China treats AIDS as PR problem

By Steve Friess

BEIJING -- They admitted the problem. They vowed to spend lots of money to start fixing it, too. They even held a conference this month to talk it over.

Then, just as China really looked like it was trying to do the right thing about its AIDS problem, it couldn't quite help itself. The media, ostensibly invited in to document the conference, were forced to leave the four-day meeting after hearing Chinese health officials utter lofty goals and fabricated infection statistics in the opening session.

And so, as the world's most populous nation looks ahead to a bleak future in which as many as 20 million people are infected with HIV, those in control apparently haven't heard that silence equals death. Or, more likely, they don't care.

What they do care about -- what China has always cared about most -- is its image. That's why, in facing one of the most grave health crises in any nation's history, the leaders have treated this not as a human problem but as a public relations problem.

At the AIDS conference, journalists were also allowed to hear more blather about how the government is cleaning up the blood supply, making plans to care for people with HIV and AIDS and creating new public awareness and prevention campaigns. In short, China said everything the West wanted to hear.

For good measure, conference organizers even allowed some dire warnings about the problem in China to be aired by Peter Piot, executive director of the consortium of United Nations agencies involved with the global AIDS issue. Piot, who leant his prestige to the event believing the Chinese were serious about taking on the issue, told The New York Times later that the cancellation of a speech by Vice Premier Li Lanqing proved the top level of this government still doesn't understand the magnitude of the problem they face.

Many a hopeful activist noted that health officials are at least allowing discussion and, for members of a tight-lipped totalitarian regime, have become uncharacteristically forthcoming of late. In August, Deputy Health Minister Yin Dakui held a surprising Aug. 23 press conference to concede the nation is facing a potential AIDS epidemic and to announce $117 million to clean up the horrifically tainted blood supply. That followed a June speech to the UN in New York by Yin's boss, Health Minister Zhang Wenkang, who estimated 600,000 Chinese people have HIV and 1.5 million could be infected by 2010.

Those numbers are laughably low, but surprisingly few people laughed. The UN puts the current figure at more than 1 million infected and predicts 20 million cases by 2010. But China won this round of the PR campaign anyway because saying anything at all exceeded the world's super-low expectations. China admitting it has an AIDS problem may be akin to the sun admitting it's on fire, but everybody would be impressed if the sun spoke, too.

Yet at the same time as these so-called revelations, the Ministry of Health was hard at work trying to suppress and distort another part of the AIDS story in China. The impoverished central provinces are rife with HIV, unusual because they're remote areas not given to intravenous drug use, prostitution or even much tourism that would bring many foreigners or urbanites through.

The disease spread into this region after thousands of poor farmers spent the late 1990s selling their blood to illegal collectors for $5 a pop, often daily. The blood was stored -- unscreened and unsterilized -- in tanks dem arked by blood type, where it mingled with everybody else's, including that of HIV-positive blood sellers. The whole blood and plasma, the more profitable parts of blood, were skimmed off and sold to hospitals and clinics for use in transfusions. The rest was returned to the veins of those who sold it because they were donating so often they would get weak without the transfusion. There's no more efficient way to spread HIV than to inject it directly into people's arms.

One village, Wenlou, received lots of attention because a doctor in the province studied it and found an HIV infection rate among adults of more than 50 percent. For her willingness to tell the foreign media of this disaster, that doctor had her phone tapped and was barred from going to Washington DC to receive the Global Health Council's Jonathan Mann Award for Global Health and Human Rights.

Beijing pretended to care, expressing concern and condemning the local officials who allowed the blood-selling. They even claimed to have set up a 24 -hour AIDS clinic in Wenlou, but they won't let the media in to verify that. Guards are now posted outside Wenlou and dozens of similarly affected villages in the region to keep out reporters, and phone numbers in the village was changed so journalists in Beijing wouldn't be able to call their sources there.

Then came the November conference -- billed as China's contribution to World AIDS Day on Dec. 1 -- to further the government's farce. In addition to Piot and Chinese health officials, the opening session featured an unnamed man with AIDS speaking of his experience. He sat on the side of a darkened stage holding green glow sticks to obscure his face. Some of the most seasoned AIDS activists in attendance said this bizarre bit of theater reminded them of the early 1980s.

It also was completely unnecessary if the government wanted to destigmatize AIDS to the nation. At that same moment, a crowd of HIV-positive farmers from a central province were in Beijing calling any journalist who would listen to the prejudice they face and the lack of medical attention they receive. Any one of these people would have been more than happy to get up there and speak, sans glow sticks.

The bottom line -- and this doesn't require a four-day conference to figure out -- is that China is about to take a wallop from HIV. Millions of people will die. The health care system will be stretched to its limits. The public will remain clueless about how it all happened and how to prevent it.

And, all the while, somebody at the Ministry of Health will be looking for a way to spin it.

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