Commentary
Previously ignored AIDS crisis is China's No. 1 social issue

By Tom Plate

A medical expert hands out AIDS posters at a stall organized by China's Ministry of Health at Beijing's West Railway Station. Advertiser library photo • Dec. 1, 2000

No, the challenge is not economic. In truth, the national government in Beijing appears to have that challenge in hand, though the looming world downturn could stall its reform and development program.

No, the challenge is not political. The Jiang Zemin government appears to be in steady control, though there's no guarantee that this sprawling country — troubled by past decades of inept management, a history of internal violence and sometimes unfriendly neighbors — can hold together forever.

The real issue is the mainland's AIDS and HIV pandemic. Although Beijing won't officially admit it, China is one of the most badly hit countries in the world. Estimates of HIV carriers range from a low of 600,000 — the figure officially admitted last month at China's first-ever international AIDS conference — to 6 to 10 million. There's simply no way of knowing for sure.

That's because, for one thing, China is a very unevenly governed country.

The central government barks loudly in Beijing but has much less bite than outsiders would imagine in the far-flung provinces, where local authorities often seem particularly hard of hearing. In Henan — a centrally located province far from Beijing — hundreds of villagers either HIV-infected or with fully developed AIDS protested outside the government office. They were demanding better health care and compensatory damages.

That's because, outside of cities such as Beijing and Shanghai, China is still a staggeringly poor country. While it has one of the largest economies in the world, overall its per-capita income hovers at less than $1,000 annually. Many rural villagers have been selling their blood to firms willing to pay $5 a pint. Experts worry that in some rural communities, 60 percent of the population is infected.

And that's because China, for all its many admirable advances, remains a relatively undereducated country. While its society values learning and has done an excellent job producing an educated elite that can compete well in today's globalized economic environment, its general population is poorly publicly schooled indeed, including in public health. And it is now reaping the tragic results of that ignorance. How can it be, in this day and age, that so many people in China do not generally know that reusing dirty needles and pooling collected blood for transfusion are the easiest known ways to accelerate the disease's spread?

This is absolutely unacceptable, especially from a government in Beijing that has otherwise done an absolutely commendable job in inculcating its many complex economic reforms.

What's especially appalling is that some of the ignorance is either at best uncaring or at worst willfully permitted. Some profiteering blood-supply companies simply don't worry about whether their business is so deadly. China's new materialistic atmosphere — "To be rich is glorious," as the modern mainland mantra goes — is in many ways terrific for the Chinese, not to mention Western entrepreneurs capitalizing on the huge market opportunities there in many areas of commerce.

But business ethics can be as important as business profits in today's world, with its many far-flung transactions depending on internationally accepted codes of conduct. The central government should make an example of these blood profiteers with the ruthlessness it shows outspoken political dissidents. Perhaps even more so: For the former are doing far more damage than the latter to China.

Finally, perhaps, that realization may now be dawning. The official Chinese press recently informally approved an AIDS Web site, originating from Shanghai. A visit to http://sh.netsh.com/bbs/8109 will provide advice on the kind of symptoms and treatment that's now so common and freely available in the West.

That wasn't always the case, to be sure. Frightening ignorance and sheer prejudice kept America from fully facing the AIDS problem honestly even up to the late '80s. The West shouldn't condemn but help. Beijing needs to move quickly to contain this crisis before it erodes not just its international image but its domestic public health.

Jiang Zemin's No. 1 social issue is now AIDS in China. By comparison, tension with Taiwan, the Falun Gong annoyance and serious anti-party terrorism in the West are nothing but mere sniffles.

Indeed, just as the government is going methodically about the business of implementing the requirements of its new membership in the World Trade Organization, it now also ought to take more seriously its membership obligations in another important world agency: the World Health Organization.

Tom Plate, a columnist with The Honolulu Advertiser and the South China Morning Post, is a professor at UCLA. He also has a spot on the Web.