Reduction Association, the International Lesbian, Gay, Bisexual, Trans and Intersex Association (ILGA), and the International Planned Parenthood Federation (IPPF) provides a broad “snapshot” of the legal environment related to HIV. Titled “Making the law work for the HIV response,” the matrix covers over 190 countries, territories and entities, detailing whether or not a country has certain types of protective or punitive laws which either support or block the attainment of universal access to HIV prevention, treatment, care and support. 

“It is incomprehensible that HIV-related entry and residency restrictions still exist in these times,” says Mr Kevin Moody, International Coordinator and CEO of GNP+. “These restrictions are blatant violations of human rights, stimulating stigma and discrimination and actually hurting the response to the HIV epidemic.”

International AIDS Conferences and meetings have had a major influence on the reversal of HIV-specific entry and residence restrictions in recent years.  The International AIDS Society will not sponsor major HIV and AIDS-focused conferences or events in a country with HIV entry restrictions. 

"I'm proud of the role International AIDS Conferences and other international fora continue to play in advancing the removal of these and other laws that are counter to public health and human rights principles," said Dr Julio Montaner, President of the International AIDS Society. "HIV-specific laws and regulations on entry and residence are both overly intrusive and ineffective public health policy." 

After the removal of Namibia's restrictions, UNAIDS counts 51 countries, territories, and areas that continue to impose some form of restriction on the entry, stay and residence of people living with HIV. These include restrictions that completely ban entry of HIV-positive people for any reason or length of stay; ban short stays, for example for tourism; or prevent longer stays, such as immigration, migrant work, asylum, study, international employment, or consular service.

In July 2008, United Nations Secretary-General Ban Ki-moon reiterated the long-standing United Nations call for the elimination of HIV-related restrictions on entry, stay and residence. UNAIDS is closely monitoring which countries continue to employ them and has designated 2010 as the “year of equal freedom of movement for all.”