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Yunnan, Province of China


By the end of 2002, the Ministry of Health of China estimated that there were possibly more than one million cases of HIV/AIDS in China. Located in South-West China, Yunnan, a poor interior province bordered by Lao PDR, Myanmar and Viet Nam, has been particularly hard-hit by the HIV/AIDS epidemic. The first group of 146 HIV carriers were found in Yunnan in 1989 and the province is considered the "birthplace" of HIV/AIDS in China. Yunnan Province has the highest reported HIV infection rate in China and in 1999, the number of HIV carriers in Yunnan accounted for 43.6% of the national total. This dropped to 32% in 2002.

In the early 1990s, the HIV epidemic was predominantly found among intravenous drug users along the Myanmar-Yunnan border. Since 1995, HIV has spread along truck routes to most parts of Yunnan and the rest of China. In 2001, a total of 8,317 HIV/AIDS cases were documented in Yunnan, and 326 AIDS deaths were reported. The increase in HIV cases in Yunnan is especially noticeable along highways leading to the Myanmar border.

A poor understanding of the interlinked problems of drug use, trafficking and HIV/AIDS is still one of the primary reasons for the increasing number of people infected and affected by HIV/AIDS. High cross border mobility and the difficulty in reaching mobile populations and the ethnic minorities in the region are also main contributing factors to the spread of HIV/AIDS in Yunnan.

Despite an overall low prevalence rate of less that 0.2% (2002), China is currently experiencing one of the most rapidly expanding HIV epidemics in the world. Since 1998, the number of reported cases has increased by about 30% yearly. By 2010, China could have as many as ten million infections and over 260,000 orphans if no intervention is undertaken. The most frequent modes of HIV transmission have been sharing of contaminated needles among injecting drug users in southern and western China and unsafe practices among paid blood donors. HIV/AIDS is now rapidly spreading to the general population via sexual transmission.

National Strategic Framework

China has developed and adopted a strategic framework in the form of the nationwide National Medium- and Long- Term Plan for AIDS Prevention and Control (1998-2010), and the Plan of Action (2001-2005) for immediate intervention. Areas for priority action include timely implementation of AIDS prevention; strategic planning; improvement of STI care system; investment of human and financial resources for AIDS prevention; and expanding AIDS response at all levels and in all sectors.

The State Council Co-ordinating Committee for AIDS/STD Control (SCCC) is the designated national multisectoral co-ordination body and is composed of 34 government ministries. SCCC has the overall responsibility for co-ordinating and promoting collaboration among government agencies, the private sector and civil society. The committee meets once or twice a year and is also responsible for the monitoring and evaluation component of the national plan. The newly appointed Minister of Health, April 2003, is expected to chair the SCCC.

Policy support for implementation of the framework is provided through, among others, a national policy for conducting comprehensive health education through mass media and a national condom promotion strategy. In addition, in 2003, tariffs on imported ARV drugs were waived to facilitate access to care.

The total cost of implementation of the Plan of Action alone is estimated at US$320 million. In 2002, US$151 million was provided to blood centres to upgrade facilities and ensure safe donation practices and US$109 million was provided to poorer areas in China to address HIV/AIDS. In addition, the central government increased the outlays in HIV prevention and control from US$1.8 million in 2001 to US$15 million in 2002 and the provincial governments allocated US$7 million in 2002 as direct inputs to HIV prevention & control.

At present, local and sectoral plans are at various stages of development and implementation of the national plan. According to the Xinhua News Agency, Yunnan Province has established an HIV/AIDS monitoring system, including prevention and treatment centres, test labs and monitoring stations with funding from both government and non-governmental agencies, including the UN and the Asian Development Bank. In addition, the province has launched prevention and treatment of HIV and AIDS programmes in more than 20 cities and counties.