Civil society involvement in national HIV/AIDS programs

Globally, the AIDS response relies on active participation of nongovernmental organizations (NGOs) and civil society. In China, the government is the main provider of health and social services, and the role of NGOs is more limited than in other countries. Despite this, China has opened the door for NGO participation in its AIDS response, initially because of donor pressure but increasingly due to official acknowledgment of the important role these groups play in controlling the epidemic. Since the first AIDS NGOs were established in China in the 1990s, Chinese AIDS NGOs have made unique contributions to China’s AIDS response in critical areas like access to drugs, support for treatment compliance, outreach to marginalized at-risk groups, and efforts to reduce stigma among marginalized populations. However, there has been a substantial drop-off in donor funding in recent years, and although the Chinese government has filled the funding gap, demonstrating its commitment to the sector, recent policy moves toward greater control over the work and funding of NGOs threatens their survival. Thus far, China’s AIDS response has been noteworthy, but these new NGO funding and regulatory developments pose significant challenges to the next phase of outreach, prevention, treatment, and care.