BEIJING - Departing from the Chinese government's general reticence on the subject of AIDS, a senior official acknowledged yesterday that China is facing an epidemic that threatens to outpace government efforts to control it.
The official, Deputy Health Minister Yin Dakui, also conceded the government's failure to develop effective education programs and the tendency of some local officials to cover up the extent of infection in their jurisdictions, allowing the disease to spread unchecked.
"Like many other countries, we are facing a very serious epidemic of HIV-AIDS," Yin said, adding that the government had "not effectively stemmed the epidemic."
Yin's 90-minute news conference - the first by a top Chinese official on the subject - was the latest in a series of small steps suggesting that China is ready to address more openly a topic that has been mostly taboo.
Yin insisted that China's epidemic of HIV, the virus that causes AIDS, is still relatively small - but he released alarming new statistics. Reported HIV infections rose 67.4 percent in the first six months of 2001 compared with the same period last year, he said. About 5 percent of drug users in China are infected with HIV, up from less than 0.5 percent in 1995.
In response, the government has decided to spend about $12 million annually for AIDS prevention and control, he said, as well as more than $117 million this year to improve blood safety. (The U.S. government has budgeted $744 million for HIV prevention in fiscal year 2001, according to the Centers for Disease Control and Prevention.)
More important, though, Yin addressed some of the politically sensitive aspects of the AIDS problem, touching on China's shortcomings in dealing with the crisis forcefully and in time. "In some regions, leaders and the general public have not fully realized the hidden dangers of a large-scale epidemic," he said.
He also discussed, for the first time, an AIDS epidemic covered up in Henan province, where tens of thousands of poor farmers have contracted AIDS by selling their blood using unsanitary practices.
Last week, Yin held a widely publicized meeting with AIDS patients in the village of Wenlou, in Henan province. It was the first time such a high-level delegation had visited the area and the first time the situation had been featured in the state press.
Yesterday's news conference was a milestone of sorts, but it also underscored the gulf between the government and its critics in and outside China who remain skeptical, feeling that the government has been far too slow in confronting a burgeoning AIDS problem.
"In the past I may have believed things, but now I'm not sure about what I'm told, so I must observe and judge," said Dr. Gao Yaojie, a retired gynecologist who earned international praise and the enmity of local officials by creating her own HIV-education program in Henan.
And the government's apparent commitment to greater openness about AIDS was undercut by the fact that reports on yesterday's lengthy news conference in the state-controlled press were brief and statistical, leaving out Yin's judgment that China faces a "serious epidemic" and not mentioning Henan province by name.
Despite acknowledging a rapid increase in the number of people testing positive for HIV, Yin defended previous ministry estimates that 600,000 Chinese were infected with the virus at the end of 2000. And he repeated the goal, set by the central government in May, that China should contain the number of HIV cases to less than 1.5 million in 2010.
But a recent United Nations report estimated that "above 1 million" Chinese had HIV at the start of 2001, and that if current trends continue there could be 20 million by the end of 2010.
According to government data, almost 70 percent of those infected with HIV are intravenous drug-users, though critics say that statistic may be partly a result of intensive testing in that group.
Even those who welcomed the government's new approach said it was too little, too late for thousands who had been needlessly infected in recent years while health officials failed to take decisive action.
The U.N. report said China was experiencing local HIV epidemics that could have been prevented with simple education programs.
For example, government research found that the rate of needle sharing among drug users in Jiangxi province increased sharply in the 1990s, reaching 93 percent in 1999. Because health officials made inadequate efforts to stem the practice, HIV spread quickly.
"Education is extremely important especially at the grass-roots level," said Gao, who is distributing 120,000 copies of a book she wrote and printed on the topic. "Education is essential," she said, "and so is a proper attitude toward people with AIDS - an attitude of support and understanding."
