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asijustwitnessedduringmyrecentvisithere,chinahasmadesubstantialprogressincheckingthespreadofhivbutthereisstillalongwaytogo.fromaninfectionunknownonly27yearsago,aidshasbecometrulyglobalized.today,33millionpeoplelivewithhivaroundtheglobe,and25millionmorehavedied.
thesefiguresaresobering.however,itisimportanttonotethatwehaveenteredanewphaseinrespondingtoaids-aphasethatwillultimatelybefarmorechallengingthananythingwehavedonesofar.
now,forthefirsttime,theaidsresponseisproducingrealresults.
in,fewerpeoplegotnewlyinfectedandthenumberofpeopledyingofaidsworldwidedropped,mainlythankstobetteraccesstoantiretroviraltreatment.
inchina,over34,000peoplearenowtakinghivdrugs,upfrom5,000in.but,wecannotslowdowninourvigilance.whereassubstantialprogresshasbeenachievedinthiscountry,thenumberofpeoplereceivinghivdrugsisstilllessthanhalfthenumberwhorequirethem.theepidemiccontinuestorunaheadoftheresponse:foreverytwopeoplewhostarttakingantiretroviraldrugs,anotherfivebecomenewlyinfectedwithhiv.
manyofthoseinfectionsoccurinsituationsthatareillegaloroutsideofmainstreamsociety.thesegiverisetoapparentcontradictionsbetweenrespectforthelawandprotectingthehealthofpeoplewhoinjectdrugsoraresexworkers,betweensexualityandmorality,betweenneedsofpublicsecurityandpublichealth,drugcontrolandsafeinjections.indeed,toconfrontaidsistoconfrontcontradictionsinsociety.
oncloserinvestigation,however,mostofthesecontradictionsprovetobefalsecontradictions.ascientifically-basedaidsresponsecansolvethemforthegreaterwellbeingofmorepeople.
drugabuse,forexample,isbadforanindividual'shealthandforthecommunityheorshelivesin.hivinfectionsareparticularlyhighamongpeoplewhoinjectdrugs.lawsagainstdrugsmustberespectedtoprotectsociety.
ultimately,though,thebestwaytoprotectboththewiderpopulationanddrugusers,andatthesametimereconcilepublicsecurityandpublichealthconcernsistoadoptthe"harmreduction"approach.scientificevidence-includinghereinchina-showsthatprovidingdruguserswithsubstitutiontherapyandcleanneedlesreduceshivtransmissionandsupportsenforcementoflawsagainstdrugabuse.
similarly,workingwithsexworkersandtheirclientstoencouragecondomusereduceshivamongthesegroupsandinsocietyasawhole.whensuchprogramsarebackedupbypovertyreductioneffortstoreducewomen'sneedtoengageinprostitution,theirimpactisevengreater.
itisissuessuchasthesethatmakeaidssuchacomplexproblemtodealwith.complexproblemsrequirecomplexsolutions.theyalsorespondbesttocollectiveapproaches.workingwithcommunitygroups,forexample,cangreatlyincreasetheimpact-andeffectiveness-ofaidsstrategies.infact,giventhatmostinfectionsarehappeninginsituationsoutsidethemainstreamnorm,itisoftenverydifficultforgovernmentalonetoreachthosewhoneedtobereached.
itisencouraging,therefore,tonotethattherehasrecentlybeenanincreaseinthenumberofcommunityorganizationsworkingonaidsinchina.manyofthesegroupsaredoingincrediblework.
thejointassessmentreportpublishedlastyearbythegovernmenttogetherwiththeunitednationssystemclearlyhighlightstheneedforgreaterinvolvementofcommunity-basedorganizationintheroll-outofprogramstoreachpeoplewithrelevantservices.
currently,therearenoeasywaysforcommunity-basedorganizationstoregister.withoutregistration,therecanbenobankaccountandthusnoeasywaytoreceivefunding.manyofthegroupsihaveseenaredoingagreatjob-buttheirworkisbasedonvolunteerism.thisisneitherefficientnorsustainable.
chinahassolidpoliciesinplaceandhasmadesignificantprogressinthefightagainstaids.itistimenowtousethetremendousarrayofresourcesatitsdisposaltobuildonthatprogress,andtotacklenew,toughchallengeslikeharmreductionandincreasingcivilsocietyinvolvement,
aschairmanmaosaidmorethan60yearsago:"wemustnotbecomecomplacentoveroursuccess.weshouldcheckourcomplacencyandconstantlycriticizeourshortcomings,justasweshouldwashourfacesandsweeptheflooreverydaytoremovethedirtandkeepthemclean."