When Thomas Cai was counseling HIV/AIDS patients at Guangzhou No. 8 Hospital in 2001, he founded AIDS Care China, never dreaming it would expand to four provinces with 32 full-time staff covering 2,500 patients in five years.

Based in Guangzhou, AIDS Care China operates care centers near hospitals and clinics offering HIV/AIDS patients and their families free accommodation and dining services, and counseling.

The organization also offers direct employment to those living with HIV/AIDS and provides training and education, enabling them to participate in AIDS prevention and awareness programs.

"AIDS Care China promotes the concept that people living with HIV/AIDS should not isolate themselves in fear of being pitied," says Cai, director of AIDS Care China. "Rather, they should face the wider realities and embrace society, and mobilize more resources to fight AIDS."

On the World AIDS Day this year, the organization received the Red Ribbon Award and a 5,000-U.S.-dollar grant from the United Nations for its crucial community-based approach to creating a dialogue between the government health authorities and people living with HIV/AIDS. It was the first time a Chinese non-governmental organization had received such high-profile global recognition for HIV/AIDS care.

"The Red Ribbon Award not only recognizes this outstanding group, but it also recognizes the crucial role communities can play with local authorities at a crucial time for the HIV/AIDS epidemic in China," said Khalid Malik, the United Nations Development Program (UNDP) representative in China, at the award ceremony on Dec. 1 in Beijing.

Indeed, China has seen a more active grass-roots organizations in HIV/AIDS prevention and care in recent years. Over 50 registered non-governmental organizations working nationwide have HIV/AIDS programs and dozens of volunteer groups dedicated to AIDS care in community.

"The government has recognized the active and important role of grass-roots organizations in HIV/AIDS prevention and control," said Chen Xiaohong, Vice Minister of Health. "Government efforts alone are not enough if China is to prevent the further spread of HIV/AIDS."

Figures from the Health Ministry show the number of recorded HIV/AIDS cases rose by almost 30 percent to 183,733 in the first 10 months of this year, from 144,089 cases at the end of last year.

Health experts say actual cases are likely to be more and both the government and the World Health Organization (WHO) estimated 650,000 Chinese were living with HIV/AIDS at the end of 2005.

"Grass-roots organizations should play a more important role, especially in the advocacy awareness campaign, care and treatment in the community," said Dr. Henk Bekedam, WHO representative in China.

Care and prevention in the community should begin with preparation of the community by providing HIV/AIDS education and information so people know about and understand the disease, says Cai.

"This helps to create acceptance in the community of HIV/AIDS patients and keeps their needs in mind when the community and healthcare system work as a team in planning and solving HIV/AIDS problems," he says.

Tang Zhou, deputy director at Nanning No.4 Hospital in Guangxi Zhuang Autonomous Region, where AIDS Care China has its care center, says," Without their help, it is hard to imagine how we could manage HIV/AIDS patients effectively with limited medical staff."

She says 1,049 HIV/AIDS patients are being treated at the hospital by just six doctors and 12 nurses. "As a result, we spend much energy on medical treatment, but have no time for psychological counseling and support."

The "Red Ribbon Center" run by AIDS Care China in the hospital serves as a venue for peer counseling services, community gatherings and training as well as medical treatment.

The center also informs patients in advance of medical appointments with software being developed by AIDS Care China that can containing confidential contact information and medical records so the center can provide more individual attention to each person and assist rural patients to arrange transport to go to the hospital.

AIDS Care China provides prevention, awareness and treatment information and hope through its bi-monthly "AIDS Bulletin" newsletter, which has a distribution of 3,000, its website (http://www.aidscarechina.org), which receives more than 5,000 hits a day, and a telephone hotline.

They also make and distribute red envelopes (hongbao), traditionally used to give gifts of money for Chinese New Year, to migrant workers and university students. Each packet contains a condom, a red ribbon and a booklet about HIV prevention.

"Grass-roots organizations can bridge the gap between the patients and society. We give care and understanding to sufferers, who need more than medical treatment, and reduce the public stigma," says Cai.

As the war on AIDS has never been easy, so has the growth of grass-roots organizations in China. Cai recalls how residents drove him out of one neighborhood after his shelter for people who had contracted the disease through drug-taking was disclosed by the media in 2002.

"Sometimes we joke that our organization is like a wild mushroom," he says. "Many people might think all wild mushrooms are poisonous, and yes, some could be, but actually, some are also very beneficial."

 In 2003, AIDS Care China received funding from UNDP, its first official funding. AIDS Care China now has financial and technical support from the UNDP, UNAIDS, the International AIDS Alliance, Treat Asia, the Ford Foundation, the Barry and Martin Foundation among others, with total donations of 1.4 million yuan (175,000 U.S. dollars) in 2005.

AIDS Care China is working with the UNDP to support the socio-economic empowerment of women living with HIV/AIDS through a micro-enterprise scheme in Yunnan and Guangdong provinces with funding of 40,000 dollars.

The aim of this project is to encourage and support women living with HIV/AIDS groups to set up and run their own small businesses. Profits from the businesses are channeled back into the group to fund support activities, reducing donor dependency and increasing sustainability.

"AIDS Care China's success lies in the strong support from partnerships with local nurses and doctors, tireless volunteers, government and private sectors, which makes me believe that the campaign against HIV/AIDS is too formidable to be fought alone," says Cai.

Since 2002, the government has allocated 20 million yuan (2.5 million dollars) for 231 projects by non-governmental bodies and communities in 150 counties of 30 provinces, autonomous regions and municipalities.

The Global Fund to Fight against AIDS, Tuberculosis and Malariahas given 450,000 dollars to 72 Chinese non-governmental organizations. About 43 percent of the 29 million dollars the Global Fund has pledged to China in the latest funding will support non-government programs.

"The government and NGOs should cooperate like the two wheels of a car and the two wings of a bird. In HIV/AIDS prevention, grass-roots organizations would play an even greater role," said Zhang Weiqing, head of the National Population and Family Planning Commission of China (NPFPC), at the 16th International AIDS Conference in Toronto in August this year.

Editor: Donald