Asia 09.12

ADS Global Forum

Gerald R Ford School of Public Policy ** Integrated Policy Exercise ** January 2003

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AIDS: A "state secret" is revealed

THE government of China said on September 6th that by the end of the year at least 1m of its citizens will be HIV-positive, the condition that can lead to AIDS. Although China has been acknowledging over the past year that it has a problem with the disease, this is the first time it has admitted its extent. The figure is in line with a United Nations estimate in June of between 800,000 and 1.5m.

The epidemic seems to be particularly widespread in the northern province of Henan. In a government report published on the Internet in August by a doctor, Wan Yanhai (who was later arrested for "revealing state secrets"), Henan health officials admitted that state-sponsored "blood stations" had exposed hundreds of thousands of people to the HIV virus. Blood was taken from donors for $5 a bag without suitable safeguards in place, and recycled. This practice, combined with the use of unsterilised equipment, led to an HIV infection rate of 35-45% in some villages in the province.

While the government's new candour has been widely welcomed, there are doubts about China's financial means and technical ability to tackle the epidemic. The country has only 20 or so experts with a knowledge of international experience in dealing with HIV/AIDS. Many more are thought to be needed to devise and implement a useful campaign.

The cost of treatment also remains high. Reports that the government had threatened to produce copies of patented HIV medicines were quickly denied by China. But the government says it has started treating patients with a domestically produced version of AZT, for which patents recently expired, and that ten Chinese firms have applied for permission to make versions of other HIV drugs with expired patents.

A modest five-year nation-wide plan was set up last year, designed to combat AIDS by focusing on prevention, and improving the safety of donated blood. But two AIDS researchers, Joan Kaufman and Jun Jung , authors of a report on the disease in SCIENCE, an American magazine, argue that the fight against AIDS in China should take place primarily at a local level. Provincial officials have tended to play down the spread of the disease for fear of losing foreign investment, and have been complicit in private blood collection. Students currently receive little formal sex education beyond advice to abstain, and have limited access to reproductive health counselling and services. Public understanding of the nature of the virus, and how it is spread, is limited.

A survey conducted by a newspaper in the southern province of Guangdong found that even in a prosperous part of China, almost half of those aged 20-64 did not think that condoms protected against AIDS, and more than half the respondents thought that it could be contracted through sneezing and shaking hands. Given such misinformation, China will need to work hard to catch up with one of the world's biggest medical problems.