Clinton prods Chinese officials to confront AIDS epidemic

Former president delivers speech at Beijing summit

top leaders don't attend

November 11, 2003|By Gady A. Epstein | Gady A. Epstein,SUN FOREIGN STAFF

BEIJING - Former President Bill Clinton addressed a conference on AIDS at one of China's most prestigious universities yesterday, delivering a message to top officials that they must confront the country's HIV epidemic - but the top officials weren't there to hear him.

Qinghua University's AIDS and SARS Summit symbolized China's muddled approach to HIV and AIDS. That the conference was even held reflected an increasing official acceptance that the nation faces a crisis, with as many as 2 million people infected with HIV and projections of 10 million to 20 million cases by 2010.

But the glaring absence of anyone from the top tiers of government also showcased the leadership's reluctance to face the AIDS problem publicly, in contrast to the aggressive handling of SARS this spring.

"If we continue to ignore the implications of AIDS, it will be terrible, not only for China but for all the friends and partners of China all around the world," Clinton said in a 30-minute speech. "It won't go away. It will only get worse."

Activists, long frustrated by leaders' unwillingness to confront AIDS, are seeing signs the government is taking it more seriously. They predict only incremental progress, though, until there is a major, top-down political breakthrough.

As was demonstrated so clearly with SARS, the Communist Party bureaucracy and the public will not mobilize without a signal from the highest levels of government.

"Many committed and talented Chinese ... are anxiously awaiting a clear and unequivocal directive from the top," said David Ho, a prominent American AIDS researcher who spoke before Clinton. Choosing his words carefully, Ho said he was speaking personally as a "citizen of the world" who cares about China. "Until such a call to action comes, the response to AIDS will be muted."

The same was true with SARS, which officials allowed to spread for several months before firing the health minister and the Beijing mayor. That was accompanied by a stunning admission of initial failures in handling SARS and an equally stunning commitment of hundreds of millions of dollars to fight the problem - far more than had ever been promised for AIDS.

President Hu Jintao and Premier Wen Jiabao, China's top two leaders, publicly led the "People's War" on SARS. Now, AIDS activists say the obvious social and economic threats of SARS - which killed only thousands but frightened hundreds of millions - might have spurred more interest in AIDS.

The next opportunity for a major gesture on AIDS would logically be Dec. 1, World AIDS Day. A public call to arms from Hu, Wen or even Health Minister Wu Yi, a member of the Politburo, would be a first.

"It has to be a priority in the way SARS is a high priority," Ho said in an interview yesterday.

In the past two years, the government has taken some small steps toward dealing with AIDS more directly. Officials revised sharply upward their estimates of total cases in China, which has the second-largest number of infections in Asia, behind India.

The official numbers - currently 840,000 infected with HIV and 80,000 with full-blown AIDS - are still far lower than the estimates made by international experts, but Chinese health officials now openly acknowledge they are dealing with an HIV epidemic that is growing at 30 percent a year.

Some, like Zeng Yi, a leading AIDS expert in the Health Ministry, have been yet more candid.

"The Chinese government and the public's underestimation of the severe epidemic and its disastrous results caused a delay in AIDS prevention work," Zeng said in comments reported last month by the official New China News Agency.

"The government didn't make effective policies, there was no effective education in the society, the current intervention measures are not persistent and the investment in scientific studies ... was insufficient."

In the past year, the central government and some local governments have also shown more interest in AIDS outreach and education, including condom advertising. But often such efforts are limited by fear, born of bureaucratic timidity, that they will draw too much attention.

Some provinces continue to ignore or cover up the spread of AIDS, in part because they lack the resources to do anything about it and in part because there has been no SARS-like mandate from Beijing to do otherwise.

Clinton, who has devoted a significant portion of his work to AIDS since leaving office, had private audiences later yesterday with Hu and with Jiang Zemin, who was president when Clinton visited China in 1998. But Clinton did not mention any of China's leaders by name in his speech.

He instead suggested the need for more vocal leadership from the top. He spoke of the impact that Nigerian President Olusegun Obasanjo had on social attitudes in his country when he hugged an AIDS patient in an appearance with then-President Clinton on national television there.

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