19 August 2004
Geneva, 19 August - The Global Fund to Fight AIDS, Tuberculosis and Malaria has signed a grant agreement worth US$ 32 million over two years for an HIV/AIDS program in China.
The recipient of the grant, “China CARES” (China Comprehensive Aids RESponse), is an extensive community-based HIV treatment, care and prevention program launched in 2003 by t he Chinese Government in response to the worsening AIDS crisis in the country.
"Stemming the AIDS epidemic in China is essential if we are to prevent a truly global AIDS catastrophe " , says Richard Feachem Executive Director of the Global Fund. " We have a great opportunity to stop the Chinese epidemic in its tracks. The Chinese government sees this, and the Global Fund is pleased to help finance this offensive and at the same time, sustain the lives of tens of thousands of people infected as a result of this great tragedy."
China is eligible for Global Fund grants as a lower-middle-income country, by World Bank definition, and is meeting additional requirements, including co-financing for the proposal. The Chinese Government is contributing approximately US$ 13.4 million dollars per year to the program. Global Fund resources are to be additional to that contribution, and will total US$ 98 million over the full five years of the program. In June 2004, the Board of the Global Fund approved a further HIV/AIDS grant proposal to China of US$ 24 million, currently in negotiation, which will target injecting drug users and commercial sex workers, both vulnerable populations at the heart of the epidemic in China.
Last year, according to a China CDC survey support ed by WHO, UNAIDS and US CDC, there were an estimated 840,000 people living with the virus in China.
The Global Fund grant will facilitate the rapid expansion of the China CARES program. Seven provinces (Anhui, Hebei, Shandong, Henan, Hubei, Shanxi, Shaanxi) targeted in the proposal are in urgent need of a comprehensive prevention and care response due to a high HIV case burden fuelled by paid plasma donations in the early and mid 1990s. This practice affected large numbers of rural poor who repeatedly sold plasma at blood collection points. These blood collectors often pooled everyone's blood to extract the valuable plasma, and then returned the blood to the donor to avoid anemia and so that the process could be repeated in a few days. Thus one infected donor would infect the entire pool of donors.
Those unsafe procedures have now been banned. But their consequence is that there is now a major wave of "former plasma donors" concentrated in specific locations in Central China which is experiencing symptoms of HIV infection. Many have progressed to AIDS, thousands have died, and there are growing numbers of orphans.
In some of the more affected villages, in excess of 20 percent of the people were infected. Here, urgent provision of treatment and care are demanded. In addition, prevention efforts will be undertaken by the program to reduce transmissions through spouses, mother-to-child, casual partners and unsafe/unnecessary medical injections. Within the targeted counties, HIV treatment and care will also be offered to others who need it, including injecting drug users, commercial sex workers and others, without discrimination.
The proposed project aims at rapidly increasing the number of people under antiretroviral (ARV) treatment, using all first-regimen drugs provided free by the government and involves a pioneering project to provide free ARV treatment to some 3,000 former plasma donors in Henan and four other provinces. In order to make ARV drugs more readily available, the government has also licensed two domestic drug companies to manufacture generic ARVs, and it has waived tariffs on imported ARVs.
Other a ctivities of the project include advocacy, communication, a range of preventive services, voluntary counseling and testing, treatment of opportunistic infections, and community-based care and support . In addition, activities associated with capacity building, management and governance of the project are included as part of the proposal.
The expanded China CARES program will provide a solid basis from which China can take a further major step forward to a fully scaled-up program of treatment, care and prevention during the remaining years of the decade. The program also demonstrates high-level political commitment to fight the disease, and the government is working toward the universal provision of free ARVs for all who need them.