After denying for years that it had a problem, China last week acknowledged the HIV-AIDS epidemic that is sweeping that country. But the relief that greeted this long-overdue candor was tempered by Beijing’s admission that it has also detained the country’s most outspoken AIDS advocate — for exposing the government’s attempt to cover up the problem. China is asking the international community for help in dealing with this horrible disease. There should be no delay in responding with aid and assistance, but the world should demand that Beijing take the lead in efforts to fight the epidemic.
For years, Beijing denied that HIV-AIDS was a health problem in China. Official Chinese data showed that in 2001, 30,736 people had the HIV virus that leads to AIDS, 1,594 had full-blown AIDS and 684 people had died from illnesses related to the disease. In reality, the numbers are much greater. According to a recent U.N. report, between 800,000 and 1.5 million people carry the HIV virus; with the infection growing at some 30 percent a year, the figure could reach 10 million by 2010. The report concludes that China is “on the verge of a catastrophe that could result in unimaginable suffering, economic loss and social devastation.” “It’s more than a disease . . . it’s a disaster,” said the chairwoman of the U.N. Theme Group on HIV/AIDS in China, which prepared the study.
Beijing last week conceded that it had underestimated the threat, and raised its estimate of the number of people with the infection to 1 million, implicitly endorsing the U.N. study — and its worrisome conclusions. It is unclear what triggered the shift in the Chinese position. There is speculation that Beijing’s application for a $90 million grant to the Global Fund for AIDS, Tuberculosis and Malaria requires it to show good-faith efforts to fight the disease. Reportedly, China’s first request for aid was denied because of the government’s refusal to face up to the scale of the problem. This time, however, government officials are being more forthright.
As one sign of the Chinese government’s new seriousness, the Communist Party Central Committee has reportedly commissioned a special study on HIV-AIDS. It has also shifted its position on the manufacture of AIDS drugs. Until now, Beijing has argued that as a new member of the World Trade Organization it would have to respect Western patents on the drug cocktails that have proven effective in combating the disease. That has virtually eliminated this treatment option: The drugs cost about $8,000 a year — more than double China’s per capita GDP. Chinese negotiations with drug companies have managed to cut that figure in half, but that still leaves the drugs beyond reach for virtually all Chinese. Only about 100 Chinese are receiving cocktails, and most of the medicine has been donated by foreign groups.
Cheaper versions of the cocktail — costing as little as $300 annually — are available in Thailand. China would have no difficulty making the drugs. The country’s pharmaceutical manufacturing industry is strong, and has even acquired notoriety for copying Western drugs. One Chinese company already legally makes the raw ingredients for many of the pills in the AIDS cocktail, which are shipped to India and transformed into generic pills that are unavailable to Chinese. While respect for intellectual property rights is important, the scale of the AIDS problem in China and the trends are too alarming for business as usual. Moral suasion has been applied in sub-Saharan Africa and it has yielded results. The same pressure should be used on China’s behalf.
But that approach will only work if China changes its thinking. Thus far the changes are only cosmetic. Proof is found in confirmation by the country’s Bureau of State Security that it has detained the country’s most outspoken AIDS advocate, Mr. Wan Yanhai. He disappeared two weeks ago after being harassed all summer by security officials. His crime? Putting documents on the Internet that showed that government officials were aware of the magnitude of the HIV problem in Henan province as early as 1995.
The tragedy in Henan is horrific. Farmers there sold their blood to the government to earn money, but they were infected with HIV as a result of highly unsanitary processing practices. It is estimated that the majority of adults in some villages in Henan are now HIV positive and that there could be over 1 million people infected in that province alone.
Combating HIV-AIDS is always difficult, and China’s size and poverty magnify the problems exponentially. But there can be no solution unless the government acknowledges there is a problem and begins a full-scale assault. Last week’s announcement is an important sign of change in Beijing’s thinking. When Mr. Wan is released, the world will know that China is truly serious about fighting AIDS.
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