Gates Foundation, China to partner in HIV prevention

The Bill & Melinda Gates Foundation is launching a major partnership with the Chinese government to fight the spread of AIDS in China, after years of groundwork.

The foundation said Tuesday it will commit an initial $50 million toward rapidly expanding HIV-prevention efforts in high-risk populations and work with both the central government and nongovernmental organizations.

Dr. Ray Yip, former China director of the U.S. Centers for Disease Control and Prevention, will head the program from Beijing, where a small team of Gates Foundation staff will administer the funding and provide technical support.

The Gates funding would equal one-third of China's total government spending on HIV/AIDS this year. Of the total, $20 million will go to the Chinese Ministry of Health and $30 million will go to local, national and international NGOs.

The grants will target the groups most vulnerable to HIV infection, such as injection drug users, sex workers and men who have sex with men.

While the prevalence of HIV remains relatively low in China, with about 650,000 people infected, halting its further spread is key to preventing an epidemic, experts say. In some parts of the country, more than half of injection drug users are HIV-positive.

In the 1990s, thousands of people became infected in rural Henan province after donating blood plasma at collection centers that used contaminated equipment. Infection rates are also growing among men who have sex with men.

The government has made some progress, including opening 350 methadone clinics to curb needle-sharing by heroin addicts.

At the same time, social stigma and official mistrust of grass-roots AIDS groups remain powerful obstacles. The country's top AIDS activists are routinely put under house arrest, and the foundation cited a study in China that found nearly a third of doctors said they would refuse to treat an HIV-positive person.

The funding will go toward expanding HIV testing, ensuring care and support for HIV-positive people, training to reduce high-risk behavior and educating the public.

"It really is right on target," said Dr. King Holmes, professor of medicine and director of the University of Washington Center for AIDS and STDs. "When you have an HIV epidemic so concentrated in high-risk populations, it's much more efficient and effective to focus prevention efforts on those groups."

The approach is similar to the Gates Foundation's Avahan HIV prevention initiative in India.

While other organizations focus on treatment or a vaccine, "the Gates Foundation really almost stands alone in emphasizing prevention of HIV transmission," Holmes said.

Kristi Heim: 206-464-2718 or kheim@seattletimes.com