China Conference Urges Cooperation Among Ministries

Participants discuss China’s unique challenges to treatment scale-up

January 2004—To prepare for the enormous task of scaling up treatment access in China, the country must mount a coordinated response involving all levels of government and those working outside it. That was the conclusion of a one-day workshop amfAR sponsored in Beijing on November 7, 2003. Organized by Harvard University and the John F. Kennedy School of Government, the conference assembled participants from nongovernmental organizations (NGOs), groups working on treatment and policy issues in China, and representatives from the Chinese Ministry of Health. Their goal was to examine the policy impediments to treatment access in China.

Dr. Shen Jie, Director of the Chinese Centers for Disease Control and Prevention, and Joan Kaufman, Director of the AIDS Policy Project at the Center for Business and Government at the Kennedy School, welcomed the group. Dr. Zhang Fujie, Director of the Treatment and Care division of China’s National Center for HIV/AIDS Prevention and Control, gave the first presentation–an overview of China’s plans to increase antiretroviral (ARV) treatment and the issues the country must face in order to do so. Masami Fujita, Regional Director on HIV/AIDS for the World Health Organization (WHO), also outlined the current constraints on treatment provision in China.

Kevin Frost, amfAR's Vice President for Clinical Research and Prevention Programs and director of TREAT Asia, explains the role TREAT Asia plays in the region.

Several participants from around the region spoke about their countries’ experiences with implementing ARV therapy. Among them was Dr. Sanchai Chasombat, of the AIDS division of the Thai Centers for Disease Control, who shared the lessons learned from Thailand’s scale-up program. Kevin Frost, amfAR’s Vice President for Clinical Research and Prevention Programs and director of TREAT Asia, discussed the role TREAT Asia can play in facilitating the exchange of knowledge and experience across Asia.

After the presentations, Henk Bekedam, the WHO’s representative in Beijing, moderated a discussion on the next steps to be taken.

Conference participants agreed upon the enormity of the challenge China faces. Choosing the right treatment regimens, educating the health care workforce, and even drug procurement and delivery are vast undertakings in a country as large as China with an epidemic concentrated in poor rural areas. Before any of these efforts begins in earnest, organizations must systematically identify and address all of the relevant issues, among them the rapid increase in unsafe behavior within the population.

Participants shared the view that AIDS cannot be treated as a health problem exclusively, because so many of the issues surrounding it cut across areas such as trade, economics, and security. For instance, when the Ministry of Health is sending a prevention message to injection drug users and commercial sex workers, while the Security Ministry is putting them in jails (where HIV thrives) without information on how to protect themselves, then different branches of the same government are working at cross-purposes.

“I think the overall outcome of this workshop was that China needs to coordinate all of these ministries into an effective response,” said Kevin Frost.

The experiences of the participants and presenters were testament to the effectiveness of a multi-sector approach. Key to that coordination, said Frost, would be political leadership that provided a mandate for cooperation among ministries. It was also agreed that there is a need for an advisory body in China to advise the State Council on the issues, and to allow information to flow among ministries.

Participants from the Chinese Ministry of Health agreed to raise these ideas and issues at the Ministry and State Council level, and they hoped to have a response by January.

The conference was co-sponsored by the U.S. Centers for Disease Control and Prevention, the Chinese Centers for Disease Control and Prevention, the World Health Organization, and UNAIDS.