问答题 HIV/AIDS is now recognized clearly as a growing threat to China. According to official Chinese estimates, China now has approximately 840,000 persons infected with HIV. As of the end of 2003, only 62,159 persons had been tested and officially confirmed to be HIV-positive. The remaining HIV-positive persons in China, estimated at 780,000 persons or more, are not known to public health authorities, and the individuals themselves probably do not know their status, posing significant risks for the further spread of HIV. Senior Chinese officials, as well as international experts operational in China, now assert that HIV is steadily moving from source population such as injecting drag users and commercial sex workers into the general population.
However, China has made important advances in outlook, policy and resource commitments. New leaders have emerged in China with a stronger commitment to improving social welfare and to addressing HIV/AIDS in particular. China has initiated a more proactive response to the HIV/AIDS challenge, including a national treatment and care program. New policy guidelines promote "four frees and one care": free drug treatment for poor citizens, free testing and counseling for poor citizens, free treatment to prevent mother-to-child transmission of HIV, free schooling for AIDS orphans, and care for families affected by HIV/AIDS. Senior leaders have committed to implementing harm reduction strategies, including condom promotion, needle exchange, and methadone substitution therapy for drug addicts.
Formidable challenges lie ahead. In spite of many positive developments, daunting challenges -- political, technical, and normative -- lie ahead for China to combat HIV/AIDS. It is difficult to overstate the scale and challenges in terms of planning, costs, logistics, human resources, technical capacity, and the pervasive problems posed by stigma. Weak and incomplete national HIV testing and surveillance system, debilitated and dysfunctional public health system, particularly in rural areas, serious lack of qualified personnel and the necessary equipment and technologies to properly diagnose, counsel, treat, monitor and care for HIV/ADS, just to name a few.
US-based commentators have suggested that success in addressing HIV/AIDS in China will require continued high-level leadership, both in China and internationally. For engaged US policymakers, as well as country leaders and heads of international organizations, priority should lie in near to medium-term steps which sustain Chinese leadership's focus on HIV/AIDS and public health. China's formidable structural and organizational weaknesses must be addressed systematically. Failure to implement a more strategically coordinated plan risks the loss of international support over time. Prevention and awareness should receive higher priority in China's strategic national Plan to combat HIV/AIDS. And human resources development, through education and training of medical professionals, is crucial.