Far Eastern Economic Review: HIV And AIDS Are Spreading Rapidly Across China

[Editor's note: Billions of Renminbi (Chinese currency) has been spent on persecuting Falun Gong while the projects truly needing money are little funded.]

August 7, 2002

ZHAO LIYANG is one in a million. Facing a shaky hand-held camera she shivers against the winter cold and tells of the plague in her village, Dongguan, in Henan province, about 500 miles south of Beijing. Around her in the spartan room sit other villagers with HIV and AIDS. "It doesn't matter if we die, but what will become of our children?" Zhao pleads through tears. There may be up to one million people like her in this province.

The video that tells Zhao's story is an extraordinarily powerful piece of journalism. In another country it would win awards. In China, Lee Dan, the brave social activist who travelled from Beijing to shoot the documentary earlier this year risked harassment and arrest.

His aim was to publicize the plight of China's Aids victims, the bulk of whom live in rural areas and were infected at commercial plasma-collecting centres, many of them linked to government units. The fact that the video is unlikely to be shown on any TV station in China says a lot about the way the human immuno-deficiency virus and Aids are viewed by the state. But with United Nations estimates of 10 million people becoming infected with HIV and AIDS across China by the end of the decade it is time for Beijing to square up to the problem.

The warning of China's coming catastrophe was sounded in June, when the United Nations published a damning report titled HIV/AIDS China's Titanic Peril. It stated that "China is on the verge of a catastrophe that could result in unimaginable human suffering, economic loss and social devastation." The apocalyptic language stems from medical experts' fears that localized epidemics in rural villages and among intravenous drug users and sex workers are on the brink of spilling into the general population. If that happened, controlling the spread would be virtually impossible.

Aids is now the fourth-biggest killer worldwide and with reported HIV infections up by 67.4% in the first half of last year in China, according to Ministry of Health figures, Beijing cannot afford to wait for a miracle vaccine. Even the most optimistic predictions say a vaccine is five years away; for now prevention is the only way to fight the disease.

The Chinese government holds the power to ensure the cataclysm foretold by the UN never happens. A first step would be to unleash the full power of its propaganda apparatus, a huge machine that reaches the length and breadth of this vast country and penetrates into almost every pocket of society.

"They have the capacity to do public education through the family planning organization and propaganda infrastructures," says Joan Kaufman, a fellow at the Kennedy School of Government at Harvard who has studied China's Aids problem. "They also need to get the media on board in the public-education effort. There are many things that can be done quickly."

Right now the machine is in high-gear support of President Jiang's latest political theory, the Three Represents. Ordinary people may have no interest in the theory -- part of a drive to extend the Communist Party's influence -- but they cannot escape constant bombardment from radio and television reports, newspaper editorials and articles, and propaganda billboards in the countryside.

The 60 million [...] Party members in cities, towns and villages across China and tens of millions more government employees are obliged to study the Three Represents. Cadres are despatched from Beijing to the provinces to instruct officials on the application of Jiang's theory.

On an even larger scale, enormous resources have been thrown into a campaign to smash the Falun Gong movement. As well as all party members, school children and work units across the country have had to study the [regime's slanders against] Falun Gong with state media singing from one hymn sheet on the need to rid China of the movement.

Nothing like the same effort has been put into alerting people to the dangers of HIV/AIDS, say specialists in the field. "The highest leadership has not taken this on seriously enough. They need to make it a Falun Gong kind of campaign that everyone has to comply with," says Kaufman.

Ironically, the Henan villagers in the video say that local officials have accused them of being Falun Gong members in an effort to intimidate them into silence. The villagers who have contracted HIV are treated with staggering contempt by officials. "They have given us no money and no medicine, not even an apology," a Dongguan farmer with HIV, who travelled to Beijing for help late last month, told the REVIEW. He first sold blood in 1995 in response to adverts placed on local TV by government officials, he says.

[...] AIDS is creeping across the country. The epidemic is taking hold in high-risk groups. HIV infection rates among intravenous-drug users are as high as 80% in many cities in Yunnan province, according to the UN report, and are growing fast among prostitutes in Guangxi and elsewhere. A recent study by Futures Group, a British-based health and population consultancy, indicates that rapid and meaningful government intervention could cut the projected death rate by 2010 from 12 million people to 2 million.

Yet Beijing seems reluctant to recognize the true scale of the problem. According to official estimates, 850,000 people are infected with HIV/AIDS. Foreigners familiar with the epidemic and most medical experts outside the government believe the figure is much higher but nobody really knows how high. Gao Yaojie, a retired doctor who almost single-handedly exposed the Henan scandal, believes that one million people may be infected in that province alone.

The government has signally failed to provide leadership at the highest levels in the campaign against HIV/AIDS. But it certainly has the ability to launch a country-wide campaign to stem the spread of the virus. Countries like Thailand, Uganda and Senegal have shown that huge doses of education directed at high-risk groups and the general population can stem the advance of AIDS.

In contrast to the governments of most developing countries afflicted by HIV/AIDS, the Chinese state has a very long reach. "The government has the power and resources. The [...] Party has tens of millions of members, tens of millions of youth members and millions more volunteers," says Wan Yanhai, coordinator of the Beijing AIZHI Action Project, a non-government organization dedicated to raising awareness of AIDS.

The level of ignorance is staggering. Over two-thirds of Chinese do not know how the disease is transmitted. Almost one-fifth have never even heard of AIDS, according to a survey carried out by the State Family Planning Commission and released at the International Aids Conference in Barcelona last month. Good old-fashioned propaganda -- something the party is clearly good at -- could do much to turn that ignorance around. The message could be carried through the propaganda and education networks as well as government units, such as those under the State Family Planning Commission, that penetrate deep into Chinese society.

Targeting high-risk groups is essential to preventing the infection now occurring in sex workers and drug users from spreading to the general public. This kind of focus is best delivered by people not connected with the state, whose approach to these groups is far from sensitive. But Beijing distrusts NGOs. Ask Wan, whose AIZHI office was shut down by the police on July 1. "Our government invited the security department to challenge the people who are challenging AIDS," says Wan despairingly.

It's not just a question of the right to organise. "International experience shows that drug users, sex workers and men who have sex with men don't trust government and prefer civil society," says William Stewart of the China-UK HIV/AIDS Prevention and Care Project which operates in two provinces in southwest China.

There are some signs of change in China. Under a five-year plan announced last year the central government allocated 100 million renminbi ($12 million) annually to fund prevention and treatment of HIV/Aids and sexually-transmitted diseases. An additional 950 million renminbi was earmarked for the construction of a blood-collection and supply network to ensure blood safety.

Many government officials working in the field are no longer opposed to meeting with NGOs. There is a needle-exchange programme in Xinjiang. In Yunnan local and international NGOs are working "fairly unfettered in a number of outreach and education programmes," says a Western diplomat. In Guangxi and other provinces, prostitutes are being educated about HIV/AIDS and there is an experimental methadone-substitution programme for heroin addicts. Beijing schools plan to launch a sex-education class with an HIV/AIDS component.

These are all examples of what should be done on a much larger scale. Beijing has to move beyond what one UN official refers to as "permanent pilot projects" towards a national AIDS message.

If change is eventually coming why has China been so slow to recognize the problem? Part of the answer lies in the fact that China's leaders stress the importance of local, regional and national economic development. That approach has seen officials push urgent social issues, including declining education and health standards, to the sidelines lest they draw attention to deficiencies in China's modernization drive. The other uncomfortable truth is that peasants -- the bulk of the victims to date -- don't warrant the same attention from government as city folk do.

But change, however it comes, is coming too late for the farmers with HIV/AIDS who took their turn to face the camera and tell how they sold blood for money to companies, many of them linked to local party officials. As far as is known no Communist official has been punished for what is probably the biggest crime of reform-era China. The villagers now wait to die, utterly neglected by the authorities.

Reporting on Henan's HIV/AIDS crisis is not easy. Local authorities are keen to keep a tight lid on the problem. Foreign reporters have been arrested there. Late last year two reporters from China Central Television were arrested as they made a dash for the Shandong border after being caught filming in a Henan village. Beijing student Lee Dan travelled alone to Dongguan village in Henan in January to film a documentary aimed at raising awareness about HIV/AIDS. Beijing police questioned him about his activities shortly after he returned home. He laughs at the suggestion that he is brave, saying only: "You have to do something in your life." It is unlikely that his film will ever be screened in China, but he is a voice for the villagers in Henan. "In China there is a kind of thinking that people have no value because they are poor. That is wrong," he says.