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The Impact of the Global Fund on Equity, Financial Protection and Social Assistance Policy Development on HIV/AIDS Families in China

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The Impact of the Global Fund on Equity, Financial Protection and Social Assistance Policy Development on HIV/AIDS Families in China DRAFT The Impact of the Global Fund on Equity, Financial Protection and Social Assistance Policy Development on HIV/AIDS Families in China A Draft Report to the Health Alliance Xiulan Zhang Yurong Zhang Pierre Miege Xiying Wang Xiaohua Wang Yuebin Xu Chenggang Jin April 2008 Institute of Social Development and Public Policy Beijing Normal University Beijing, China © by Xiulan Zhang, Yurong Zhang, Pierre Miege, Xiying Wang, Xiaohua Wang, Yuebin Xu, and Chenggang Jin. All rights reserved. Short sections of text, not to exceed two paragraphs, may be quoted without explicit permission provided that full credit, including © notice, is given to the source. Any opinions expressed are those of the authors and not those of the Health Alliances of the World Health Organizations 1 DRAFT Contents ACKNOWLEDGEMENTS .................................................................................................................................6 ACRONYMS.........................................................................................................................................................8 CHAPTER 1: THE EPIDEMIC OF HIV/AIDS IN CHINA..........................................................................9 1.1. THE HISTORY OF THE SPREAD OF HIV/AIDS IN CHINA ................................................................................9 1.2 THE GEOGRAPHICAL CATEGORIES OF THE EPIDEMIC OF HIV/AIDS............................................................ 11 1.3 THE CURRENT SITUATION AND CHARACTERISTICS OF THE SPREAD OF HIV/AIDS IN CHINA .......................12 CHAPTER 2: POLICIES TO ADDRESS HIV/AIDS IN CHINA...............................................................15 2.1 THE STAGES OF HIV/AIDS INFECTION IN CHINA AND RELATED CHANGES IN POLICY ................................15 2.1.1 Phase of Importation (1985 to 1988) — “Keep HIV/AIDS out of China” ..........................................15 2.1.2 The Phase of Moderate Spread (1989 to 1994) — to Fight Passively and Prevent in Local Regions.16 2.1.3 The Phase of Rapid Spread (1995 to 2000) — to Intervene Positively................................................16 2.1.4 The Phase of Localized Outbreaks (2001 to Present) — Comprehensive Prevention and Control .....17 2.2 THE CHINESE GOVERNMENT’S STRATEGIC CHOICE AND ACTIONS ..............................................................18 2.2.1 The Chinese Government’s Focus and Political Commitment ............................................................18 2.2.2 The Government-lead and Multi-department-cooperate Mechanism for HIV/AIDS Prevention and Control has initially Formed........................................................................................................................20 2.2.3 Increasing Public Awareness and HIV/AIDS Education .....................................................................22 2.2.4 HIV/AIDS Interventions with High-risk Groups..................................................................................22 2.2.5 HIV/AIDS Intervention, Prevention and Control for Migrant Workers...............................................25 2.2.6 Pilot Project for Anti-Retroviral (ARV) Treatment and Comprehensive Care for Those Living with HIV/AIDS .....................................................................................................................................................25 2.2.7 Creating a Monitoring System for HIV/AIDS......................................................................................27 2.2.8 Promoting HIV/AIDS Prevention and Control through Laboratory Research ....................................27 2. 3 CHALLENGES FACING HIV/AIDS PREVENTION AND CONTROL IN CHINA...................................................28 2.3.1 Lack of Government Leadership and Coordination ............................................................................28 2.3.2 Lack of a System to Educate the Public about HIV/AIDS ...................................................................28 2.3.3 Monitoring of HIV/AIDS Should be Promoted....................................................................................29 2.3.4 The Scale of Interventions to Change High-risk Behaviors must be Increased...................................29 2.3.5 Implementing and Supervising HIV/AIDS Policies and Plans ............................................................29 2.3.6 Improving HIV/AIDS Related Policies, Regulations and Laws...........................................................30 2.3.7 Challenges Facing Comprehensive Care and Treatment for HIV/AIDS..............................................30 2.3.8 Serious Discrimination against Those Living with HIV/AIDS is still Widespread ..............................31 2.3.9 Increasing Investment of Resources and Improving Fund Management.............................................31 CHAPTER 3: INTERNATIONAL EFFORTS TO PREVENT AND CONTROL HIV/AIDS..................32 3.1 PROFILE OF INTERNATIONAL COOPERATION ON HIV/AIDS...................................................................32 3.1.1 Cooperation with Multilateral Organizations .....................................................................................32 3.1.2 Cooperation with International Bilateral Organizations ....................................................................35 3.1.3 Cooperation with International Non-government Organizations........................................................36 3.2 DETAILS OF SOME INTERNATIONAL CO-OPERATIONS ON HIV/AIDS ...........................................................36 3.2.1 World Bank..........................................................................................................................................36 3.2.2 The Current Global Fund Program to Fight AIDS, Tuberculosis and Malaria...................................40 3.2.3 USAID .................................................................................................................................................62 3.3 INTERNATIONAL COOPERATION STIMULATES ANTI-HIV/AIDS PROGRESS IN CHINA ....................................63 3.3.1 Fund and Technology Support.............................................................................................................63 3.3.2 Introducing Advanced Concepts on HIV/AIDS Prevention and Control and Pro-active Models and Methods of Intervention ...............................................................................................................................63 3.3.3 Creating a Mechanism for Coordinating Many Government Departments and Encouraging Community Involvement...............................................................................................................................64 3.3.4 Foundation and Development of NGOs in HIV/AIDS Field................................................................64 3.3.5 The Public Supports HIV/AIDS Prevention and Control.....................................................................65 3.4 IMPROVING SPACE IN INTERNATIONAL COOPERATION IN THE FUTURE ........................................................65 3.4.1 Adopting Advanced Models of Intervention in China, already Proved Effective in Practice in International Cooperation............................................................................................................................65 3.4.2 Project Coordination and Resources Integration in International Cooperation Need to be Improved66 2 DRAFT CHAPTER 4: SOCIAL ASSISTANCE FOR HIV/AIDS AFFECTED PEOPLE IN RURAL CHINA.......67 4.1 CHINA’S CURRENT RURAL SOCIAL PROTECTION SCHEMES .........................................................................67 4.1.1 The “Five Guarantees” Scheme..........................................................................................................67 4.1.2 The Minimum Income Guarantee Scheme (Dibao) .............................................................................68 4.1.3. Assistance for the Extremely Poor Households (Tekun).....................................................................69 4.1.4 Medical Financial Assistance (MFA) ..................................................................................................70 4.2 SOCIAL ASSISTANCE POLICIES FOR HIV/AIDS AFFECTED FAMILIES AND ORPHANS ...................................70 4.3 THE IMPLEMENTATION OF SOCIAL ASSISTANCE POLICIES............................................................................72 CHAPTER 5: METHODOLOGY AND EVALUATION PROCESS.............................................................76 5.1 EVALUATIO N FRAMEWORK..........................................................................................................................76 5.1.1 The Objectives.....................................................................................................................................76 5.1.2 The Methodology.................................................................................................................................77 5.2 EVALUATIO N PROCESS.................................................................................................................................78 5.2.1 The Target Site of Field Survey...........................................................................................................79 5.2.2 Selection of the Subjects......................................................................................................................80 5.2.3 Procedure of the Survey ......................................................................................................................81
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