Tuesday November 13, 2001
China finally wakes up to Aids timebomb

Epidemic fear forces more openness, but stigma remains

John Gittings, East Asia editor, The Guardian

China may have 10m HIV or Aids cases within the next decade, a senior UN official warned yesterday, as Beijing prepared to hold its first national conference on the growing crisis.

"China is at the verge of a major epidemic if business as usual continues," said Peter Piot head of the UN Programme on HIV/Aids. He urged President Jiang Zemin to speak out, saying that intervention from the top could save lives.

"Whether there will be 10m people or 50m people infected in China, that will depend in the first place on whether the country really wakes up on a massive scale," he warned.

International experts have noted that the Chinese authorities are already speaking more frankly on a subject which had previously been treated gingerly by the media.

HIV/Aids is no longer blamed on foreigners and drug users, and the conference which opens today has been given unusual advance publicity.

The health ministry has published full details of HIV infection in a village in Henan province where local authorities tried earlier this year to cover up a scandal. It says that of 300 men in Wenlou who sold their blood to commercial collectors using unsafe equipment, only five escaped infection. In Wenlou and five neighbouring villages, according to ministry statistics, more than 270 blood donors are now "awaiting death".

The Henan scandal, which was barely reported in the Chinese press, was covered in detail by the foreign media and appears to have tipped the balance of argument in Beijing towards a more open attitude.

"Health experts have been completely honest in private for several years about the extent of the problem, but it has been extremely tricky at the political level," one Beijing-based UN official said.

Chinese officials estimate that there are 600,000 HIV cases, but admit that the figure may be as high as 1m, which Mr Piot said was more likely.

In another sign of greater frankness, top Chinese television stars will perform tonight at a grand gala in Beijing to mark the opening of the conference. The organisers say this and other publicity events - including a marathon race and a TV feature - are designed to "combat public ignorance and misunderstanding".

One of the show's items will be based on the story of an Aids victim in Shanghai who has published his diary on a website, attracting more than 2m online readers. Li Jiaming - a pseudonym - says he was infected by a prostitute and cannot afford to take western anti-Aids drugs. "Living with Aids is a life of loneliness," he warns his readers. "If you tell the truth, you face discrimination that will rob you of everything you have. All you'll have left is the disease."

A medical scientist, Zeng Yi, the first Chinese to work on HIV, warned recently that sexual transfer would soon outstrip contaminated blood and drug abuse as the main source of infection. He has been calling for several years for more education and publicity.

A five-year programme to be discussed by the Beijing conference will launch a massive campaign to raise medical standards in tackling the disease. It also asks for anti-Aids funding to become a separate item in national and provincial budgets.

Tacitly acknowledging the extent of ignorance today, the programme aims to educate 80% of county-level doctors and 50% of local medical workers by the end of next year.

It does not expect fully to solve the problem of unsafe blood supplies in the countryside until the end of 2005.

Chinese Aids campaigners welcome Beijing's greater openness, but warn of the difficulty in overcoming prejudice and local cover-ups. Education among the gay community will be a big problem, according to the deputy health minister, Yin Dakui, because homosexuality is still "a taboo subject".

There are fears that infection rates through unhygienic blood collection are high in several other provinces.

Mr Piot said yesterday that commercial blood selling had also caused mass infection in the province of Shanxi. Victims in Henan have petitioned the conference for the punishment of officials who colluded with the blood collectors.