More unfavorable publicity came in June when Jintao had to undergo medical checkups to ensure he was SARS-free when meeting President Bush and other G-8 leaders in France. There is little doubt that China's international standing was clearly badly damaged by its government's mishandling of the SARS epidemic.
On July 21, 2004, Dr. Bates Gill, Freeman Chair in China Studies Committee on House International Relations Subcommittee on Asia and the Pacific, stated official Chinese estimates show China now has roughly 840,000 persons living with the HIV virus and as of the end of 2003, only 62,159 persons had been tested and officially confirmed to be HIV-positive. "The remaining HIV-positive individuals in China, estimated at 780,000 persons or more, are not known to public health authorities, and the individuals themselves probably do not know their status, posing significant risks for the further spread of HIV." Yet, outside observers believe that the number of HIV-positive persons in China is higher than China is prepared to acknowledge, perhaps 1.5 million or more, because despite improvements in estimating techniques, China's HIV surveillance system remains inadequate, and remains as a major obstacle to successfully confronting the spread of HIV.
The approximately 62,000 individuals in China who officially reported to be HIV-positive represent only 7.4% of the total estimated HIV-positive population, and in some parts of China, the gap between known and estimated cases is even more "stark." For example, health authorities in Hubei province have confirmed approximately 1,300 HIV-positive persons, yet this represents only 3.7% of the estimated 35,000 HIV-positive persons in the province. Today, HIV is apparently concentrated among injecting drug users and persons infected in the 1990's through blood donations and is present in all thirty-one provinces, autonomous regions, and municipalities, with the greatest numbers found in the eight hardest ht provinces and autonomous regions of Yunnan, Xinjiang, Guangxi, Sichuan, Henan, Guangdong, Anhui, and Hubei. However, senior Chinese officials and international experts now assert that HIV is steadily moving from source populations such a drug users and commercial sex workers into the general population.
China has made many important advance in outlook, policy, and resource commitments at the central government level, and new leaders have emerged in China with a stronger commitment to improving social welfare and to addressing HIV / AIDS in particular. Moreover, China has initiated a more proactive response to the HIV / AIDS challenge, including a national treatment and care program known as the China Comprehensive AIDS Response, or China CARES. However, present organizational structures to combat HIV / AIDS, dominated by the Chinese Center for Disease Control and Prevention, lack the technical expertise and human resources to plan and estimate costs, as well as develop, execute, coordinate, monitor, and evaluate complex national-scale treatment and care programs. It is advised that China should "incentivize" health care delivery such that medical personnel become more actively engaged in HIV / AIDS prevention, education, treatment and care. Special attention should be given to improving communication and collaboration between central and provincial authorities.
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