Closing the gap: AIDS then and now

There are other areas of the HIV response where China is doing well, but can do better. Take antiretroviral drugs. These drugs were a major breakthrough in the AIDS response, because they defer HIV infection progressing to full-blown AIDS. China is a leader in 'Treatment as Prevention' using antiretrovirals: for instance, these drugs are provided free of cost to couples when one partner is HIV positive and the other is HIV negative. This is good for the health of people living with HIV, and it will prevent transmission of HIV to their sexual partners.

But the antiretroviral treatment regime must be made much simpler, to improve uptake and adherence. People taking antiretroviral drugs in China have to take five or six pills every day. In most parts of Africa and the rest of Asia - including some of the poorest countries in the world - people on antiretrovirals need to take just one pill per day, in a fixed dose combination. By not making this fixed dose combination available here, China is falling behind the pack.

More also needs to be done to improve HIV testing. Many people with HIV actually don't know their status, and therefore miss out completely on treatment. There are now self-test kits, and rapid HIV tests that give results in 20 minutes. Through innovations like this, we can bring HIV testing to the people - and they can benefit from treatment as they need it.

Perhaps most importantly, we must eliminate stigma and discrimination towards people living with HIV, and at-risk populations such as men who have sex with men, sex workers, and injecting drug users. I've seen some of my own colleagues in the medical profession turn patients away because they disapproved of the person's sexual orientation. That is simply unacceptable, and it has to stop.

"Close the Gap" is the global theme of this year's World AIDS Day. This means we have to work harder, and smarter - to close the gaps in access to prevention and treatment, as well as the gaps we know exist in education, awareness and action, in order to end the HIV epidemic.

This World AIDS Day is special: 30 years have passed since the virus was first discovered. We have a wealth of experience, and evidence of what works and does not work. We have the science and the tools - we just need to take them out of the toolbox. And we have the power and resources of a great nation that has proven, again and again, that it can be done. The China of today has made much progress from the China I first knew. On World AIDS Day, I want China to "close the gap", so that the China of tomorrow ends the HIV epidemic for good.

The author is World Health Organization representative in China.

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