Agreement between the United States and the People’s Republic of China on HIV/AIDS Cooperation

On December 11, 2007, the Department of Health and Human Services (HHS) of the United States and the Ministry of Health of the People’s Republic of China renewed a Memorandum of Understanding (MOU) between the two countries to cooperate in the field of HIV/AIDS as part of President Bush’s Emergency Plan for AIDS Relief. HHS Secretary Mike Leavitt and Chinese Minister of Health Chen Zhu signed the extension of the MOU in Beijing, on the margins of the third, Cabinet-level session under the United States-China Strategic Economic Dialogue.

Recognizing the impact of HIV in China, HHS and the Ministry of Health will continue to work together to strengthen Chinese disease-surveillance and laboratory capacity, as well as support confidential, voluntary counseling and testing (VCT); behavior change; and care and treatment activities for Chinese communities. The MOU comes under the umbrella of the United States-China Health Protocol, signed in 1979 upon the resumption of diplomatic relations between the two countries.

Background: The First Five Years

The original MOU, established in 2002, had a focus on these priorities:

• The development of innovative intervention strategies to prevent the transmission of HIV;
• Research on AIDS vaccines, microbicides, medicines, test kits and new treatments for HIV/AIDS;
• The development of new treatment methods for Chinese citizens who are living with HIV/AIDS and its sequelae, including psychological and social support for these individuals and their families;
• Confidential, voluntary counseling and testing, especially for high-risk groups in the general Chinese population;
• The development of effective methods and strategies for collecting reliable and valid surveillance data on HIV/AIDS in China, by assuring the quality control of data and data analysis, and developing systematic monitoring and evaluation;
• The development of new strategies for enhancing the safety of the blood supply in China, and for reducing HIV transmission in Chinese health-care settings; and,
• Training Chinese health-care professionals and personnel in the care and treatment of persons living with HIV/AIDS.

A notable achievement under the auspices of the first MOU was the launch in 2002 of the five-year, Comprehensive International Program of Research on AIDS (CIPRA) by the National Institute of Allergy and Infectious Diseases (NIAID) of the HHS National Institutes of Health (NIH).  This $14.8 million grant program has focused on the following five scientific projects, as well as capacity-building in administration and training, and the management of data, statistics, the central Chinese AIDS laboratory and primates:

-- Epidemiologic and transmission factors in HIV/AIDS;

-- Behavioral interventions to prevent HIV transmission;

-- Pathogenesis of the virus;

-- Safety and effectiveness of anti-HIV drugs; and

-- The development of HIV/AIDS vaccines.

HHS cooperative activities on HIV/AIDS in China under the MOU as part of the President’s Emergency Plan totaled $4.75 million each in Fiscal Years (FY) 2006 and 2007, out of a total U.S. Government Emergency Plan budget for China of $9.25 million in FY 2006 and $9.75 in FY 2007.

Primary accomplishments under the MOU over the past year in support of the President's Emergency Plan for AIDS Relief in China during FY 2007 included the following:

• Providing palliative care to 39,171 HIV-infected individuals in China;
• Providing confidential, voluntary counseling and testing to 423,401 individuals in China for HIV and tuberculosis, including those who received their test results; and
• Providing anti-retroviral treatment to 28,884 individuals in China.

HHS and the U.S. Agency for International Development have made significant progress in integrating U.S. Government HIV/AIDS investments in China into programs at the Chinese central Government level and in 15 Provinces to provide technical assistance and advice in policy development.  For example, the Provincial Program Management Training Course, sponsored by HHS/CDC, has produced 40 graduates, many of whom now hold key posts in Provincial HIV/AIDS departments in China.  Both HHS/CDC and HHS/NIH have stationed staff in Beijing to implement the activities covered by the MOU.

Next Steps

As part of the President’s Emergency Plan, future plans under the renewed MOU call for the development of a comprehensive prevention program in China by improving the Chinese Provincial AIDS-surveillance network with case-finding capacity, and strengthening linkages within the existing infrastructure to provide care, support, and treatment for AIDS patients in China, with particular emphasis on patients in rural settings, including through the following:

• Encouraging collaboration among scientists of the two countries to conduct research and research training on AIDS, including basic scientific, clinical, and operational studies;
• Information and scientific exchanges, and the sharing of experiences;
• Encouraging attendance at professional and scientific meetings by specialists from both countries;
• Encouraging direct links between appropriate institutes and institutions of both countries; and
• Encouraging bilateral cooperation on AIDS prevention, care and research at the global level.

HIV/AIDS Cooperative Agreement