School of International and Public Affairs
Columbia University
March 15, 2005
A CHANCE FOR CHANGE
The Role of Foreign Business
and CSR in Fighting HIV/AIDS
in China
[DRAFT]
Ben Gao (LLM, 2006)
Chrissa La Porte (MIA, 2005)
Soledad Mills (MIA, 2005)
Elena Muñoz (MIA, 2004)
Anja Papenfuss (MIA, 2005)
World Bank Institute Project
Columbia University, March 2005
EXECUTIVE SUMMARY
Although China’s current national HIV prevalence rate is only about 0.1%, the country is poised
for a more widespread epidemic that could have a considerable negative impact on its long-term
economic performance.
Given that China benefits from an enormous influx of foreign investment, foreign companies
could play a pivotal role in helping to fight HIV/AIDS. They have important human and
financial resources at their disposal, can reach large audiences, and are more responsive to
stakeholder pressure than domestic Chinese companies. In addition, multinationals have often
been previously exposed to the business case for corporate initiatives concerning HIV/AIDS as
well as to the disastrous effects the disease can have on private business. Lobbying, workplace
activities and community-oriented initiatives by foreign companies could thus have a significant
impact both in directly improving the welfare and health of employees and communities, and in
pressuring suppliers, competitors, local enterprises and even government into taking greater
action, too.
Currently only few multinationals are implementing HIV/AIDS programs in China. However,
surveys indicate that companies are concerned about the disease’s impact on their performance
and that they are increasingly interested in engaging in relevant CSR activities. Moreover,
recently, notably since the 2003 SARS crisis, changes in Chinese national HIV/AIDS-related
legislation and policies sanction and encourage such corporate interventions. Nevertheless,
several obstacles and challenges remain to be addressed – particularly companies’ lack of
information on epidemiological trends, as well as on existing resources and support structures,
and discrepancies between national and local legislation.
-2-
World Bank Institute Project
Columbia University, March 2005
TABLE OF CONTENTS
EXECUTIVE SUMMARY ...................................................................................................... - 2 TABLE OF CONTENTS ......................................................................................................... - 3 ABBREVIATIONS ................................................................................................................... - 5 INTRODUCTION..................................................................................................................... - 7 I. MAKING THE CASE FOR GREATER CORPORATE INVOLVEMENT IN
COMBATING HIV/AIDS IN CHINA .................................................................................. - 10 A. HIV/ AIDS IN CHINA ..................................................................................................... - 10 1. An Overview of the Epidemic in China ......................................................................... - 10 2. Economic Impact of HIV/AIDS ..................................................................................... - 11 a. HIV/AIDS and the Macroeconomy ........................................................................... - 11 b. Public Health Expenditures........................................................................................ - 12 3. Legal/ Institutional Context for Intervention ................................................................ - 14 a. Post-SARS National Policy Reform .......................................................................... - 14 b. The Communiqué – A Strong Policy Statement ........................................................ - 15 c. Changes at the Local Level ........................................................................................ - 17 d. Implications for Businesses and Civil Society........................................................... - 18 4. Development of Civil Society ........................................................................................ - 20 B. CORPORATE SOCIAL RESPONSIBILITY IN CHINA ................................................ - 22 1. General Situation .......................................................................................................... - 22 2. HIV/AIDS and Business in China.................................................................................. - 24 a. Current Situation ........................................................................................................ - 24 b. Economic Impact of HIV/AIDS on Foreign Enterprises ........................................... - 25 C. CONCLUDING REMARKS ........................................................................................... - 27 II. HIV/AIDS INTERVENTIONS IN CHINA BY MULTINATIONAL
CORPORATIONS .................................................................................................................. - 28 A. AREAS FOR INTERVENTION ...................................................................................... - 28 -
-3-
World Bank Institute Project
Columbia University, March 2005
1. Supply Chain ................................................................................................................. - 28 a. Risk Groups in the Supply Chain ............................................................................... - 30 i. Truck Drivers........................................................................................................... - 30 ii. Migrant Workers .................................................................................................... - 31 B. LESSONS LEARNED FROM CASE STUDIES ............................................................. - 32 1. Business-level Activities ................................................................................................ - 32 2. Advocacy and Lobbying ................................................................................................ - 33 3. Key Insights ................................................................................................................... - 34 C. CONCLUDING REMARKS AND RECOMMENDATIONS ........................................ - 36 CONCLUSION ....................................................................................................................... - 39 BIBLIOGRAPHY ................................................................................................................... - 40 -
-4-
World Bank Institute Project
Columbia University, March 2005
ABBREVIATIONS
AIDS
Acquired Immunodeficiency Syndrome
ART
Anti-Retroviral Therapy/Treatment
ARV
Anti-Retroviral (drugs)
CEO
Chief Executive Officer
CSR
Corporate Social Responsibility
CSW
Commercial Sex Worker(s)
EPZ
Export-Processing Zones
FDI
Foreign Direct Investment
GATT
General Agreement on Tariffs and Trade
GBC
Global Business Coalition Against HIV/AIDS
GDP
Gross Domestic Product
HAART
Highly Active Anti-Retroviral Therapy
HIV
Human Immunodeficiency Virus
IDU
Injecting Drug Use/ Users
ILO
International Labor Organization
MFA
Multi-Fibre Arrangement
NGO
Non-Governmental Organizations
PLWHA
People Living With HIV/AIDS
SARS
Severe Acute Respiratory Syndrome
STD
Sexually Transmitted Disease
UNAIDS
The Joint United Nations Programme on HIV/AIDS
-5-
World Bank Institute Project
Columbia University, March 2005
VCT
Voluntary Counseling and Testing
WTO
World Trade Organization
-6-
World Bank Institute Project
Columbia University, March 2005
INTRODUCTION
HIV/AIDS has emerged as one of the most devastating health crises facing humankind in
modern times. The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimates that
there are currently up to 44 million people living with HIV.1 While the obligation to provide
education and treatment to curtail the HIV/AIDS epidemic rests primarily with governments,
there has been increasing pressure on private businesses to contribute to these efforts.
On the one hand, over the past decade, corporations have grown and spread throughout the world
with company profits reaching unprecedented levels. This has given them unparalleled power
and influence over national governments to effect policy change - for better or for worse. On the
other hand, corporations can complement government action with workplace and philanthropic
initiatives that not only benefit communities, but also make good business sense in the long term.
These activities fall under the World Bank Institute’s definition of Corporate Social
Responsibility (CSR) as being “a collection of policies and practices linked to relationships with
key stakeholders, values, compliance with legal requirements, and respect for people,
communities and the environment; and the commitment of business to contribute to sustainable
development.”2
As far as the global fight against HIV/AIDS is concerned, multinational corporations can make a
crucial contribution, in that they have important resources (both financial and human ones) and
can reach diverse audiences (both inside and outside the company). Indeed, due to mounting
pressure from multiple stakeholders, companies are increasingly proactive in responding to the
crisis. The Global Business Coalition Against HIV/AIDS (GBC), a coalition of 150 companies
that are committed to fighting the AIDS pandemic, conducted a consumer survey in the US that
found that over half of the consumers surveyed felt that business was doing too little to address
HIV/AIDS.3 Shareholder activists have impelled companies like Coca-Cola and Ford to report
on the effects of HIV/AIDS in their global operations. This has led to Ford becoming the first
American multinational to extend anti-retroviral treatment to its entire global workforce.4 In
South Africa, companies like BMW are now providing prevention and awareness training, free
contraceptive devices, voluntary counseling and testing (VCT), and access to anti-retroviral
therapy (ART).5 Moreover, the United Nations Global Compact, recognizing the importance of
bringing companies on board in international HIV/AIDS strategies, has recently initiated a policy
UNAIDS, ‘Global summary of the HIV and AIDS epidemic,’ December 2004. Available at:
http://www.unaids.org/wad2004/graphics/Epicore2004_Dec04_en.ppt
2
World Bank Institute, ‘Introduction to Corporate Social Responsibility,’ Online Course, 2005.
3
Global Business Coalition poll demonstrating that American consumers expect companies to be involved in the
fights against AIDS, November, 2004, available at:
www.kintera.org/atf/cf/{EE846F03-1625-4723-9A53-B0CDD2195782}/Survey%20Results%202005.pdf
4
‘Ford HIV Report Exemplifies New Shareowner Action Strategy’, William Baue, Socialfunds.com, December 7,
2004
5
Private Sector Intervention Case Example: ‘Building an HIV/AIDS Workplace Programme that Addresses BMW
South Africa’s Specific Context’, Global Health Initiative, September 2003, available at:
www.webforum.org/globalhealth/cases
1
-7-
World Bank Institute Project
Columbia University, March 2005
dialogue on the topic and is seeking ways in which to engage companies in the fight against the
pandemic.
While a small but growing number of multinational companies are addressing HIV/AIDS in their
global operations, it is interesting to note that only few have implemented programs in China – in
spite of the fact that the country is one of the largest recipients of foreign direct investment (FDI)
and one of the so-called “second-wave” countries. Meanwhile, China is experiencing
extraordinary levels of economic growth, giving businesses increased resources and reach to
address this problem. Moreover, with the phase-out of the textile quota system at the end of this
year, analysts expect to see a significant amount of manufacturing move to China, resulting in a
proliferation of textile factories and related businesses. Thus, given their increasing resources,
extensive supply chains and outreach into the country, multinationals are uniquely positioned to
significantly contribute in the fight against HIV/AIDS in China.
About this paper
This paper presents the findings of an independent research project undertaken by a team of
students at Columbia University’s School of International and Public Affairs at the request of the
World Bank Institute. Based on an extensive literature review and interviews, it seeks to explore
the barriers, real or perceived, for multinationals with subsidiaries in China to carrying out
HIV/AIDS initiatives there. This paper also seeks to identify trends and/or conditions that would
facilitate, necessitate or accelerate such interventions by companies in China.
Section I assesses the current and potential impact of the HIV/AIDS pandemic on China and
makes the case why greater HIV/AIDS initiatives are needed. Section II gives an overview of
recent developments in Chinese legislation and policies that could help to facilitate, necessitate
or accelerate interventions by companies in the field of HIV/AIDS. In the final section, the paper
presents specific recommendations on how the presence of multinationals in China could be
better used to combat HIV/AIDS and what measures could encourage greater corporate
involvement in this fight.
While the team recognizes the importance of Chinese companies in the fight against the
epidemic, it chose to exclusively focus on American and European businesses operating in China
in the present report. This can be explained by several facts. First, foreign-owned companies are
more inclined to respond to external pressure from stakeholders. Second, multinationals are
likely to already have been exposed to the business-case for CSR activities in the field of
HIV/AIDS and to the experiences of other companies in this field. In fact, some of the
companies currently investing in China have already been involved in such activities in other
countries or have experienced the devastating effects of the disease in other countries. These
factors make them more likely to get involved in HIV/AIDS initiatives than either the stateowned enterprises or private Chinese businesses. At the same time, foreign companies have the
potential to positively influence local Chinese businesses, for instance by exerting pressure on
suppliers and competitors, thus creating important positive externalities and trickle-down effects.
The 2002 United Nations Theme Group’s blueprint for Corporate Engagement Initiative in
-8-
World Bank Institute Project
Columbia University, March 2005
China6 confirms the appropriateness of a phased approach, beginning with foreign companies, to
corporate involvement in HIV/AIDS activities. This paper aims at complementing the blueprint
by tracing recent developments in China that are likely to affect companies’ incentives to engage
in HIV/AIDS-related activities and by focusing more specifically on the needs of foreign
companies operating there.
‘Blueprint for Corporate Engagement Initiative in China’, United Nations Theme Group (Prepared for UNAIDS),
December 12, 2002
6
-9-
World Bank Institute Project
Columbia University, March 2005
I. MAKING THE CASE FOR GREATER CORPORATE INVOLVEMENT IN
COMBATING HIV/AIDS IN CHINA
A. HIV/ AIDS IN CHINA
Addressing HIV/AIDS in China is crucial to the success of international efforts to bring the
HIV/AIDS global pandemic under control. China (together with India, Ethiopia, Nigeria and
Russia) is one of the so-called “second wave” countries—i.e. a country where current HIV/AIDS
prevalence rates are still low but are susceptible to a rapid deterioration that would affect large
numbers of people, both within the country’s borders and throughout the region. China has one
of the most rapidly expanding HIV epidemics in the world. As UNAIDS has warned, the number
of people living with AIDS in China could reach 10 million as early as 2010 if the epidemic is
left unchecked.
1. An Overview of the Epidemic in China
Accurate statistics on people living with HIV/AIDS (PLWHA) in China are hard to come by.
Especially in rural areas, HIV/AIDS cases are often under-reported, whether due to a shortage of
testing equipment and trained health staff or to continuing stigma. As Qi Xiaoqiu, director of
China’s Department of Disease Control, said, “Exact figures are difficult to arrive at because
government at local levels are very reticent to report on actual cases, a situation compounded by
individuals who are reluctant to come forward because of discrimination.”7 Indeed, local officials
sometimes deliberately attempt to hide data on HIV/AIDS for fear that admitting HIV exists on
their watch could damage them in the eyes of their superiors or scare away business investment.
At the end of 2003, UNAIDS estimated that about 840,000 people were living with HIV/AIDS in
China, with an estimated 80,000 having developed AIDS.8 Given that China’s population
reached 1.3 billion in 2004, current national HIV prevalence is only about 0.1%.9 However,
clusters of high prevalence exist, both within specific geographic regions and among certain
population sub-groups.
HIV/AIDS was first diagnosed in China in 1985. It first manifested itself as several distinct
epidemics. The first major outbreak of the disease occurred in Yunnan province in 1989 among
injecting drug users (IDU). A second epidemic occurred in the 1990s in the central provinces,
especially Henan Province, among commercial blood and plasma donors as a result of unsafe
donation procedures. Heterosexual transmission of HIV is occurring mainly in China’s eastern
provinces, fuelled by a growing commercial sex industry and large numbers of migrant workers
moving to the region in search of labor.
7
AVERT: www.avert.org/aidschina.htm
UNAIDS, see: http://www.unaids.org/en/geographical+area/by+country/china.asp
9
UNAIDS, see: http://www.unaids.org/en/geographical+area/by+country/china.asp
8
- 10 -
World Bank Institute Project
Columbia University, March 2005
However, today the epidemic is no longer confined to certain high-risk groups. It has spread
across 31 provinces and to the general population. The country is witnessing a rapid increase in
HIV infections and AIDS deaths, particularly in the central provinces where many people
became infected through the unsafe blood and blood plasma in the 1990s. There is emerging
evidence that the proportion of sexually transmitted HIV infections is increasing. In particular,
the proportion of female HIV cases has increased considerably in recent years. According to
UNAIDS, the main driving forces behind the spread of the disease to the general population are
huge income disparities, large scale labor migration and gender imbalances, all of which increase
the population’s vulnerability to HIV.10
According to a December 2004 report jointly prepared by the State Council AIDS Working
Group Committee Office and the UN Theme Group on HIV/AIDS in China, “based on the
observed patterns and trends, the future course of the epidemic may continue to increase rapidly
over the coming years, or it may start stabilizing. This will depend to a large extent on the
coverage and effectiveness of prevention programs, treatment and care throughout the
country.”11 The dangers of inaction or inaccurate responses to China’s HIV/AIDS problem
cannot be underestimated. As John Ruggie, director of Harvard University’s Center for Business
and Government, said at an AIDS conference held in Beijing in 2003, “unless China acts
decisively, it will find itself on an African trajectory, just 15 years behind. In Africa,
governments and businesses are looking back at what they should and could have done. In China,
there is still time to avert the worst-case scenario.”12
2. Economic Impact of HIV/AIDS
a. HIV/AIDS and the Macroeconomy
HIV/AIDS possesses such enormous potential to devastate an economy since the disease
primarily affects working adults between the ages of 20-29, the most productive subsection of
the population.13 Despite China’s currently low national prevalence rate, the economic risks for
China are nevertheless predicted to be dramatic.
For instance, using 1999 World Bank Data, Nicholas Eberstadt computed the “correspondence
between national life expectancy and output per member of the ‘potential work force’…and then
combin[ed] these figures with the simulations of national life expectancy and potential work
force size from the various HIV scenarios.”14 In a base-line scenario without HIV/AIDS, China’s
output per working-age person without HIV/AIDS would increase by over 50% in the next 25
10
UNAIDS, see: http://www.unaids.org/en/geographical+area/by+country/china.asp
‘A Joint Assessment of HIV/AIDS Prevention, Treatment and Care in China’ (hereafter ‘Joint Assessment’), State
Council AIDS Working Group Committee Office & UN Theme Group on HIV/AIDS in China, 2004, p. i
12
‘A Saving Embrace’, The Economist, Nov. 20, 2003
13
Liu, Gordon G.; Guo, Jeff J.; and Smith, Scott R., ‘Economic Costs to Business of the HIV/AIDS Epidemic’,
Pharmacoeconomics Volume 22 Issue 18, 2004, p. 1184
14
Eberstadt, Nicholas, ‘The Future of AIDS’, Foreign Affairs Volume 81 Issue 6, Nov/Dec 2002
11
- 11 -
World Bank Institute Project
Columbia University, March 2005
years. However, a mild epidemic, with a peak HIV prevalence rate of 1.5% according to
Eberstadt’s definition, would reduce this growth by half, lowering China’s long-term economic
growth rate by more than 0.5% per year.15 By extension, a more severe epidemic would reduce
China’s economic growth more significantly.
The “Socioeconomic Impact of HIV/AIDS in China” report published in 2002 also quantifies the
possible impact of HIV/AIDS on China’s economy, based on medical expenditures (not
including HAART16 therapy) and productivity losses. The report finds that under the most
optimistic scenario, where the HIV prevalence rate is 0.26% in 2010, China’s GDP loss will
equal 7.6 billion Yuan, a cumulative loss of 22.5 billion Yuan in ten years. With a more severe
epidemic that peaks at 1.38% in 2010, the GDP loss would reach 15.9 billion Yuan in 2010,
representing a cumulative loss of 40 billion Yuan in ten years.17
b. Public Health Expenditures
Below the level of the macroeconomy, the HIV/AIDS epidemic will impose severe costs on
China’s deteriorating public health sector and on the savings of individual households. In 1975,
the public healthcare system provided insurance coverage to almost all of the urban population
and 85% of the rural population. However, by 1997, only 10% of the rural population and 50%
of the urban population had insurance coverage.18
Heather Zhang attributes this deterioration in the public health system to marketization,
reduction in government funding and rising user fees.19 Moreover, as noted by the Economist,
“State-owned enterprises once shouldered much of the responsibility for basic health care,
including the running of their own hospitals…Private businesses are supposed to pay for medical
insurance, but most do not bother.”20 One survey of American firms that had invested in China
found that those companies new to China did provide such benefits as medical care but that more
established firms were less likely to provide these benefits.21
15
Ibid.
Highly Active Anti-Retroviral Therapy
17
Yip, Ray; Stover, John; et al., ‘The Socioeconomic Impact of HIV/AIDS in China’, Aug. 2002, p. 8, 12, available
at: www.unicef.org/evaldatabase/index_14213.html
18
‘China 2020: Financing Health Care’, World Bank, Sept. 1997, p. 1, 3
19
Ziaoquan Zhang, Heather, ‘The Gathering Storm: AIDS Policy in China’, Journal of International Development
Volume 16 Issue 8, 2004, p. 1165
20
‘Where are the Patients?’, The Economist, Aug. 21, 2004.
21
Sanyal, Rajib N. and Guvenli, Turgut, ‘Employee Benefits in American Firms in China’, International Journal of
Commerce and Management, Volume 11 Issue 1, 2001, p. 111. Interestingly enough, the authors attribute this
development to the fact that State-Owned Enterprises have become less likely to provide these benefits due to their
fragile financial condition and that the Chinese government provides a “safety net of welfare and medical care for all
its citizens not covered otherwise.”
16
- 12 -
World Bank Institute Project
Columbia University, March 2005
As a result, HIV/AIDS seems to be having stark effects on household finances. According to one
estimate, 75.5% of AIDS patients pay their medical bills themselves, with only 10.3% relying on
the public medical care system and 7.9% on insurance.22 Based on research by Bloom and Mahal
(1996) and Bloom and Glied (1993), the ratio of HIV/AIDS treatment costs to per capita income
in China was 2.2 or more than double current income.23
While the Chinese government has been slow to react to the growing HIV/AIDS epidemic, as
discussed in greater detail in the next section, it has recently dedicated increased funds to combat
HIV/AIDS and has begun to guarantee treatment for certain sectors of the population. For
example, in 1996 the central government’s AIDS-related fund was only five million Yuan,24 but
by 2004 the total HIV/AIDS budget had risen to 810 million Yuan.25 Provincial governments
have also increased their spending on HIV/AIDS, with funding increasing 53% from 2003 to
2004.26 However, these increases in funding may still prove inadequate. According to one
estimate of the HIV/AIDS resource needs in China, in 2004, there was a total resource need of
3.1 billion Yuan under a low cost scenario and 5.2 billion Yuan under a high cost scenario.27
The economic repercussions of the comparatively short-lived Severe Acute Respiratory
Syndrome (SARS) epidemic provide a striking counterpoint to predictions of the potential drain
of HIV/AIDS on the Chinese economy. After a delayed but thorough mobilization of the public
health sector, SARS’ effect on the Chinese economy was estimated at $17.9 billion or 1.3% of
China’s annual GDP in 2003.28 Even as government policy has shifted with respect to HIV/AIDS,
there remains a strong imperative for the government to commit greater resources to limit the
effects of HIV/AIDS in China. Moreover, the gap between current resources committed by the
government and the overall HIV/AIDS resource needs in China suggests that there is
considerable room for other actors, such as international business and NGOs, to contribute to the
government’s efforts.
22
Yip, Stover, et al., p. 9 (supra note 17)
D.E .Bloom and A. Mahal (1996) and D.E. Bloom and S. Glied (1993), cited in: ‘Asia's Economies and the
Challenge of AIDS’, David E. Bloom, Ajay Mahal, Larry Rosenberg, Jaypee Sevilla, David Steven, Mark W.
Weston, Asian Development Bank, April 2004, p. 58, available at: www.adb.org/Documents/Books/AsiaAIDS/default.asp
24
Zhang, p. 1162 (supra note 19)
25
Joint Assessment (supra note 11), p. 22.
26
Ibid.
27
Ibid., p. 24. The authors of the report note that these resource needs account for “the objectives set in the China's
Medium-and Long-Term Programme for the Prevention and Control of AIDS (1998-2010), recent progress against
these objectives and an assessment of implementation capacity in 2004.” (p. 24)
28
Zhang, 2004, p. 1164-5 (supra note 19)
23
- 13 -
World Bank Institute Project
Columbia University, March 2005
3. Legal/ Institutional Context for Intervention
The SARS crisis in China, with its initial debacle and later policy turn-around,29 showed the
Chinese leadership the potential implications of an epidemic and the necessity for an effective
policy response.30 The lessons of SARS, coupled with new leadership at the highest levels of the
Ministry of Health, lead to “profound” changes in the HIV/AIDS policy. 31 As explained below,
while the post-SARS HIV/AIDS policy does not strongly emphasize civil society involvement in
HIV response, it does show that the national government is willing to adopt new and innovative
initiatives, including those involving businesses and international organizations.
a. Post-SARS National Policy Reform
The months since the SARS crisis, which ended in late 2003, have been a busy time for Chinese
officials entrusted with China’s HIV/AIDS response. As noted above, both national and regional
financial commitments to combating HIV/AIDS have increased substantially since 2003. In
December 2003, Beijing announced the “Four Frees and One Care” policy, providing for: free
anti-retroviral drugs (ARV) for rural residents and urban poor, free Voluntary Counseling and
Testing, free ARVs for HIV-positive pregnant women, free schooling for AIDS orphans, and
care and economic assistance to households with PLWHA.32 In the same month, both the
Chinese Premier and the Vice-Premier visited AIDS patients in a hospital in Beijing and in a socalled “AIDS village” in Hubei. They shook hands with patients and talked with local AIDS
activists to inquire about the situation on the ground. Both events were shown on national
television, followed by an interview with a HIV patient, where the patient talked openly about
his experience of living with HIV.33
In February 2004, the State Council formed the State Council AIDS Working Committee,
specifically to provide for dedicated top level leadership in the national AIDS response.34 In
August, the National People’s Congress revised its Contagious Disease Prevention and Control
Law. This revision took AIDS off the list of contagious diseases that required isolation35 and
See generally ‘The World Health Report 2003: SARS: Lessons From a New Disease’, World Health Organization
(WHO), 2003, available at: www.who.int/entity/whr/2003/en/Chapter5-en.pdf
30
See Dolven, Ben, ‘Building New Chinese Walls’, Far Eastern Economic Review, May 22, 2003, at 24.
31
‘China Takes Active Measures to Control HIV/AIDS’, Xinhua, Oct. 6, 2004, available at: http://en1.ce.cn/National/Law/200412/01/t20041201_2445435.shtml#### (quoting Ray Yip, director for the Global AIDS
Program of the U.S. Centers for disease Control and Prevention in China). See also ‘A Lonely Crusade to Change
Chain’s Face of AIDS’, Rod Mickleburgh, The Globe and Mail, Nov. 8, 2004, p. A10 (quoting Dr. Gao a renowned
AIDS activist in China); Joint Assessment, supra note 11, p. 8 (“The year 2004 has seen a dramatic
improvement....”); ‘New Law Prepared on HIV/AIDS’, China Radio International (CRI), Dec. 1, 2004 (quoting a
senior lawyer from Shanghai who has given legal assistance to many HIV/AIDS patients that “[t]his year is a
turning point ...” and citing Xia Guomei, a professor from Shanghai Academy of Social Sciences and a consultant
with UNAIDS.)
32
Joint Assessment (supra note 11), at §2.1.1. p 9.
33
Joint Assessment (supra note 11), p. 8-9. See also ‘Handshake Highlights Fight Against AIDS’, People’s Daily
Online, Mar. 6, 2004; ‘Chinese Vice-Premier Calls on Public Not To Discriminate Against AIDS Patients’, BBC
Monitoring Asia Pacific, Dec. 26, 2003
34
Joint Assessment (supra note 11), at §2.1.2.
35
Contagious Disease Prevention and Control Law, Clause 3, 39 available at: www.moh.gov.cn (the revised law
reclassified AIDS from a Category A disease to a Category B disease that does not require mandatory isolation).
29
- 14 -
World Bank Institute Project
Columbia University, March 2005
inserted a clause that contained language – though vague - prohibiting businesses and individuals
from discriminating against individuals infected with a contagious disease.36
Beyond mere legislation, a host of pilot projects were initiated and expanded in high prevalence
areas in 2004 and 2005. According to the September 2004 State Council and UNAIDS report,
these pilot projects included:




A 100% Condom Use Program pilot project expanding into additional sites
located in five provinces;
A comprehensive intervention project directed at commercial sex workers (CSW),
initiated at around 30 sites in 2004;
Clean needle exchange programs expanding into 50 sites across seven provinces;
A methadone treatment pilot project, to be initiated in 2005.37
According to the State Council, many of these projects have demonstrated success in reducing
the transmission of sexually transmitted diseases (STDs) and of HIV transmission through
IDU.38 In addition, the community-based treatment and care program, China CARES, funded
jointly by The Global Fund to Fight AIDS, Tuberculosis and Malaria39 and the Chinese central
government, has obtained a new round of funding from the Global Fund specifically for
intervention programs among vulnerable populations, including peer education and methadone
treatment. The project will start sometime in 2005 in 74 project sites.40
b. The Communiqué – A Strong Policy Statement
The new government policy is roughly consolidated in the March 2004, State Council (the
Chinese Cabinet) document #7, Communiqué Regarding Concretely Improving AIDS Prevention
and Treatment (hereafter, the Communiqué). The Communiqué provides an outline of the
priorities set at the highest levels of the Chinese government regarding AIDS. In the introduction
to the Communiqué, the State Council bleakly stated that “overall, the HIV situation is still
worsening rapidly in our country, and we have not been able to reverse the epidemic’s spread.”41
The Communiqué’s introduction cites weaknesses in the areas of HIV/AIDS awareness
education, epidemic surveillance, disease intervention, legal regulation, and capacity of
prevention programs.42 In the first section of the document, the State Council explicitly criticizes
36
Ibid. Clause 16. The language is ambiguous because it does not define what discrimination is, and exactly what
kind of discrimination is prohibited. The word for business is also ambiguous as to if it applies only to state-owned
enterprises, or also to local governments, or private businesses.)
37
Joint Assessment (supra note 11), p. 16-18.
38
Joint Assessment (supra note 11), p. 16-18.
39
A program of the UNAIDS that serves as a funding mechanism for projects designed to combat AIDS,
Tuberculosis and Malaria in needy countries. See www.theglobalfund.org/en/
40
‘People’s Republic of China, Reducing HIV Transmission Among and From Vulnerable Groups and Alleviating
Its Impact in Seven Provinces in China’, Approved Round 4 Proposal to the Global Fund to Fight AIDS,
Tuberculosis and Malaria, available at: www.theglobalfund.org/search/portfolio.aspx?countryID=CHN
41
Joint Assessment (supra note 11), p. 5 (author’s translation).
42
Ibid.
- 15 -
World Bank Institute Project
Columbia University, March 2005
local governments for not taking HIV prevention work seriously, and threatens punishment
against local officials who fail in their HIV/AIDS prevention duties.43
The Communiqué adopts two distinct HIV/AIDS policies, one targeted at the general population,
and another targeted at high prevalence areas. The policy for the general population focuses on
education, condom promotion, and treatment. The stated goal of the public education campaigns
is to “educate the public about transmission routes and prevention methods, to establish civilized
and healthy living habits, and to prevent unnecessary panic and reduce discrimination against
PLWHA.”44 The document contains a series of paragraphs, each describing measures to be taken
by one of the following institutions: the media,45 educational institutions46, public transportation
systems,47 and cultural and entertainment institutions.48 Healthcare facilities and family planning
organizations are given the special task of educating the public about the specifics of condom use,
while other relevant institutions are asked to increase their efforts in education, condom
manufacturing, and establishing automated condom machines.49
For high prevalence areas, the planners called for the implementation of “comprehensive AIDS
response demonstration projects.” Within the context of these projects, the document called for
comprehensive HIV/AIDS response strategies that are adapted to local realities, and are aimed at
creating a social environment conducive to HIV/AIDS education, prevention and treatment for
various vulnerable groups.50 The Communiqué’s language treats PLWHA as a part of “all social
groups,” along with other high risk groups and the general population.51 The Communiqué’s
charge to create an overall favorable social environment for HIV/AIDS prevention in high
prevalence areas is perhaps left appropriately vague to allow local governments the freedom to
experiment.52 A review of the pilot projects that are in operation or being planned show that they
typically cover five to seven provinces (out of 41), and are focused on intervention efforts among
vulnerable groups, such as peer education programs among sex workers, and clean needle or
methadone treatment programs for IDUs.53
‘Communiqué Regarding Concretely Improving AIDS Prevention and Treatment’, State Council of China
document #7, Mar. 2004, at §1.
44
Ibid., at §1(1).
45
That significant media outlets at all political levels should have plans for public education, including designated
programs and periodic public announcements on the topic of HIV and voluntary blood donation.
46
Communiqué, (supra note 43), at §2. Directing the education institutions to include AIDS prevention and blood
donations in the curriculum of middle school and higher students.
47
Ibid. That all public transportation system administrations will integrate HIV/AIDS education and voluntary blood
donation information into their public outreach materials. Establish bulletin boards and displays on the topics, and
broadcast HIV and voluntary blood donation public service announcements on entertainment systems.
48
Ibid. Entertainment venues are directed to make AIDS prevention literature and products publically available.
Government organized civil institutions such as the Youth League and the Women’s League are asked to participate
in AIDS prevention education and public outreach.
49
Ibid. at §2(2) (that the network of health care and family planning facilities should be used to educate their clients
about HIV, condom use, ... install automated condom machines, social marketing of condoms).
50
Ibid. at §2(3).
51
Ibid. at §II.3.
52
Unlike the rest of the document, the section of the Communiqué dealing with high prevalence areas does not
contain specific policies, programs or action mandates.
53
infra (beginning of this section)
43
- 16 -
World Bank Institute Project
Columbia University, March 2005
Notably, four of the seven sections of the document are devoted to disease management,
including disease monitoring, treatment, and social welfare. Section three calls for the
establishment of a nationwide free and voluntary testing and counseling program.54 Section four
provides for free or reduced cost anti-retroviral medication to the rural population and urban
poor.55 Funding for these projects are promised at the central level with requested local
contributions (section five).56 Section six provides for the social welfare of PLWHA and their
families. The section calls on local governments at all levels to include AIDS patients and their
families in the social welfare system in order to provide for their subsistence, to offer free
education for AIDS orphans, and to create employment opportunities for HIV-positive persons.57
In a separate paragraph, section six asks local governments to reduce discrimination against HIV
patients and advocates for a patient management model combining treatment, social services and
community services.58 This part of the document refers to a Ministry of Health normative
document that recommended protection for HIV patients’ employment, civil, and privacy
rights.59 This reference to anti-discrimination is in addition to the one mentioned in the education
section.60
c. Changes at the Local Level
In accordance with the new central government policy, many cities and provinces have passed
new laws implementing the Communiqué in various forms. For example, in June 2004,
Shandong Province made it illegal for employers to fire employees with HIV/AIDS.61 In August
2004, Jiangsu Province enacted local HIV/AIDS prevention legislation that largely followed the
objectives set out by the Communiqué.62 The law also prohibits discrimination against HIVinfected persons in the areas of employment, education, healthcare, and social activities.63 Other
examples of swift legislative action following the release of the Communiqué include legislation
54
Communiqué, (supra note 43), at §3. The section also asks disease control agencies at various levels to increase
their monitoring and research of the epidemic. Local governments and health departments are asked to follow the
reporting procedures stipulated in the revised China Infectious Disease Law to timely report the progress of the
epidemic, or face serious sanctions.
55
Ibid. at §4. Local governments are asked to research the possibility of including anti-retroviral drugs in
formularies for worker’s insurance program and co-insurance schemes.
56
Ibid. at §§3-5. The implementation of the testing program is to be worked out between the Ministry of Health and
Department of Finance. The cost of the drug cocktails is to be defrayed partly by their inclusion in the formulary of
the national healthcare program for the poor and rural residents and partly by increased local funding. Where local
funding may be disproportionate because of high prevalence rates, the Communiqué promises central government
funding.
57
Ibid. at §6.
58
Ibid. Perhaps to counter balance the progressive elements of the section, the paragraph finishes by calling for legal
and moral education for HIV patients to prevent intentional spread of the virus, and legal prosecution for violators.
59
Ibid. at §3. The document referred to is 关于对艾滋病病毒感染者和艾滋病病人的管理意见, published by the
Ministry of Health in 1999.
60
See discussion infra at the beginning of this section regarding stated goals of the general public education
campaign.
61
‘Shandong Moves to Protect Employees With HIV/AIDS’, David Fang, South China Morning Post, Jun. 1, 2004
62
‘Jiangsu Province Introduces The First Local Legislation on AIDS Prevention’, Guo Pinsheng, Xinhua, Aug. 21,
2004
63
Ibid.
- 17 -
World Bank Institute Project
Columbia University, March 2005
passed in Hubei,64 Yunnan,65 Urumqi,66 and Nanjing.67 Yunnan province even passed an
ordinance that deals with issues like needle exchange and mandatory condom sales in hotels.
These new laws passed after the publication of the Communiqué are in addition to similar,
existing local laws that are already on the books in Zhejiang,68 Yunnan,69 Suzhou70 and other
localities. Even though the laws vary considerably in several important aspects, all of them are
heavily focused on providing care for HIV/AIDS patients and preventing discrimination against
them.
d. Implications for Businesses and Civil Society
The Communiqué’s priorities demonstrate that the leadership understands that the general
population is at risk for HIV/AIDS and has chosen to place strong emphasis on testing, treatment
and care, disease monitoring, and educating the public. The special policy for high prevalence
areas suggests that the government has realized that its existing policies may be inadequate and
‘Hubei announces free and reduced fee policy for AIDS control’, Xinhua, June 10, 2004. available at:
www.china-aids.org/english/News/News356.htm (Announcing “free anti-retroviral treatment, reduced fee treatment
for common opportunistic infections, free voluntary HIV testing, [and] free treatment to prevent mother to child
HIV transmission . . . ”).
65
‘Yunnan passes new AIDS policy, will provide clean needles to drug users’, China News Service, April 7, 2004,
available at: www.china-aids.org/english/News/News345.htm (describing an expanded locally run clean-needleexchange and Methadone-treatment project in various Yunnan cities).
66
‘Capital’s entertainment venues to start implementing new health certificates’, Xingjiang Metropolitan News,
Aug. 27, 2004, available at: www.china-aids.org/english/News/News373.htm (describing a new city certification
program that mandates “health inspection (AIDS and STD testing) of service workers at entertainment
establishments and bath houses...” Presumably, individuals with AIDS and STDs would not be allowed to work in
these entertainment venues).
67
‘Nanjing AIDS patients to be fully covered by low-income insurance’, Nanjing Daily, Oct. 10, 2004 available at:
www.njnews.cn/l/ca537621.htm (requiring each district, township, and rural cooperative in the city’s confine to
place anti-retroviral drugs on the drug formula of low-income insurance programs).
68
‘Zhejiang Province to Enact AIDS and Sexually Transmitted Disease Prevention and Control Law’, Zhang
Xidong and Xiandai JinBao, Jan. 17, 2004, available at: www.china-aids.org/english/News/News326.htm (reporting
that Zhejiang province enacted a new law that regulates illegal blood collection programs, standardizes the reporting
of AIDS cases to authorities and prohibits the release of AIDS epidemiological data, mandates HIV testing for
service workers and foreign entrants, centralizes HIV/AIDS treatment to specialized facilities, stipulates the
isolation of HIV-positive individuals in drug rehabilitation centers or sex worker re-education centers, and provides
for the inclusion of anti-retroviral drugs in the drug formulary of low income health programs. In cases where a
service worker is found to be HIV-positive, the law mandates reporting of the test result to the employer, but only
allows the employer to transfer the employee to a non-service position, but not fire him/her.)
69
‘Yunnan AIDS Prevention and Control Law to Take Effect in March’, Yunnan Daily, Feb. 5, 2004 (Yunnan has
one of the most liberal HIV/AIDS response programs in the country. The law enacted here provides for wide
distribution of condoms, the right of privacy for people testing for HIV, prohibition of discrimination by anyone
against either the infected person or her families, mandated anti-retroviral treatment that is free to urban dwellers
who cannot afford it, living assistance for those with HIV, and strict laws regarding testing of blood and organ
donation).
70
‘New Rules to Control Disease’, Zhang Feng, China Daily Oct. 16th, 2002 (reporting that Suzhou city
government passed a new anti-discrimination law that “guaranteed equal rights of employment, education and
healthcare,” and made private personal medical records of AIDS patients).
64
- 18 -
World Bank Institute Project
Columbia University, March 2005
that it is open to new and innovative policies, whether they are based on local experimentation or
international experience.71
While the Communiqué may be notable for its lack of any substantive comment on involving
civil society in the HIV/AIDS response, the political space for such programs is almost certainly
there, especially in high prevalence areas. The adoption of direct intervention programs for
vulnerable populations such as sex workers and IDUs is striking in its contrast to the
government’s traditionally strict law enforcement stance against such groups,72 suggesting that
disease management considerations are overcoming the traditional law and order mentality of the
government.73 The rapid implementation of central government laws at the local level as well as
the initiation of bold local HIV/AIDS prevention projects suggest that strong commitment at the
center is creating a space at the local level.
This political openness has been noticed internationally, and organizations are already taking
advantage of it with pioneering projects. One of the largest international networks on corporate
social responsibility, the United Nations Global Compact, is making China its focus of 2005.74
The upcoming November 2005 Global Compact meeting in Shanghai could help China to come
up with an explicit policy for CSR and maybe more broadly, civil society participation in
fighting AIDS.75 Among International NGOs, Marie Stopes International in China recently
began to work with the Ministry of Railways to develop a sexual health and HIV/AIDS
awareness project for construction workers on the Qinghai Tibet Railway line, most of whom are
mobile (floating) workers.76 Other such projects are detailed in the following section.
The government’s encouragement of experimental intervention programs carried out at the local
level by both public and private actors suggests a new opportunity for NGOs, businesses, and
local governments to initiate business-oriented programs. For instance, it is conceivable to have a
public-private partnership that integrates PLWHA into private businesses as employees, thereby
providing both an earning possibility for the person, as well as chance for stigma reduction at the
Section seven of the Communiqué (supra note 43) called for China’s active participation in International AIDS
response initiatives, and for learning from international experiences.
72
See generally State Council of China, China Mid and Long Term Plan for HIV/AIDS Prevention and Control
(1998-2010); State Council of China, China Plan of Action to Contain, Prevent and Control HIV/AIDS (2001-2005)
The 2001-2005 Action Plan called for “[s]trengthen the construction of socialist spiritual civilization. According to
law, strike out against prostitution, drug use and drug sales. Use ‘drug free neighborhood’ programs to strongly
propagate drug prohibition education.” See also, ‘Locked Doors: The Human Rights of People Living With
HIV/AIDS in China’, Human Rights Watch, 2003, 60-63, available at: www.hrw.org (describing administrative
detention and forced education through labor camps used against CSW and IDU).
73
Undoubtedly, the Chinese government has had a long reputation of repression against independent civil society
groups. See ‘Country Reports on Human Rights Practices 2003: China’, U.S. Department of State, 2004, §2.a-c.
available at: www.state.gov/g/drl/rls/hrrpt/2003/27768.htm (detailing the Chinese government’s abuse of civil
liberties such as press, assembly and religion). However, this maybe changing both in the HIV/AIDS area, as
discussed here, as well in other less politically sensitive areas. See generally Leibman, Benjamin L., ‘Watch Dog or
Demagogue: The Media In the Chinese Legal System’, 105 Columbia Law Review 1, 2005, 41-49, available at:
www.columbialawreview.org/articles/index.cfm?article_id=742; Xiaobo, Liu, ‘The Rise of Civil Society in China’,
China Rights Forum, No. 3, 2003
74
UN Global Compact website: www.unglobalcompact.org; Newsletter: www.enewsbuilder.net/globalcompact
75
UN Global Compact Newsletter, first quarter, 2005: www.enewsbuilder.net/globalcompact
76
Marie Stopes International Website: www.mariestopes.org.uk/ww/china.htm
71
- 19 -
World Bank Institute Project
Columbia University, March 2005
work place, in accordance with the policy statement’s goal of providing productive opportunities
for PLWHA. The Communiqués’ prescription for comprehensive prevention programs that
would change the social environment in favor of HIV intervention could feasibly cover many
projects involving businesses, NGOs, PLWHA, local governments, or a combination of the latter.
Especially in high prevalence areas, such programs, if successful, could serve as examples for
the rest of the country of how CSR in the form of HIV/AIDS interventions could be implemented
in the Chinese context, and may even affect the direction of future national policies.
4. Development of Civil Society
Over the past twenty years, driven by the opening of China’s market and its integration with the
international community, the number of non-governmental organizations (NGOs) in China has
grown rapidly, and there is evidence to suggest that civil society has developed into a force for
social change on some issues.77 However, Chinese laws and regulations on NGOs remain
ambiguous, and it is still almost impossible for NGOs tackling politically sensitive issues to
operate legally.78 Furthermore, some observers suggest that the government retains tight control
over the NGOs it does tolerate.79 NGOs concerned with the environment or health issues are
considered the least controversial, while those dealing with human rights, labor or religion are
unlikely to be able to function freely.80 Most NGOs in China must register with the state as
corporations, foundations, social organizations, educational institutions or not-for-profit
organizations while others may become GONGOs or government-organized NGOs.81 Foreign
NGOs also have to navigate through various bureaucratic obstacles before they can be set up in
China, although many of the largest international NGOs, such as Greenpeace, have managed to
establish a presence.
The Chinese Government, due to the SARS epidemic and international pressure, has become
more tolerant of HIV/AIDS organizations. Initially, AIDS activists such as Dr. Gao Huijie and
Wan Yanhai faced constant harassment and intimidation from the Chinese Government for
exposing the blood-selling scandal in Henan Province. Wan Yanhai was imprisoned by the
government for some time until an international media backlash, coupled with US threats to
withdraw funding for China’s AIDS programs, compelled the government to release him and to
grant his organization, the Aizhi Action Project official status.82 In addition, Dr. Gao Yaojie was
allowed to meet with Vice-Premier Wu Yi and was given an award by China Central Television
in 2004,83 further confirming the change in attitude that has occurred at the political level.
With regard to workplace HIV/AIDS initiatives, a small number of indigenous Chinese NGOs or
social organizations are working with international donors to provide factory workers with
Ye, Zhang, ‘China’s Emerging Civil Society’, Working Paper, Center for North-East Asian Policy Studies, The
Brookings Institution, June 2003, available at: www.brook.edu/fp/cnaps/papers/ye2003.pdf
78
‘Chinese NGO’s – Carving a Niche within Constraints’, United States Embassy Beijing 2003, available at:
www.usembassy-china.org.cn/sandt/ptr/ngos-prt.htm
79
Xiaobo, Liu, ‘The Rise of Civil Society in China’, China Rights Forum, No. 3, 2003
80
‘Chinese NGO’s – Carving a Niche within Constraints’, (supra note 78)
81
‘Chinese NGO’s – Carving a Niche within Constraints’, (supra note 78)
82
Liu, 2003 (supra note 79)
83
Lau, Kelly and Pullam, Felicia, ‘Open for Business: The Case for HIV/AIDS Management in China’, The
American Chamber of Commerce China Brief, Volume 12 Number 4, May 2004
77
- 20 -
World Bank Institute Project
Columbia University, March 2005
HIV/AIDS education and contraception with a particular emphasis on female migrant workers.
Table 1 (below) outlines some of the organizations involved in these activities. The scope of the
interventions and their geographical concentration in Guangdong Province, the major
manufacturing center of China, suggests that there is considerable room for involvement by
foreign corporations. In one case, an international NGO assisted a multinational company in
implementing AIDS awareness programs in its factories in China. This case will be examined in
more detail in the section below along with other examples of company-initiated interventions.
Table 1: Examples of HIV/AIDS Interventions Targeting Workers
ORGANIZATION
TYPE
ACTIVITIES
Guangdong Provincial Labor Union
in collaboration with the Women’s
Federation and the Guangdong
Women’s Cadre College
Union
HIV/AIDS education for migrant women
Local Family Planning Associations
Government
Shenzhen FPA provides HIV education to factory workers
through lectures and participatory discussions.
Guangdong Women’s Cadre College
NGO
HIV/AIDS awareness for migrant workers through lectures,
peer education and performance
Hong Kong Christian Industrial
Committee
NGO
Workplace training on HIV/AIDS
DKT International
Int’l NGO
HIV/AIDS awareness among migrant women in Shanghai
working with factory managers and local officials
Marie Stopes International
Int’l NGO
Sexual health education for youth and migrants. HIV/AIDS
program for railway workers
Verité
Int’l NGO
Partners with multinationals such as Timberland to conduct
workplace education for factory workers including
HIV/AIDS awareness
Levi Strauss Foundation
Int’l Donor
Supports HIV/AIDS awareness programs
The Asia Foundation
Int’l Donor
Supports projects with local labor unions and women’s
federations. HIV/AIDS education program for migrant
women in Guangdong.
The Ford Foundation
Int’l Donor
Supports factory-based projects that help migrants
including HIV/AIDS projects
The World Bank
Int’l Donor
Project with Guangxi Family Planning Association on
AIDS/STD education and condom promotion project
among migrant workers
- 21 -
World Bank Institute Project
UN Family Planning Association
(UNFPA)
Columbia University, March 2005
IGO
Condom promotion. Supported prevention and condom
promotion project targeting construction workers in
Guangxi.
Source: Adapted from ‘Corporate Social Responsibility in China: Mapping the Environment’, Study
commissioned by the Global Alliance for Workers and Communities, April 2004, available at:
www.theglobalalliance.org/ documents/ChinaReport-web_001.pd f
B. CORPORATE SOCIAL RESPONSIBILITY IN CHINA
1. General Situation
While CSR has become an essential component of business operations in many European and
American companies, which often have entire departments dedicated to it, in China, even basic
concepts of CSR remain underdeveloped. State-owned enterprises used to provide employees
and their families with housing, healthcare, and education, but as the economy liberalizes,
privatization and international competition is forcing Chinese companies to tighten their budgets
and focus on the bottom line. Chinese officials at the local level often perceive the
encouragement of higher social and environmental standards as a barrier to growth in the regions
they control. The incentive structures created by the central government mean that local
government officials view any attempt to raise such standards as potentially damaging to their
revenue stream.84
As an increasing proportion of Western multinational corporations establish a presence in China,
efforts are underway to encourage best practices in CSR, both among the multinationals and
among their Chinese business partners. For example, the American Chamber of Commerce has
set up a CSR Committee that aims to “expand, share and optimize [members’] CSR programs in
China” and to find “CSR partners” for small and medium-sized Chinese enterprises.85 The
Committee also organizes educational seminars, charity events, and provides guidance for its
members in creating workplace policies and programs concerning labor relations, access to
healthcare, safety, and sustainable environmental practices. Recognizing the importance of
mobilizing businesses in China for CSR, the UN Global Compact, one of the largest international
CSR networks, is making China its focus of 2005. As mentioned above, in November 2005, the
UN Global Compact will convene an international conference in Shanghai to give participants an
opportunity to dialogue with their Chinese counterparts. Currently, the UN Global Compact lists
44 Chinese companies as members of the initiative.86
‘Corporate Responsibility Seen as a Barrier to Growth in China’, Tobias Webb, Ethical Corporation, Oct. 18,
2004, www.ethicalcorp.com
85
‘White Paper on American Business in China 2004’, American Chamber of Commerce, China, 2004, available at:
www.amchamchina.org.cn/publications/white/2004/en19.htm+%22american+chamber+of+commerce%22+china+c
sr&hl=en
86
UN Global Compact (supra note 74)
84
- 22 -
World Bank Institute Project
Columbia University, March 2005
A number of obstacles to engaging in CSR in China have been identified in a recent report by the
Kenan Institute Working Group on Corporate Social Responsibility and China.87 The Working
Group found that many US and Chinese companies want to act responsibly in China but face
several problems. These include the uneven government implementation of Chinese law, which
makes it particularly difficult for foreign investors to identify what laws apply when national,
provincial, and local laws are in conflict. Furthermore, Chinese citizens and policymakers
frequently do not know about their rights and responsibilities under Chinese law. Human rights
are not fully protected under the law, in part due to lax enforcement, which allows factories to
exploit workers with impunity. It is this environment of non-compliance that has forced
multinational corporations sourcing from or operating in China to adopt and monitor codes of
conduct that in many cases are no more demanding than Chinese labor law.
The focus of multinational corporations on improving working conditions in factories which
produce their goods stems from domestic pressure they have faced over the last decade with
regard to “sweatshop” conditions. As a result, companies, especially those in the toy, apparel and
footwear industries, are implementing and enforcing codes of conduct in their factories in China.
Companies send auditors to check factories regularly and reports of non-compliance are
addressed through remediation. This means that many multinationals are already exercising some
oversight in these factories even where they are not the factory’s sole customer and do not
wholly own the production facility.
While multinational corporations operating in China are undertaking various corporate social
responsibility initiatives, mostly addressing labor rights, there is little evidence of a concern for
corporate social responsibility emanating from Chinese companies. Most conferences and
roundtables on the subject are organized by Western companies seeking to inculcate a sense of
corporate responsibility in their Chinese counterparts. However, the evolution of the concept in
the West has been influenced to a large extent by non-governmental organizations, shareholder
activism and consumer pressure – dynamics which are at best, nascent and at worst, non-existent
in China. There is an increasing awareness among Chinese factories that corporate responsibility
and compliance with codes of conduct do translate into a competitive advantage—but only
where there is an incentive from the Western, socially conscious multinational buyer.88
Multinational corporations, then, are best positioned to take a leadership role in initiating
workplace HIV/AIDS programs in China. These programs may then be imitated by their Chinese
business partners which, if successful at a local “experimental” level, could lead to a government
policy or advisory on corporate involvement and responsibilities in the fight against HIV and
AIDS. Such a policy would have a broader reach, especially towards indigenous Chinese firms.
‘Statement of Findings: Promoting CSR in China’, Kenan Working Group on Corporate Social Responsibility and
China, The Frank Hawkins Kenan Institute of Private Enterprise Washington Center, Sep. 2004
88
Lillywhite, Serena, ‘Pursuing Corporate Responsibility in China – Supply Chain Management and Labour
Rights’, Proceedings of the 15th Annual Conference of the Association of Chinese Economics Studies Australia,
2003, available at: http://mams.rmit.edu.au/abxu8vs7fx7s1.pdf
87
- 23 -
World Bank Institute Project
Columbia University, March 2005
In this way, best practices on HIV/AIDS interventions could be spread throughout the business
community in China.
2. HIV/AIDS and Business in China
There has been an increasing recognition in the business community in the West and in countries
with high HIV/AIDS prevalence rates that companies can have a positive impact on the
HIV/AIDS crisis. Many large multinationals have been forced to confront the issue head-on as
they operate in regions with the highest prevalence rates in the world. This has prompted a
variety of corporate responses ranging from HIV/AIDS awareness and education programming
to voluntary testing and counseling, to the provision of anti-retroviral drugs to their employees
and employees’ dependents. These interventions have been well-documented in the context of
sub-Saharan Africa, a region that became acutely affected by the pandemic early on. However,
less information is available on corporate responses to HIV/AIDS in China, which suggests
multinationals are taking a more complacent approach to the disease in what is considered a lowprevalence country. Compounding this complacency is the uncertain regulatory and political
environment, and the hesitant activities of NGOs working on HIV/AIDS, as discussed in the
previous section. However, recent studies indicate a desire by companies to move towards
greater HIV/AIDS intervention, given more explicit political and popular support.
a. Current Situation
Even though few businesses in China currently have HIV/AIDS-specific policies, in recent years
an increasing number of companies have expressed interest in such CSR activities as evidenced
by the following survey data.
In 2002, The Futures Group surveyed 65 mostly foreign-owned companies operating in China to
determine the level of corporate engagement with respect to HIV/AIDS.89 The survey found that
most companies did not have formal HIV/AIDS programs or policies in place. However, 75% of
respondents indicated that they wanted their companies to provide at least one HIV/AIDS
initiative, and a few companies had already begun to address the issue. In a survey on Business
and HIV/AIDS published in 2005 by the World Economic Forum in cooperation with
UNAIDS,90 19% of the 254 Chinese companies surveyed reported having an informal
HIV/AIDS policy in place. A further 74% had no policy, and only 4% had a formal written
policy. Despite their current lack of policies, companies’ responses indicated that they were
aware of the issue. Thus, 32% of companies in China reported that HIV/AIDS was having “some
impact” on their recruitment and training expenses and 31% said that HIV/AIDS was having
‘Corporate Survey Report: HIV/AIDS Awareness, Policies, and Programs in the Workplace in China’, Futures
Group Europe in participation with UNAIDS, Jan. 2003, available at:
www.51condom.com/english/resources/Ourreports/Corporate_Survey_Report_Final_English.pdf
90
‘Business and HIV/AIDS: Commitment and Action? A Global Review of the Business Response to HIV/AIDS
2004-2005’, World Economic Forum Global Health Initiative, January 2005, available at:
www.weforum.org/pdf/Initiatives/GHI_Report_2005_Final.pdf
89
- 24 -
World Bank Institute Project
Columbia University, March 2005
“some impact” on productivity and absenteeism. More critically, 40% of companies thought that
HIV/AIDS would have a “serious impact” on their business in the next five years.
Recent initiatives have responded to this increased interest on the part of companies. In 2003,
participants at the World Economic Forum in Beijing called for the Chinese government to allow
private businesses to lead the fight against the spread of HIV/AIDS. International business
leaders asked that they be allowed to use their marketing power and resources to educate
employees and consumers about the disease.91 These requests reflect a desire for some
semblance of an official government endorsement in this regard since foreign corporations fear
potential political repercussions for business action on HIV/AIDS, since the issue was
considered politically sensitive by the Chinese Government until recently.92
Similarly, the Global Business Coalition announced the formation of a China Business and AIDS
Working Group in July 2004. This Working Group was designed to organize foreign and
domestic businesses in China to help them address the HIV/AIDS epidemic.93 The GBC will
hold/held a high-level meeting in March 2005 with Ministry of Health officials and the VicePremier Wu Yi in attendance.
Corporations may also be feeling the pressure from their shareholders to implement HIV/AIDS
programs in China. One group of socially responsible investors, the Interfaith Center on
Corporate Responsibility, has expressed its intention to target companies operating in China with
shareholder resolutions proposing actions on HIV/AIDS.94
b. Economic Impact of HIV/AIDS on Foreign Enterprises
Businesses in China will clearly not remain sheltered from the effects of the epidemic. A recent
Asian Development Bank report noted that, “The costs to business arise from two major
factors—the effect of HIV on the workforce and the threat to the customer base, with potential
further impact on a company’s corporate reputation stemming from the presence of HIV-infected
individuals at the company.”95 Reduced employee productivity, higher rates of absenteeism, and
loss of employees are among the most direct costs of the epidemic. For example, productivity
losses have been estimated at $11,544 per year for an asymptomatic HIV-positive individual in
the US and at $22,703 for a symptomatic HIV-positive individual.96 Interviews with HIV-
‘China Aids’, Luis Ramirez, Voice of America, Nov. 6, 2003
Lau and Pullam, 2004 (supra note 83)
93
‘Global Business Coalition on HIV/AIDS Announces New China Business and AIDS Working Group’, Xinhua –
PR Newswire, Jul. 6, 2004, available at: www.businessfightsaids.org
94
‘Faith-Based Investors Plan to Expand Shareholder Campaigns Demanding Action on AIDS by Multinational
Companies’, Business&AIDS Magazine, Summer 2004, Vol. 1 Issue 1, Global Business Coalition on HIV/AIDS,
available at: www.businessfightsaids.org
95
Bloom et al., 2004, p. 63 (supra note 23)
96
Liu, Guo, Smith, 2004, p. 1191 (supra note 13)
91
92
- 25 -
World Bank Institute Project
Columbia University, March 2005
positive individuals in China have indicated that about half of them quit their jobs after getting
infected with HIV.97
Due to already high turnover rates among employees and difficulties finding skilled personnel,
foreign enterprises in China have been forced to make significant investments in their Chinese
staff. Moreover, due to the high expense of sending employees overseas, foreign companies have
instead sought to attract and train local staff. As a result, companies have instituted employee
development schemes to train staff and have provided generous compensation packages in order
to combat high turnover rates, which reach as high as 15% in Beijing.98
The impact of HIV/AIDS upon a company’s workforce extends well beyond managerial staff. As
will be examined further in Section II, multinational corporations’ supply chain structures rely
heavily on migrant workers as factory labor in the production of goods for export. The UN
Theme Group on HIV/AIDS in China and the State Council AIDS Working Committee office
identified migrant workers as a group at risk of infection and of transmission of the AIDS
virus,99 which suggests that productivity may be affected if the prevalence rate among migrant
workers continues to increase. As labor costs rise, factories will be forced to pass on the costs to
their multinational clients as they already often operate on razor-thin profit margins. Therefore,
multinational corporations have an economic interest in preventing the spread of the disease
among factory workers.
Geographically, multinational corporations may become more vulnerable to the effects of
HIV/AIDS judging by recent trends in FDI. Traditionally, coastal regions have attracted the most
FDI, with the eastern region of China accounting for 88% of FDI in 1998.100 Likewise, the share
of national GDP represented by the eastern region increased from 45% of national GDP in 1980
to 51.37% in 1990.101 There are, however, indications that this trend may be changing. In 2004,
the US-China Business Council observed, “Traditional coastal investment destinations are
experiencing rising land costs and labor shortages in addition to being heavily affected by power
shortages. These developments, along with government incentives promoting development in
western and northeastern China, are pushing FDI inland.”102 As foreign business investment
patterns in China shift, this could potentially change the implications of the HIV/AIDS epidemic
for business as they move into areas more heavily affected by the epidemic, such as Henan,
Yunnan, and Guanxi Provinces.
97
Yip, Stover, et al., p. 8-9 (supra note 17)
‘Country Commerce: China’, Economist Intelligence Unit, Feb. 2004, p. 76.
99
Joint Assessment (supra note 11)
100
Sun, Qian; Tong, Wilson; Qiao Yu, ‘Determinants of foreign direct investment across China’, Journal of
International Money and Finance, Volume 21, 2002, p. 84.
101
Taube, Markus and Ögütçü, Mehmet, ‘Foreign Investment in China’s Regional Development: Prospects and
Policy Challenges’, Main Issues Paper, OECD-China Conference, October 11-12, 2001, p. 4.
102
‘USCBC Analysis: Foreign Investment in China’, US-China Business Council, 2004, available at:
www.uschina.org/statistics/fdi_2004.html
98
- 26 -
World Bank Institute Project
Columbia University, March 2005
C. CONCLUDING REMARKS
It has been acknowledged by the international community and the Chinese government that,
based on experiences elsewhere, HIV/AIDS is a major problem in China and that the disease
could have a potentially significant economic impact.103 The legal and regulatory framework on
HIV/AIDS is changing and reflects a shift in government and Party views about the disease. New
laws are focusing on anti-discrimination and de-stigmatization of people living with HIV and
AIDS. Furthermore, this change in policy has allowed HIV/AIDS NGOs more freedom to
operate, signaling a nascent civil society movement on the issue.
Within the Chinese business community there remain many barriers to regular CSR activities
although the concept is slowly gaining momentum among Chinese companies. Foreign
multinational corporations are taking the lead in the area of HIV/AIDS interventions since many
have experience with such programs in other countries where they operate. These first-movers
recognize the negative impacts that HIV/AIDS can have on their business and are tentatively
moving forward with similar programs in China as will be seen in the section II (B). Nonetheless,
these companies represent a fraction of the multinational corporations operating in China, which
suggests more needs to be done to encourage other companies and eventually, Chinese
companies, to join in the effort to combat the disease through workplace initiatives. The
following section will examine where such initiatives might take place and gives examples of
corporate responses to HIV/AIDS in China.
See, for example, IMF report on ‘The Macroeconomics of HIV/AIDS’, Edited by Markus Haacker, Nov. 2004,
www.imf.org/external/pubs/ft/AIDS/eng/index.htm
103
- 27 -
World Bank Institute Project
Columbia University, March 2005
II. HIV/AIDS INTERVENTIONS IN CHINA BY MULTINATIONAL CORPORATIONS
Since multinational corporations may already be involved in some type of CSR activities in their
supply chains, they are well-positioned to take action against HIV/AIDS in the workplace.
Moreover, given the structure of their supply chains, they have the ability to influence a large
cross-section of workers, including migrant workers and truckers, two groups that are considered
at a higher risk of contracting and transmitting the HIV virus. By taking such actions in their
supply chain and subsidiary offices in China, multinationals can promote best practices among
their Chinese suppliers and partner companies.
A. AREAS FOR INTERVENTION
1. Supply Chain
The trend of multinational corporations outsourcing manufacturing work has been gathering
speed in recent years as China formally acceded to the World Trade Organization (WTO) in
2001. Guangdong Province, the manufacturing powerhouse of China, attracted investments of
over $10 billion in 2004, making it the largest recipient of FDI in the country.104 Wal-Mart alone
is said to source from 4,400 factories in the province.105 Meanwhile, Guangdong is also one of
the provinces with a higher than average HIV/AIDS prevalence rate.106 Given the abundant labor
resources in China, multinationals often hold the majority of the bargaining power and are
therefore in a position to exert considerable pressure in terms of prices and speed-to-market
demands on factories. Furthermore, as discussed above, child labor scandals in the mid-1990s
forced the apparel and footwear industries towards a culture of monitoring that includes “social
compliance” or compliance with corporate codes of conduct in addition to the traditional health,
safety, and quality monitoring. In the last ten years, there has been a proliferation of voluntary
standards ranging from internally generated policies to external regulation from independent
organizations. This trend has also started to occur in other industries, such as electronics and
automobile parts as public pressure and scrutiny of multinationals has accelerated.
China’s share of global production in the textile industry is predicted to increase dramatically as
the phase out of the Multi-Fibre Arrangement (MFA) was finalized on December 31, 2004. The
MFA was originally negotiated under the General Agreement on Tariffs and Trade (GATT) and
allowed industrialized countries to place bilateral quotas on textiles and clothing imports.
Smaller developing countries such as Bangladesh are fearful that their textile industry, artificially
created by the quota system, will be swallowed by China’s cheaper, larger, and more efficient
production capacity.107 Nonetheless, this change may create more stability as multinationals
‘Guangdong Takes Lead in Luring FDI’, Business in China, China.com, Jan. 24, 2005
‘Toys of Misery 2004’, Joint Report by National Labor Committee and China Labor Watch, Feb. 2004
106
‘Joint Assessment (supra note 11)
107
‘Where Free Trade Hurts’, BusinessWeek, Dec. 15, 2003
104
105
- 28 -
World Bank Institute Project
Columbia University, March 2005
consolidate their supply chains and source from fewer regions – the Gap currently sources from
58 countries108 – thereby creating the conditions where closer, longer-term relationships with
suppliers may be possible. This would be an incentive to multinationals to take into
consideration the welfare of the workers in their suppliers’ and subcontractors’ factories and
would also make investments in HIV/AIDS initiatives more cost-effective. Such initiatives could
easily build on current labor standards and compliance efforts.
Export-oriented multinationals producing in China organize their sourcing structures in a variety
of ways. They may contract all of the manufacturing to Chinese firms with components or raw
materials imported or sourced from local suppliers. Alternatively, they may set up a joint venture
with a Chinese company in order to exert more control over the production process. Many
multinational corporations set up in Export-Processing Zones (EPZs) to take advantage of tax
incentives and flexible regulatory standards. China allows full foreign ownership of plants in
EPZs.109 Processing exports110 accounted for over 55% of China’s total exports between 1997
and 2002, over 60% of which came from foreign invested enterprises.111 Furthermore, as China’s
economy opens up as a result of its accession to the WTO, foreign companies are allowed to
wholly own production facilities in an increasing number of sectors. Thus, we are witnessing a
change in the ownership structure of multinationals’ manufacturing operations in China from
joint ventures to wholly owned subsidiaries. However, in some industries, such as apparel,
multinationals prefer not to wholly own their factories because they require expertise in many
different areas and demand for their goods fluctuates according to seasons and consumer trends.
In this way, they can retain some flexibility and can focus on their core competencies of
marketing and retailing.
The Government offers incentives in the form of tax breaks to companies that source their
components or raw materials locally. Other options for companies include importing their
supplies from abroad or encouraging their suppliers to set up operations in China. Regionalism in
China, along with conflicting central and local regulations has created considerable barriers to
setting up efficient supply chain networks in China. To counter this, companies either set up their
own distribution networks or outsource to local logistics providers. Intel, Nokia, and NEC set up
wholly-owned supply chains by building chip plants and distribution centers in China.112 WalMart has also centralized its supply chain in China by running its own distribution centers,
although the trucking is contracted out.113 McDonalds brought in its longtime logistics partner,
108
Gap Inc. Social Responsibility Report, 2003, available at: www.gapinc.com/social_resp/social_resp.htm
Feenstra, R.C. and Hanson, G.H., ‘Ownership and Control in Outsourcing to China: Estimating the PropertyRights Theory of the Firm’, National Bureau of Economic Research, Inc Sept. 2003, available at:
www.nber.org/papers/w10198.pdf
110
This is where the firm “sends intermediate inputs to a processing factory, which converts the inputs into finished
goods and then exports the final output.” Feenstra and Hanson, 2003 (supra note 109)
111
Feenstra and Hanson, 2003 (supra note 109)
112
Jiang, Bin, ‘How International Firms are Coping with Supply Chain Issues in China’, Supply Chain Management:
An International Journal, Volume 7, Number 4, 2002
113
Huffman, Ted P., ‘Wal-Mart in China: Challenges Facing a Foreign Retailer’s Supply Chain’, China Business
Review, September-October 2003
109
- 29 -
World Bank Institute Project
Columbia University, March 2005
HAVI Group LP, when it entered China in 1992, which owns and manages a fleet of trucks
operating out of distribution centers located throughout the country.114 With China’s entry into
the WTO leading to a lessening of restrictions on foreign businesses, large multinationals like
UPS and MAERSK are predicted to become dominant players in the nationwide distribution
business.115 As an increasing number of companies choose to control their logistics providers and
with multinationals poised to capture a large market share in China’s underdeveloped logistics
sector, HIV/AIDS initiatives, if undertaken by these companies, could have a potentially national
reach.
Despite the great potential that these sourcing structures present, there exist several obstacles to
promoting CSR initiatives through supply chains. Among them are the lack of transparency and
accountability in the system. Global production networks are highly complex and multinationals
often source through agents or trading houses by way of licensing arrangements without having
any direct contact with or even knowing the identity of the suppliers of the goods.116 However,
the power that multinational corporations have should not be underestimated. Supply chains in
the more labor-intensive industries where a multinational retailer focuses on research, design and
marketing, while outsourcing production to a network of suppliers and subcontractors, are
described as “buyer-driven” chains.117 In such chains, control is exercised closer to the point of
consumption, so the multinationals have a significant influence on the suppliers’ operations in
terms of, for example, mandating a code of conduct. Big brand multinational companies
concerned with their reputations often submit their suppliers to frequent social audits and in
some cases, compel the factories to foot the costs of compliance or threaten to withdraw their
business. Multinationals could therefore conceivably utilize their leverage over their suppliers in
requesting that they implement workplace HIV/AIDS initiatives.
a. Risk Groups in the Supply Chain
Based on the structure of multinational companies’ supply chains and logistics networks, it is
clear that, in addition to office staff in the company’s regional headquarters in Beijing or
Shanghai, multinationals have the potential to reach a large number of workers at different levels.
Two of these groups, truckers and migrant workers, are also groups that are traditionally more at
risk of contracting and spreading the HIV/AIDS virus.
i. Truck Drivers
In areas of emerging economic development, like Yunnan Province, coupled with the aspirations
for modernization is a growing concern for the implications of economic growth and population
mobility in a country with significant income disparities. Foremost among these concerns is the
114
Jiang, 2002 (supra note 112)
Jiang, 2002 (supra note 112)
116
Lillywhite, 2003 (supra note 88)
117
Fichter, Michael; and Sydow, Jörg, ‘Using Networks Towards Global Labor Standards? Organizing Social
Responsibility in Global Production Chains’, Industrielle Beziehungen, 9. Jg., Heft 4, 2002
115
- 30 -
World Bank Institute Project
Columbia University, March 2005
spread of HIV/AIDS. The trucking sector has been of particular interest in Yunnan Province, as
truckers are both victims and perpetrators. The multi-lane highways and 4-wheeler trucks are a
sign of the times in China’s Yunnan province: the advent of economic liberalization and easing
of emigration restrictions have heralded in an era of greater economic opportunities and mobility.
However, Yunnan shares borders with Thailand, Myanmar, Lao PDR, and Cambodia – the
countries of the Golden Triangle, infamously known for their prolific heroin trade. As a result,
intravenous drug use has traditionally been the biggest cause of HIV/AIDS in the region.
However given the recent growth in the economy, there is increasing concern that the next wave
of infection will come through sexual transmission.
The trucking industry is vulnerable to spreading the disease since truckers have income and often
spend time away from home, making them a prime target for prostitutes. In a 2002 report,
TREAT ASIA notes that this situation is exacerbated when these truckers return home to their
rural communities to infect their spouses, who then pass the infection on to their newborns.118
However, TREAT ASIA also makes the distinction that this is not necessarily particular to
truckers, but rather trucking routes: “Throughout the region, HIV is spreading along trucking
routes, among traveling salesmen, sailors, soldiers, fishermen, and migrant workers, and within
the sex industry, which is itself fueled by population shifts and increased economic disparity.”119
Therefore, the fear is that as development continues, the prevalence of commercial sex workers
along trucking routes will continue to rise, fueling the spread of HIV/AIDS in China and in the
bordering countries.
ii. Migrant Workers
Most low-skilled factory jobs in China go to migrant labor. Migrant workers typically emigrate
from rural areas to the prosperous coastal regions, such as Guangdong, where most of the
manufacturing is located. Shenzhen, Guangdong’s booming southern city, has three and a half
million migrants out of a total population of five million people.120 Factors driving migrants from
the countryside include rising unemployment and underemployment as well as extreme poverty.
Migrants travel great distances and often take large financial risks in search of a better fortune in
the cities. Migrant worker remittances are also a significant source of income for rural areas.121
Because of their inferior social status in the cities due to the complex household registration
system that controls movement of people, many migrant workers cannot access basic healthcare
facilities. This, in addition to their dormitory-style living conditions, makes them vulnerable to
‘HIV/AIDS in Asia: An Overview’ TREAT ASIA, July, 2002, available at: www.amfar.org/cgibin/iowa/asia/aids/index.html?record=4
119
Ibid.
120
‘Shenzhen Government Disregards Migrant Workers’ Rights’, Yang Chen, China Labor Watch, May 2, 2003,
available at: www.chinalaborwatch.org/en/web/article.php?article_id=50038
121
Kuhn, Anthony, ‘A High Price to Pay for a Job’, Far Eastern Economic Review, Jan. 22, 2004
118
- 31 -
World Bank Institute Project
Columbia University, March 2005
HIV infection and other sexually transmitted diseases.122 Furthermore, migrant workers have the
capacity to spread the disease to more remote areas as they often return home during holidays
and many eventually migrate back to the countryside after working in the cities for a few years.
Women make up the majority of migrant workers representing as much as 60% of the ten million
migrant laborers in Guangdong Province.123 These women often are unable to access to public
healthcare and lack basic knowledge of health risks. According to a report on women’s health in
global supply chains by Business for Social Responsibility, women migrant workers are
susceptible to a range of health problems including sexually transmitted diseases.124 The report
concludes that workers need more information and health education with sustained action by
factory management as well as an improved public healthcare system. The most effective
programs in China have involved worker participation in peer education activities and have
provided education and services at the factory site, since the workers have limited mobility.125
Although companies’ interventions are by no means limited to the above groups, the latter
illustrate that companies directly deal with and thus can influence high-risk groups. Thus trucks
and migrant workers would be good first audiences for companies to target when starting
HIV/AIDS initiatives.
B. LESSONS LEARNED FROM CASE STUDIES
In fact, some multinational companies already recognize their potential to positively effect
changes in workers, communities and the supply chain. Interviews and case studies of foreign
companies that have already started HIV/AIDS-related programs show that companies can
engage in a large variety of activities. The latter can be classified into two groups – initiatives at
the business level on the one hand, and activities such as advocacy and lobbying of (local)
governments and international organizations that aim at effecting larger policy changes on the
other hand.
1. Business-level Activities
Business-level activities can aim at the prevention of new HIV infections and/or at care and
support for PLWHA. They can target and involve employees and/or communities.
‘Corporate Social Responsibility in China: Mapping the Environment’, Hilary Murdoch and Daniella Gould of
Impactt Limited, commissioned by the Global Alliance for Workers and Communities, April 2004, available at:
www.theglobalalliance.org/documents/ChinaReport-web.pdf
123
Ye, Zhang, ‘Hope for China’s Migrant Women Workers’, The China Business Review, May-June 2002
124
‘Addressing the General and Reproductive Health Needs of Women in Global Supply Chains’, Business for
Social Responsibility, October 2002, available at:
www.bsr.org/CSRResources/HumanRights/WomensHealth_Report.pdf
125
Ibid.
122
- 32 -
World Bank Institute Project
Columbia University, March 2005
Prevention education among employees and communities
Preventive health and HIV/AIDS education can be undertaken through a variety of means,
including providing informational material (posters, billboards, brochures, features in internal
newsletters, or even through performances) in relevant languages, distributing condoms, training
of all or certain groups of employees considered to be at high risk for HIV/AIDS, meetings and
talks with experts, and offering voluntary counseling and/or testing services. The materials and
services can be provided either through external actors (NGOs, consultants, international
organizations could be invited to do so) or through peer educators, that is employees who have
been selected and trained for such activities. As an example, Lafarge has such induction and
awareness-raising campaigns using peer educators in all its production sites in China, and also
incorporated “light” HIV/AIDS information in its on-going activities in local schools. Currently,
Lafarge plans to extend programs to reach high risk migrant workers and truckers specifically.126
Standard Chartered, an international bank, not only celebrates World AIDS Day but also holds
an annual company-internal AIDS event, when employee volunteers distribute condoms, red
ribbons, balloons, sell calendars and extent awareness-raising activities to the community (for
instance through exhibitions and stalls in the local shopping mall).127 Cooperations with NGOs
Timberland, a shoe and apparel company, outsourced most of its HIV/AIDS interventions to
Verite, that has also brought HIV/AIDS prevention programs to 45% of workers at Timberland’s
suppliers in China.
Improving the quality of life for PLWHA
As with prevention, care and support for PLWHA can be targeted either only at employees (and
possibly their dependents) or also at the community in which the company operates at large.
Successful initiatives have included companies’ commitment to non-discrimination against
PLWHA in recruitment and promotional matters, the creation of meaningful job opportunities
for employees with HIV/AIDS, as well as relevant health care provision and access to treatment
for employees and their dependents. Philanthropic projects such as the donation of ARVs to
NGOs or other health care providers, donations to HIV/AIDS orphans, orphanages and clinics
are also conceivable and might be particularly suitable for companies that so far have not
engaged in HIV/AIDS activities and do not want to make any long-term commitments and
internal policy and structural adjustments yet. For instance, Standard Chartered, an international
bank, encourages HIV-positive staff to become Living with HIV Champions (volunteers for peer
education). The company also provides information on how to live positively and how to access
practical and emotional support and organizes fundraisings for HIV/AIDS programs.128
2. Advocacy and Lobbying
At the policy level, companies can make a significant contribution to advocacy and lobbying
activities, including those of other actors like NGOs and foundations with local and national
126
Email Interview with Nicolas Lecerf, (Lafarge China Communications Manager)
Email Interview with Standard Chartered
128
Email Interview with Standard Chartered
127
- 33 -
World Bank Institute Project
Columbia University, March 2005
governments and international organizations. Companies can support such external or preexisting initiatives that aim at larger policy changes (for instance greater resource allocations to
address the epidemic and improve care and support for people infected or affected by HIV/AIDS)
by making financial and/ or human/ other resources available to those actors. This can take the
form of in-kind and financial donations, the sponsoring of volunteers, technical assistance and
granting the right to use companies’ locales and other assets (such as vehicles, printing and
distribution facilities for instance), and the collecting and making available of relevant data and
information (on HIV prevalence in employees and communities for example) that can help these
external actors strengthen their advocacy strategy. For instance, Standard Chartered has HIV
Ambassadors at manager level who give talks to Chambers and liaise with the media, NGOs and
local governments. 129
3. Key Insights and Recommendations
Key insights from case studies and interviews

There is a variety of possible interventions for companies to engage in, irrespective of
their current level of engagement. Thus, companies can design or adapt programs in
accordance with the specific needs identified by the company and employees, available
resources and desired level of commitment.

Companies who engage in non-HIV/AIDS-related CSR, such as environmental protection
activities and basic health awareness, can build on their capital of credibility and trust
that they have acquired through such programs when starting HIV/AIDS interventions.

Even if local HIV awareness is low, interventions are possible: as Nicolas Lecerf from
Lafarge put it, “Nothing is taboo; it is how you tackle it, in respect of local culture, which
is key.”130

The benefits of such programs for companies are sizeable. Programs significantly reduce
direct costs (benefits payments, medical care, recruitment and training), indirect costs
(reduced productivity, absenteeism, supervisor’s time, vacancies and new hires), costs at
the organizational level (low workforce morale, worsened labor relations, senior
management time, production disruptions, loss of institutional memory and experience)
and costs from reduced family incomes and savings (due to the reduction in demand for
goods and services, lower sales and profits).131 On the positive side, workplace and
employee-run community initiatives can contribute to employees greater motivation,
dedication to the company, social stability and thus to overall productivity and
performance.
129
Email Interview with Standard Chartered
Email Interview with Nicolas Lecerf, (Lafarge China Communications Manager)
131
Open for Business: The Case for HIV/AIDS Management in China, AmCham China Brief (May 2004), by Kelly
Lau
130
- 34 -
World Bank Institute Project
Columbia University, March 2005

The perceived benefits for companies of running HIV/AIDS programs are increasing
with recent evidence that officials and businessmen are far more likely to purchase sex
than supposedly more easily “replaceable” unskilled and physical laborers. 132

Commitment at the management/ CEO level is crucial to the success of programs.

The valorization and recognition of work done by volunteers as well as the guarantee of
strict confidentiality in VCT programs are also considered to be essential.

It is important not to create negative side-effects through prevention campaigns, such as
“HIV/AIDS paranoia” where the groups targeted by programs become overly concerned
with getting infected. Explicit and detailed information on transmission methods can help
prevent this.

The government’s new attitude about AIDS means that business action has a potential for
favorable political recognition. Especially “early movers” and innovative, high quality
programs like Novartis’ (which includes workplace education, free VCT, treatment, and
other health education activities for employees and their dependents), are likely to be
praised as a model for best practices in China. In this sense, HIV/AIDS-related CSR
could have higher returns in terms of image and political recognition in China than in
other countries, precisely because the current level of corporate engagement is relatively
low.133

Companies that are currently engaged in HIV/AIDS-related programs are willing to share
information on their experiences and best practices with other companies, competitors,
NGOs, and other local stakeholders. They do not consider such information to be
competitive.134

Companies should not be asked to take the lead over government action. Primary
responsibility to address the epidemic lies with the government, and corporate
interventions should aim at complementing, not supplanting government programs.

Companies greatly appreciate the support of external actors, such as UNAIDS, UNESCO,
the ILO, APCO (a consultancy group) and Futures Group (a public health management
group).

Companies realize the importance of getting Chinese companies on board, especially
small and medium sized companies, as those are key players in the social jigsaw.
Recommendations for companies that are not involved in HIV/AIDS activities yet

Start with a pilot project in one region.

Start with workplace/ internal activities. Employees are usually the most captive and best
known audience.
132
Open for Business: The Case for HIV/AIDS Management in China, AmCham China Brief (May 2004), by Kelly
Lau
133
Open for Business: The Case for HIV/AIDS Management in China, AmCham China Brief (May 2004), by Kelly
Lau
134
Email Interview with Standard Chartered
- 35 -
World Bank Institute Project
Columbia University, March 2005

Survey and consult employees and local communities concerning possible interventions.

Make sure management/ Country CEO is supportive and involved.

Identify existing resources and possible sources of support: Find out what has been done
by company offices in other countries and what is being done at the local level by other
actors (other companies, local NGOs, government, international organizations, GBCs,
etc).

Vet relevant local legislation, its application to corporate activities and enforcement
mechanisms.
Recommendations for companies that are already involved in HIV/AIDS activities

Ensure quality of programs and consistency in the companies’ messages through
effective monitoring and evaluation.

Share information, experiences and best practices with other companies and local
stakeholders.

Reward and motivate volunteers. Support PLWHA in the workplace and encourage them
to become peer educators.

Scale up and diversify existing programs to reach greater audiences in different regions,
namely communities outside the main developed cities.

Make sure that roles and responsibilities for different HIV/AIDS-related activities
(prevention, care and support, advocacy and liaising) are well-delineated, both within the
company and with potential partner organizations.
C. CONCLUDING REMARKS AND RECOMMENDATIONS
As seen above, there have been substantial positive developments in Chinese legislation and
policies that could facilitate corporate engagement in the fight against HIV/AIDS. However,
there still is a gap between companies’ active interest in getting involved and the limited
numbers of companies who are actually implementing programs. This section proposes a number
of recommended actions that could help bridge this gap, that is encourage more companies to
engage in HIV/AIDS initiatives and persuade those that are already active to scale up and
diversify their interventions. While the legislative and regulatory environment certainly plays an
important role, less coercive measures that instead rely on positive incentives and broad support
for companies’ activities should not be neglected as these are the very bases of CSR. It is also
important to note that the following recommended actions are interdependent, meaning that they
will be most effective when undertaken simultaneously.
Thus, the Chinese government, potentially with the help of international organizations, should:

Provide better epidemiological data and information on the epidemic’s magnitude,
impacts and trends
- 36 -
World Bank Institute Project
Columbia University, March 2005
Poor surveillance and shortage of sound data about the status of the epidemic in china,
its spread, trends and effects make it difficult for companies to assess and verify the
business case for corporate HIV/AIDS initiatives.

Work towards greater consistency of HIV/AIDS-related legislation and policies
Several companies stressed the fact that the lack of harmonization between the central
and local governments’ laws and regulations (especially concerning the protection of
confidentiality, requirements to report test results and the rights of PLWHA) as well as
the absence of reliable enforcement of such legislation posed problems to their actions.
Companies further stressed the difficulty of having to deal with complex and sometimes
bureaucracy.

Organize informational workshops for companies
Raising awareness as to the extent and consequences of the Chinese HIV/AIDS epidemic
and sharing information and best practices between companies and/ or with other actors
(NGOs, international organizations, local governments, etc) that are involved in the fight
against the disease are crucial to raise companies’ sense of urgency, point out the costsaving advantages of HIV/AIDS programs and facilitate their engagement. The
government already participated in and sponsored a number of HIV/AIDS-related
workshops and conferences, including technical meetings and a joint Harvard/WEF
“HIV/AIDS and Business” workshop.135 In the future, these conferences and
workshops should be publicized more widely to increase awareness. Also, they should
preferably take place in a greater variety of locations throughout the country so as to
permit more companies to attend and profit from them.

Continue and increase high-profile political support to the fight against HIV/AIDS
This will help reduce the social stigma that is still associated with HIV/AIDS infection
and thus lessen companies’ fear that HIV/AIDS initiatives will be perceived negatively
by workers, clients/ customers, investors and politicians. National media should also be
involved in order to keep the issue in the spotlight. While the central government has
recently shown its support, provincial and local governments still seem to lag behind in
this respect.

Lend visibility and recognition to corporate engagement
Publicized competitions and awards for the best and most innovative corporate
HIV/AIDS initiatives can be a powerful incentive for companies to implement and
improve programs due to the increased visibility and greater reputation it affords them
with customers, investors, the government, and the international community at large.
Examples of such existing mechanisms include the GBC Award of Business Excellence
in the Workplace.

Allow for greater NGO activism and interventions
135
Open for Business: The Case for HIV/AIDS Management in China, AmCham China Brief (May 2004), by Kelly
Lau
- 37 -
World Bank Institute Project
Columbia University, March 2005
As several successful existing cooperations between companies and NGOs have shown,
NGOs can be crucial in motivating and helping companies set up and run HIV/AIDS
initiatives. Pooling information and other resources with local partners is particularly
crucial when operating in a relatively new and uncertain CSR environment like China.

Increase the funding and availability of HIV care and treatment to those who need it
China’s current health care system is insufficiently equipped (in terms of trained health
personnel and medical infrastructure) to be able to deal with the growing epidemic.
Several studies have shown that ARV availability is a crucial complementary component
of prevention as people who have access to treatment are more likely to get tested for
HIV.
- 38 -
World Bank Institute Project
Columbia University, March 2005
CONCLUSION
In the recent past, pressure on the Chinese government, international business in China, and the
broader international community has been mounting to contribute to the fight against the
HIV/AIDS epidemic within China. With the epidemic having spread from high-risk groups to the
general population, China is facing the possibility of a public health crisis without parallel—one
that would impose an enormous burden both in terms of the loss of human life and foregone
economic growth. However, recent shifts in national legislation suggest a greater commitment by
the Chinese government to addressing the HIV/AIDS epidemic. As a result, the possibility for
engagement by civil society, including corporations and NGOs, has been growing.
Moreover, foreign businesses in China are beginning to express greater interest in developing
HIV/AIDS-specific CSR activities, even if so far only a few companies have initiated such
programs. However, multinational companies represent a unique channel in the fight against
HIV/AIDS in China, especially as they are well positioned to reach large numbers of workers,
including groups at high risk for contracting HIV/AIDS such as truckers and migrant workers. At
the same time, companies’ resources and extensive supply chains enable them to reach audiences
beyond their employees and to extend the benefits of their programs to wider communities. Thus,
it is important to bridge the current gap between companies’ theoretical interest and commitment
to the fight against the disease on the one hand and a reality of limited actual interventions on the
other. The Chinese government as well as international organizations could encourage and
facilitate more pro-active and extended corporate engagement in the issue by providing relevant
data and information, sharing best practices, informing companies about existing initiatives and
potential partners, and granting other types of informational, logistical, technical and financial
support.
- 39 -
World Bank Institute Project
Columbia University, March 2005
BIBLIOGRAPHY
Reports:

‘A Joint Assessment of HIV/AIDS Prevention, Treatment and Care in China’, State
Council AIDS Working Group Committee Office & UN Theme Group on HIV/AIDS in
China, 2004

‘Addressing the General and Reproductive Health Needs of Women in Global Supply
Chains’, Business for Social Responsibility, Oct. 2002, available at:
www.bsr.org/CSRResources/HumanRights/WomensHealth_Report.pdf

‘Asia's Economies and the Challenge of AIDS’, David E. Bloom, Ajay Mahal, Larry
Rosenberg, Jaypee Sevilla, David Steven, Mark W. Weston, Asian Development Bank,
Apr. 2004, available at: www.adb.org/Documents/Books/Asia-AIDS/default.asp

‘Blueprint for Corporate Engagement Initiative in China’, United Nations Theme Group
(Prepared for UNAIDS), Dec. 12, 2002

‘Building an HIV/AIDS Workplace Programme that Addresses BMW South Africa’s
Specific Context’, Global Health Initiative, Sept. 2003, available at:
www.webforum.org/globalhealth/cases

‘Business and HIV/AIDS: Commitment and Action? A Global Review of the Business
Response to HIV/AIDS 2004-2005’, World Economic Forum Global Health Initiative, Jan.
2005, available at: www.weforum.org/pdf/Initiatives/GHI_Report_2005_Final.pdf

‘China 2020: Financing Health Care’, World Bank, Sept. 1997

‘Corporate Social Responsibility in China: Mapping the Environment’, Hilary Murdoch
and Daniella Gould of Impactt Limited, commissioned by the Global Alliance for
Workers and Communities, Apr. 2004, available at:
www.theglobalalliance.org/documents/ChinaReport-web.pdf

‘Corporate Survey Report: HIV/AIDS Awareness, Policies, and Programs in the
Workplace in China’, Futures Group Europe in participation with UNAIDS, Jan. 2003,
available at:
www.51condom.com/english/resources/Ourreports/Corporate_Survey_Report_Final_Eng
lish.pdf

‘Country Commerce: China’, Economist Intelligence Unit, Feb. 2004

‘Country Reports on Human Rights Practices 2003: China’, U.S. Department of State,
2004, available at: www.state.gov/g/drl/rls/hrrpt/2003/27768.htm

Email Interview with Nicolas Lecerf, (Lafarge China Communications Manager)

Email Interview with Standard Chartered

‘Global summary of the HIV and AIDS epidemic’, UNAIDS, Dec. 2004, available at:
www.unaids.org/wad2004/graphics/Epicore2004_Dec04_en.ppt
- 40 -
World Bank Institute Project
Columbia University, March 2005

‘HIV/AIDS in Asia: An Overview’, TREAT ASIA, Jul. 2002, available at:
www.amfar.org/cgi-bin/iowa/asia/aids/index.html?record=4

‘Locked Doors: The Human Rights of People Living With HIV/AIDS in China’, Human
Rights Watch, 2003, available at: www.hrw.org

Open for Business: The Case for HIV/AIDS Management in China, AmCham China Brief
(May 2004), by Kelly Lau

‘Social Responsibility Report’, Gap Inc., 2003, available at:
www.gapinc.com/social_resp/social_resp.htm

‘Statement of Findings: Promoting CSR in China’, Kenan Working Group on Corporate
Social Responsibility and China, The Frank Hawkins Kenan Institute of Private
Enterprise Washington Center, Sept. 2004

‘The Macroeconomics of HIV/AIDS’, Edited by Markus Haacker, IMF November 2004,
available at: www.imf.org/external/pubs/ft/AIDS/eng/index.htm

‘The Socioeconomic Impact of HIV/AIDS in China’, Ray Yip, John Stover, et al., August
2002, available at: www.unicef.org/evaldatabase/index_14213.html

‘The World Health Report 2003: SARS: Lessons From a New Disease’, World Health
Organization (WHO), 2003, available at: www.who.int/entity/whr/2003/en/Chapter5en.pdf

‘Toys of Misery 2004’, Joint Report by National Labor Committee and China Labor
Watch, Feb. 2004

‘USCBC Analysis: Foreign Investment in China’, US-China Business Council, 2004,
available at: www.uschina.org/statistics/fdi_2004.html

‘White Paper on American Business in China 2004’, American Chamber of Commerce in
China, 2004, available at:
www.amchamchina.org.cn/publications/white/2004/en19.htm+%22american+chamber+o
f+commerce%22+china+csr&hl=en
Journal Articles:

Dolven, Ben, ‘Building New Chinese Walls’, Far Eastern Economic Review, May 22,
2003

Eberstadt, Nicholas, ‘The Future of AIDS’, Foreign Affairs Volume 81 Issue 6, Nov./Dec.
2002

Feenstra, R.C. and Hanson, G.H., ‘Ownership and Control in Outsourcing to China:
Estimating the Property-Rights Theory of the Firm’, National Bureau of Economic
Research, Inc September 2003, available at: www.nber.org/papers/w10198.pdf

Fichter, Michael; and Sydow, Jörg, ‘Using Networks Towards Global Labor Standards?
Organizing Social Responsibility in Global Production Chains’, Industrielle Beziehungen,
9. Jg., Heft 4, 2002
- 41 -
World Bank Institute Project
Columbia University, March 2005

Huffman, Ted P., ‘Wal-Mart in China: Challenges Facing a Foreign Retailer’s Supply
Chain’, China Business Review, Sept.-Oct. 2003

Jiang, Bin, ‘How International Firms are Coping with Supply Chain Issues in China’,
Supply Chain Management: An International Journal, Volume 7, Number 4, 2002

Kuhn, Anthony, ‘A High Price to Pay for a Job’, Far Eastern Economic Review, Jan. 22,
2004

Lau, Kelly and Pullam, Felicia, ‘Open for Business: The Case for HIV/AIDS
Management in China’, The American Chamber of Commerce China Brief, Volume 12
Number 4, May 2004

Leibman, Benjamin L., ‘Watch Dog or Demagogue: The Media In the Chinese Legal
System’, 105 Columbia Law Review 1, 2005, available at:
www.columbialawreview.org/articles/index.cfm?article_id=742

Lillywhite, Serena, ‘Pursuing Corporate Responsibility in China – Supply Chain
Management and Labour Rights’, Proceedings of the 15th Annual Conference of the
Association of Chinese Economics Studies Australia, 2003, available at:
http://mams.rmit.edu.au/abxu8vs7fx7s1.pdf

Liu, Gordon G.; Guo, Jeff J.; and Smith, Scott R., ‘Economic Costs to Business of the
HIV/AIDS Epidemic’, Pharmacoeconomics Volume 22 Issue 18, 2004

Sanyal, Rajib N. and Guvenli, Turgut, ‘Employee Benefits in American Firms in China’,
International Journal of Commerce and Management, Volume 11 Issue 1, 2001

Sun, Qian; Tong, Wilson; Qiao Yu, ‘Determinants of foreign direct investment across
China’, Journal of International Money and Finance, Volume 21, 2002

Taube, Markus and Ögütçü, Mehmet, ‘Foreign Investment in China’s Regional
Development: Prospects and Policy Challenges’, Main Issues Paper, OECD-China
Conference, Oct. 11-12, 2001

Ye, Zhang, ‘Hope for China’s Migrant Women Workers’, The China Business Review,
May-Jun. 2002

Ye, Zhang, ‘China’s Emerging Civil Society’, Working Paper, Center for North-East
Asian Policy Studies, The Brookings Institution, Jun. 2003, available at:
www.brook.edu/fp/cnaps/papers/ye2003.pdf

Xiaobo, Liu, ‘The Rise of Civil Society in China’, China Rights Forum, No.3, 2003

Ziaoquan Zhang, Heather, ‘The Gathering Storm: AIDS Policy in China’, Journal of
International Development Volume 16 Issue 8, 2004

‘Chinese NGO’s – Carving a Niche within Constraints’, United States Embassy Beijing
2003, available at: www.usembassy-china.org.cn/sandt/ptr/ngos-prt.htm
News:
- 42 -
World Bank Institute Project
Columbia University, March 2005

‘A Lonely Crusade to Change Chain’s Face of AIDS’, Rod Mickleburgh, The Globe and
Mail, Nov. 8, 2004

‘A Saving Embrace’, The Economist, Nov. 20, 2003

‘Capital’s entertainment venues to start implementing new health certificates’, Xingjiang
Metropolitan News, Aug. 27, 2004, available at: www.chinaaids.org/english/News/News373.htm

‘China Aids’, Luis Ramirez, Voice of America, Nov. 6, 2003

‘China Takes Active Measures to Control HIV/AIDS’, Xinhua, Oct. 6, 2004, available at:
http://en-1.ce.cn/National/Law/200412/01/t20041201_2445435.shtml####

‘Chinese Vice-Premier calls on Public Not To Discriminate Against AIDS Patients’,
BBC Monitoring Asia Pacific, Dec. 26, 2003

‘Corporate Responsibility Seen as a Barrier to Growth in China’, Tobias Webb, Ethical
Corporation, Oct. 18, 2004, www.ethicalcorp.com

‘Faith-Based Investors Plan to Expand Shareholder Campaigns Demanding Action on
AIDS by Multinational Companies’, Business&AIDS Magazine, Summer 2004, Vol. 1
Issue 1, Global Business Coalition on HIV/AIDS, available at:
www.businessfightsaids.org

‘Ford HIV Report Exemplifies New Shareowner Action Strategy’, William Baue,
Socialfunds.com, December 7, 2004

‘Global Business Coalition on HIV/AIDS Announces New China Business and AIDS
Working Group’, Xinhua – PR Newswire, Jul. 6, 2004, available at:
www.businessfightsaids.org

‘Guangdong Takes Lead in Luring FDI’, Business in China, China.com, Jan. 24, 2005

‘Handshake Highlights Fight Against AIDS’, People’s Daily Online,

‘Hubei announces free and reduced fee policy for AIDS control’, Xinhua, June 10, 2004.
available at: www.china-aids.org/english/News/News356.htm

‘Jiangsu Province Introduces The First Local Legislation on AIDS Prevention’, Guo
Pinsheng, Xinhua, Aug. 21, 2004

‘Nanjing AIDS patients to be fully covered by low-income insurance’, Nanjing Daily, Oct.
10, 2004 available at: www.njnews.cn/l/ca537621.htm

‘New Law Prepared on HIV/AIDS’, China Radio International (CRI), Dec. 1, 2004

‘New Rules to Control Disease’, Zhang Feng, China Daily Oct. 16th, 2002

‘Shandong Moves to Protect Employees With HIV/AIDS’, David Fang, South China
Morning Post, Jun. 1, 2004
- 43 -
World Bank Institute Project
Columbia University, March 2005

‘Shenzhen Government Disregards Migrant Workers’ Rights’, Yang Chen, China Labor
Watch, May 2, 2003, available at:
www.chinalaborwatch.org/en/web/article.php?article_id=50038

‘Where are the Patients?’, The Economist, Aug. 21, 2004.

‘Where Free Trade Hurts’, BusinessWeek, Dec. 15, 2003

‘Yunnan AIDS Prevention and Control Law to Take Effect in March’, Yunnan Daily, Feb.
5, 2004

‘Yunnan passes new AIDS policy, will provide clean needles to drug users’, China News
Service, April 7, 2004, available at: www.china-aids.org/english/News/News345.htm

‘Zhejiang Province to Enact AIDS and Sexually Transmitted Disease Prevention and
Control Law’, Zhang Xidong and Xiandai JinBao, Jan. 17, 2004, available at:
www.china-aids.org/english/News/News326.htm
Chinese Laws and Government Documents:

‘Communiqué Regarding Concretely Improving AIDS Prevention and Treatment’, State
Council of China document #7, Mar. 2004

Contagious Disease Prevention and Control Law, Clause 3, 39 available at:
http://www.moh.gov.cn

State Council of China, China Mid and Long Term Plan for HIV/AIDS Prevention and
Control (1998-2010), Nov. 12, 1998, available in English at:
www.unchina.org/unaids/ekey15.html

State Council of China, China Plan of Action to Contain, Prevent and Control HIV/AIDS
(2001-2005), May 2001, published by Ministry of Health, discussed in the Joint
Assessment (see above)
Websites:

Avert: www.avert.org/aidschina.htm

Global Business Coalition on HIV/AIDS poll of American consumers, November, 2004:
www.kintera.org/atf/cf/{EE846F03-1625-4723-9A53B0CDD2195782}/Survey%20Results%202005.pdf

The Global Fund to Fight AIDS, Tuberculosis and Malaria: www.theglobalfund.org/en/

Marie Stopes International Website: www.mariestopes.org.uk/ww/china.htm

UNAIDS: www.unaids.org/en/geographical+area/by+country/china.asp

UN Global Compact website: www.unglobalcompact.org
- 44 -
World Bank Institute Project
Columbia University, March 2005

UN Global Compact Newsletter, first quarter, 2005:
www.enewsbuilder.net/globalcompact

World Bank Institute Online Course, ‘Introduction to Corporate Social Responsibility’,
2005: www.worldbank.org
- 45 -