A visit long overdue

December 02, 2003

ON WORLD AIDS Day, Chinese Premier Wen Jiabao yesterday visited and shook hands with three AIDS patients at a Beijing hospital. Along with China's recent decision to begin distributing free anti-retroviral drugs to some HIV-positive citizens, the unprecedented, highly symbolic visit was another sign that the world's largest nation may finally be getting serious about one of the world's fastest-growing AIDS problems.

If so, it's a desperately needed switch from the Chinese leadership's years of unconscionable denials in the face of spreading AIDS problems on the mainland. The question remains, however, whether Beijing's turnabout is still too little and too late to prevent the disease from infecting 10 million to 20 million Chinese by 2020 - a question in which the whole world has a big stake.

Right now, the Chinese government acknowledges only 840,000 HIV-positive citizens (and 80,000 AIDS cases). This would be just a fraction of the estimated 40 million people worldwide who are infected. But independent experts believe the actual number of Chinese cases could be many times higher. Chinese state media have reported that the number of AIDS patients in the first of half of this year alone jumped by 40 percent and that HIV infections are growing by 30 percent a year.

In China, the virus took hold in the 1990s via a fertile combination of a sudden spurt in drug use, rapidly changing sexual mores, a dramatic loosening of internal migration restrictions, a vast and uneducated population, a crumbling state health care system, and disinformation efforts by a government that cast AIDS as a "foreigners' disease."

In central China's Henan Province, as many as 1.2 million peasants - concentrated in dozens of "AIDS villages" - may be HIV-positive as a result of regularly selling blood at government stations in the early 1990s. Officials not only covered up this scandal for years, delaying victims' treatment, they also harassed and detained local activists for exposing the epidemic.

Henan is the center of initial efforts to offer free drugs, now almost entirely foreign-funded. But recent Western reports from there indicate officials are simply handing out pills to infected villagers with little monitoring by doctors. If patients quit taking the drugs or take them improperly, this could make matters far worse by brewing drug-resistant HIV strains.

This is just one example of the uphill AIDS battle in China. Its health ministry estimates the entire nation has no more than 150 properly trained AIDS physicians. A recent survey found that only one in four rural Chinese had ever heard of AIDS, and one in five knew HIV could be transmitted sexually.

As with the recent SARS crisis, Beijing is capable of an effective public health campaign once it summons the will. The developed world should provide aid and expertise. But first and foremost, Beijing must launch a sweeping war on AIDS, backed by a far greater commitment of resources.

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