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II. Professional Training

In November 2003 CAI and ADARC helped the Chinese Academy of Medical Sciences (CAMS) establish the AIDS Research Center (ARC), whose mission is to create a coordinating center within CAMS to direct China's research and treatment efforts in HIV/AIDS.  One of the Center’s principal goals is to transmit modern, state-of-the-art scientific technologies to Chinese medical schools, hospitals and biomedical research institutes. To that end, CAMS and ADARC have collaborated on numerous professional training projects. With help from ADARC, the ARC has pursued three main areas of training to build the health system’s capacity to respond to the AIDS epidemic, especially in rural areas.

A.  Nationwide Physicians Training: The ARC has been the pioneer in training physicians at rural hospitals to care for and treat patients living with HIV and AIDS.  When the government announced its free treatment program in 2003, only a handful of doctors in China had experience with antiretroviral therapy.  More limiting than access to drugs was the lack of qualified medical and technical personnel to deliver care and treatment, especially in rural areas where the need is greatest.  For the AIDS Research Center, training medical staff to deliver systematic antiretroviral therapy and treatment for opportunistic infections became a top priority.

On behalf of CAI and with support from the Clinton Foundation, Dr. Yunzhen Cao has developed a physician’s network that reaches across China.  Drawing from her experience at ADARC in New York, Dr. Cao developed an innovative training curriculum that focuses less on theory and more on practical, clinical experience. Her training programs include lectures, clinical diagnosis, ward patrolling, case studies and patient consultations: all of these help prepare doctors and medical staff to respond to immediate patient needs.  The training team returns after three months to provide a follow-up seminar that addresses specific questions identified during the doctors’ clinical experiences.  A number of provincial and municipal hospitals initiated their treatment programs as a direct result.

B. Training Health Care Professionals in HIV/Hepatitis C Coinfection:  The high prevalence of HIV and hepatitis C virus (HCV) co-infection poses enormous challenges to medical practitioners in China.  The two diseases share modes of transmission from injection drug use, contaminated blood products, and sexual contact. With technical assistance from ADARC, CAMS’ AIDS Research Center has developed a specialized curriculum to train health care professionals to diagnose HIV infection as it relates to Hepatitis C infection. The objectives are: 1) to provide local health care professionals with the most recent information about HIV/AIDS and Hepatitis C infection, 2) to train physicians and nurses to properly collect blood samples for future studies, and 3) to teach laboratory technicians to measure HIV-1 and Hepatitis C-specific immune responses through ELISA or equivalent types of assays.  The resulting foundation of trained clinicians will be vital to future blood sample collection for genetic characterization.

C.  Training in Bioethics:  After gaining experience promoting antiretroviral therapy, ARC became increasingly sensitive to the importance of bioethics in clinical trials, treatment, and vaccine preparedness.  With training from ADARC, ARC set up an Institutional Review Board (IRB) to protect human subjects in all ARC programs, including national and international collaborations. The IRB has been registered and approved by the U.S. Office for Human Research Protections (OHRP) in the Department of Health & Human Services. Members include doctors, sociologists, public health practitioners, and bioethicists.

The ARC is also promoting Community Advisory Boards to encourage communication between HIV+ members of the community and healthcare workers, local leaders/policy makers, law enforcement, religious leaders, the media, and NGOs, and promote better community understanding of the content, quality and ethical dimensions of treatment and care for people living with HIV/AIDS. The ARC is developing training programs that introduce the basic concept and fundamental responsibilities of CABs, delivering bioethics training, and serving as a link between local medical personnel and newly-created CABs. The goals are to empower CABs to help affected communities understand the clinical treatment process, to promote ethical practices in HIV/AIDS treatment, such as informed consent and confidentiality, to give assistance concerning issues related to the accrual and retention of participants undergoing treatment, to give clinical treatment participants necessary advocacy channels, and to provide grievance mechanisms.