Author: Yip, R.; Stover, J. et al
Controlling the spread of HIV/AIDS is perhaps the greatest public health challenge for China today. The current low HIV prevalence is an opportunity for preventing this disease from reaching hyper-endemic stages. The Government of China and the UN Theme Group (UNTG) on HIV/AIDS cooperated on a research project to assess the social and economic impact of HIV/AIDS in China until the year 2010.
Purpose / Objective
The main objectives of this research were to understand and recognize the importance of nation-wide HIV prevention activities; to project the spread of HIV/AIDS in the coming ten years; to measure the impact of HIV/AIDS at the individual, family, society, and macroeconomic levels; and to present policy recommendations.
Interviews were held with 50 leaders of government departments, such as health department, security bureau, justice department, planning committee, agricultural department, economic and trade department and so on. Gather data about government investment and individual spending in the hospital. Individual questionnaire surveys were distributed to 470 officials about the social and economic impact of HIV positives, government officials' knowledge and attitude towards HIV prevention, and the social and economic impact of hepatitis B patients.
In addition, HIV surveillance data and national statistics were used in the study. A series of 15 surveys were conducted from October of 2001 to January of 2002. There were three different levels in the surveys: provincial, prefecture, and county. One prefecture and one county were chosen in each province: Guangdong - economic level is high; predominant transmission modes are needle sharing and heterosexuality; Guangxi - border area of lower economic status; predominant transmission mode is needle sharing; and Shanxi - poor area; predominant transmission mode was blood selling.
Key Findings and Conclusions
By 2010, the number of HIV positives is projected to be 12 million, 5 million and 2.2 million in the high-, medium- and low-projection scenario respectively. We forecast that by 2010, there will be 260,000 orphans due to AIDS in the high level projection.
HIV/AIDS impacts the society and the economy in three stages. First, on a micro level, it affects individuals and families; second, the impact extends to a sectoral and regional level; and third, it impacts the macro economy and the entire society. HIV positives, AIDS cases and their families are suffering heavily, economically and mentally. An AIDS patient typically spends RMB 17,518 on therapy and RMB 82,000-104,000 on HAART treatment. Either way, it's a huge amount that far exceeds the annual average income of people. One-third of the HIV positives surveyed said they thought about committing suicide when they learned that their blood tested HIV positive.
The impact on the health care sector and some regions is also beginning to be felt. In the future, the public health sector will have to increase spending in treatment and intervention activities. Our survey of three provinces shows that, at present, the per capita spending is a mere RMB 0.06, whereas effective prevention and intervention calls for RMB 0.50 a year per capita.
Currently, AIDS has not yet produced a palpable impact on China's macro-economy and society; however, it is not to be neglected. In the next decade, in the low level projection, China's GDP would record a decrease in GDP of RMB 22.5 billion compared with a No-AIDS scenario; in the high level scenario, the reduction in GDP would amount to RMB 40 billion. The low 2001 estimate, and the use of rates of growth much lower than historical trends, led to an economic impact lower than the 0.5% decrease in GDP foreseen by the World Bank for countries having 1% HIV prevalence.
- Increase investment in HIV/AIDS interventions as early as possible
- Launch an intervention program as soon as possible
- Improve HIV/AIDS surveillance system
- Launch public-awareness campaigns
- Treat and help HIV positives and AIDS patients
- Create a supervisory mechanism for AIDS prevention and control in line with Chinese conditions
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HIV/AIDS - Situation Analysis
DfID, UN Theme Group on HIV/AIDS in China