San Francisco Chronicle - June 15, 2005
Kathleen E. McLaughlin, Chronicle Foreign Service

Such barriers, coupled with systemic ignorance about AIDS and HIV, have made it difficult to stem the spread of AIDS in a country that could have more than 10 million HIV-positive citizens by the end of this decade, says Human Rights Watch, based in New York.

While the report acknowledges that China's government has taken steps to address the AIDS epidemic, including an ambitious nationwide program to provide free treatment to poor AIDS patients, it cites numerous examples of censorship, harassment and arrests that it says "have hamstrung China's ability to mobilize citizens to respond to the AIDS epidemic."

In its report, the group urges the Chinese government to adopt a number of measures, including the release of detainees arrested for AIDS activism, new training for health care workers and police, an end to media limits on coverage of the issue and widespread education programs.

In the days leading up to release of this report, the Chinese central government announced several new measures to combat the spread of AIDS, including an education and training partnership with the United States and expanded needle exchange programs.

Wang Longde, vice minister of health, told an AIDS conference in Shanghai on Monday that the central government planned to enact a new law by the start of next year to ban HIV/AIDS-related discrimination.

"Awareness is a top priority in combating HIV-AIDS," Wang said.

But he acknowledged China faces an uphill battle. He described a nationwide study in 2004 in which 60 percent of the Chinese surveyed said they would not work with HIV-positive colleagues. Only 7 percent knew that condoms are effective against sexual transmission of the virus, and half believed AIDS can be transmitted through a handshake.

On Tuesday, Premier Wen Jiabao met with Peter Piot, executive director of the U.N. Program on HIV/AIDS, and said China is "determined and capable of curbing the spread of the disease."

Piot, who has warned that a "truly exceptional response" is needed in China, praised the government commitment but added that the country faces major challenges, such as ensuring that its policies filter down to the grassroots level.

The Human Rights Watch report says government policies are often hampering efforts to raise awareness. Besides restrictions on free speech and free association, it says, AIDS-HIV educators and activists "continue to report constant state surveillance, a web of bureaucratic obstacles and even open harassment in the course of doing their daily work."

Wan Yanhai, director of the Beijing-based Aizhi Action network, was detained for his work in 2002, accused of mishandling state secrets. He said he and his colleagues often felt they cannot operate as openly as needed to do their work properly.

"The environment is not good," Wan said in an interview Tuesday.

Human Rights Watch outlines that environment in great detail, noting in particular the heavy-handed tactics of officials in central Henan province, which it calls "the site of one of the most disastrous and preventable HIV-AIDS catastrophes."

China's AIDS epidemic spread like wildfire in Henan in the 1990s, largely among farmers who sold their blood to earn money and were reinjected with tainted cells. Local doctors and activists estimate Henan alone has at least 1 million HIV-positive people, even though China claims just 840,000 nationwide.

In recent years, Henan has been the scene of several disturbing incidents, the report notes, from the abrupt police closure of an AIDS orphanage to the detention of several HIV-positive people, whose treatment was disrupted. Health care workers are poorly trained, patients are sometimes given inferior drugs, and profiteers often resell scarce medications at premium prices.

"Some of these problems appear to relate to scarce resources and others to poor coordination by the health care system,'' the report says. "However, Henan AIDS activists who try to publicly draw attention to these and related issues can face serious repercussions."

These problems are not isolated to one province. While activists in major cities such as Beijing and Shanghai enjoy some freedom, "the people who work inland have been really afraid to talk to us," said Sara Davis, China researcher for Human Rights Watch. "People are extremely edgy."

Critics say the government's AIDS treatment and prevention efforts have fallen short. After beginning its highly touted program of free medical service for poor AIDS patients, the report says, the government scaled back its estimated number of patients from 1 million to 840,000, thereby reducing potential costs. As of March, only about 15,000 patients were enrolled in the program.

Despite promises of greater openness and anti-discrimination efforts, Beijing continues to block the flow of information in some cases.

Damien Lu, a Los Angeles resident who helps run a Web site that operates as an information clearinghouse for China's gays and lesbians, has experienced this first-hand. Late last month, without warning or explanation, Internet censors in Beijing blocked the 6-year-old Web site, www.gaychinese.net, which had about 60,000 visitors a day.

Observers speculate that the site was shut down during a recent anti- pornography campaign. Lu insists, though, that the Web site contained no sexually explicit or politically sensitive information. Rather, it was a place where gays and lesbians could communicate openly about health and social issues such as STD prevention and depression.

"The site being blocked is a serious issue for many users," Lu said. "This site is one of the few places where they can get accurate information regarding their physical and psychological health.

"It can sometimes literally be a life and death situation."

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