ZHUMADIAN, China, Nov 27 (AFP) - Three years after a dark secret in China's heartland was revealed to the world, the government has finally recognized the need to help those devastated by AIDS, but critics say more needs to be done.
While free drugs are now available, infections could reach alarming levels, impacting economic growth, if top leaders fail to realize the disease is more than just a nuisance, international experts say.
Authorities in July began distributing free anti-retroviral drugs to people at the center of the crisis -- thousands of poor farmers in central Henan province and neighboring areas who sold blood in unsanitary conditions up until the mid-1990s in government-approved schemes.
More than 5,000 farmers in nine provinces are receiving the drugs and the government aims to provide treatment to 40,000 patients in five years, while ironing out complications, including the lack of trained doctors to keep people on the medication.
Top health officials also announced recently plans to provide treatment to all poor sufferers, believed to include drug addicts and others.
"It's a dramatic shift in attitude after many years in which the government was not willing to do anything specific for people suffering from HIV/AIDS," said a Western AIDS official based in Beijing.
"In the past, the activities, including posters, TV spots, and conferences, didn't directly impact on the HIV/AIDS sufferers. Now, for the first time, we have a program that's putting drugs in the hands of people with HIV/AIDS."
But critics say the government is still reluctant to come clean on the epidemic, which is crucial to effectively dealing with the crisis.
It has yet to reveal the true scale of the problem.
"How can you decide how much drugs to make or import when you are working with such unrealistically low numbers?" said Li Dan, head of Orchid, a charity helping AIDS orphans, and questioned the government's sincerity.
"To them, it's all about costs. They're thinking if they help these people now and can use very little money to do so, then it will be worthwhile because they are worried about China's international image."
Many infected people -- such as a mushrooming population of drug addicts and farmers in Henan province, of which Zhumadian is the worst AIDS-affected city -- remain untested and unaware.
"In this area, a lot of people don't know what AIDS is," said Di Ying, whose four-year-old son died last month from AIDS after being infected in 2000 during a blood transfusion at a rural Henan hospital.
The blood came from a farmer who sold it for a living despite a government ban against doing so. He died last year.
Local officials, meanwhile, continue to use suppression, cover ups and sometimes violence, including a night raid in June at one of several "AIDS villages", to deal with the problem.
"Local officials still feel that as long as they wait a few years, the problem will go away. These people will die," said Li.
Journalists and AIDS workers are regularly chased away. And an official this year was detained for leaking figures on Henan's epidemic, considered "state secret."
China claims it has 850,000 human immunodeficiency virus carriers, but international organizations, including the United Nations, believe it is much higher.
The government said there are 32,000 HIV carriers in Henan -- believed to be the worst affected from the blood selling schemes -- but AIDS experts argue around one million sufferers exist here alone.
They point to the widespread practice beginning in the mid-1980s of selling blood and the staggeringly-high level of infection -- ranging from 20 to 40 percent -- in many villages.
Drug users actually comprise the largest proportion of HIV/AIDS sufferers in China -- 50 percent of the total, compared to 20 percent for plasma donors.
Despite their increasing numbers and their dangerous practice of sharing needles, addicts have received little government attention.
China long considered AIDS a foreign disease, but in a matter of years it has become Asia's second worst affected country, after India.
Given the sheer size of its population of 1.3 billion, foot dragging could lead to devastating impacts on its economy, experts say, as it did in Africa, by wiping out past growth and putting the most productive segment of the workforce -- people in their prime -- out of work.
"If just 10 percent of Chinese have HIV in 10 years, the burden will be incredibly difficult to handle," the Western expert said.
"China still has three to four years left in which they can effectively treat a problem without it being widespread. If they miss this opportunity, AIDS will spread to the mainstream community."
The UN has warned China's AIDS cases could balloon to 20 million by 2010.
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