China AIDS policy must be matched by enforcement
BEIJING, Sep 11 (Reuters) China has done a remarkable about-face in dealing with HIV/AIDS, but good intentions need wider implementation in a country where eight people become infected each hour, a top UN official said today.
Peter Piot, executive director of the United Nations AIDS agency UNAIDS, said there was a mismatch between high-level policy and enforcement on the ground.
He said China's public security organs, which have in the past harassed and detained AIDS activists, must lay off.
''I'm seeing a sea change in the policies and the leadership at the central level in the fight against AIDS,'' Piot told Reuters in an interview.
''I think all the right policies are in place. The challenge is of course to make sure across the country they are being implemented,'' he said on the sidelines of the launch of an initiative to involve business in China's AIDS fight.
China recorded its first outbreak of AIDS in 1989. During the 1990s, many people -- notably in the central province of Henan -- contracted the virus through contaminated blood transfusions.
An estimated 650,000 people are living with HIV/AIDS in China, and health experts say the disease is moving into the general population with most new infections now spread sexually, although drug-users follow closely behind.
''Frankly, two years ago I could not have dreamt that there would be close to 300 methadone-providing clinics for injecting drug-users across the country,'' said Piot, who has just returned from the poor southwestern province of Guizhou.
''In Guizhou I could see methadone treatment clinics and needles are being provided. Take India, or Thailand, or Russia, or Vietnam -- they don't do that yet,'' said the Belgian-trained microbiologist.
But he said that the government must involve civil society more closely and rein in the security forces.
Early this year Chinese police held prominent dissident and AIDS activist Hu Jia in secret detention for 41 days. Last week they detained him again only to release him a day later.
''One needs to solve the tension and sometimes the contradiction between the goals and methods of public security and of public health,'' Piot said. ''You cannot really totally be successful without having space for civil society.'' Public ignorance about AIDS -- a recent survey found 20 percent of people had never heard of the disease -- is another problem, especially for the country's 140 million or so migrant workers, mostly badly educated and from poorer parts of China.
Piot said the newest problem was reaching out to sex workers in a country where prostitution is illegal and stigmatised but has made a huge comeback since Chinese economic reforms began in the 1980s.
''We have to see that public security is not going to arrest a woman who has a condom in her purse and say she is a prostitute. The State Council has issued a directive saying 'no, that's not a reason for arrest','' he said, referring to the Cabinet.
''But that's going to take time.'' REUTERS DKB KP1235