Wall Street Journal - August 15, 2002

The World Health Organization estimates that 850,000 Chinese adults and children were living with HIV/AIDS at the end of 2001. An estimated 30,000 died of the disease over the course of last year, and 76,000 children have lost one or both parents to the epidemic. As good as it is to hear that some will receive drug therapy, the United Nations estimates that 10 million people will become infected with HIV and AIDS across the country by the end of the decade.

It has become painfully clear that China has lost the chance to nip the spread of the disease in the bud. Even at this late stage, though, a relatively low-cost public health program, if begun quickly, could save millions of lives. Once, AIDS was a localized epidemic among drug user and sex workers. Now, due to contaminated blood collections and other factors, it is spreading among the general population. But most Chinese still don't even know how AIDS is spread, let alone how to protect themselves.

Even though drug companies have cut the prices of patented anti-AIDS drugs for sale in developing countries, the cost of developing the internal distribution system to get the drugs into the hands of those who need it will be expensive. In terms of saving lives, it would be much more effective to focus on education and prevention of AIDS. From President Jiang Zemin's new political theory to the family planning campaign, Beijing has demonstrated time and again the power of its propaganda machine. So why won't it use the full force of that machinery to expose the extent of the problem and educate the Chinese people about the transmission and consequences of AIDS?

To answer that question, it's necessary to review how the disease got out of control. Starting in the 1990s, a large percentage of the infections in rural villages occurred when farmers, who have little or no knowledge of AIDS, were paid to donate blood to government affiliated blood collection agencies. These agencies often pooled everyone's blood to extract the valuable plasma, and then returned the blood to the donor to avoid anemia and so that the process could be repeated in a few days. Thus one infected donor would infect the entire pool of donors. Local cadres were often in charge of these operations, using them as a way to fatten their pocketbooks.

Since the Western media exposed the practices of these blood collection agencies, the government has declared them illegal. One can only hope that government collaboration with the agencies has since ceased. But many local officials still hide the truth about AIDS and deny treatment to patients. Despite a central government crackdown, it's suspected that unsafe blood selling continues. The fastest way to stamp out the "blood heads" as the agency workers are called, would be to hold those officials who winked at the blood selling business responsible for their negligence.

Instead the opposite is occurring. Henan province was the epicenter of the blood-selling business. Some of its villages are 60% HIV positive and in others so many adults have died from AIDS that only the elderly and the young are left. Yet two of Henan's officials who have been linked to the blood selling scandal are now poised for promotion to the highest echelons of the government and Chinese Communist Party.

Li Changchun, Henan's party boss at the time of the contamination disaster, is a protege of President Jiang, and is expected to be appointed a vice-premier next year. Li Keqiang is Henan's current governor and party boss, and although he was not in Henan when the blood selling was widespread, his failure to take remedial action in the aftermath of the scandal has been much criticized. Today, Mr. Li is one of the backers of Vice President Hu Jintao, China's leader in waiting, and has been tipped as a possible future "core" leader himself.

The true scandal here is that because China's leaders are afraid of hurting their own image by acknowledging past mistakes, they are continuing to allow millions of their poorer countrymen to go on unwittingly infecting themselves with a deadly disease. It's sometimes assumed that after the beginning of the reform era in 1979, China's communist system no longer inflicted a heavy toll of unnecessary deaths, such as happened during the Great Leap Forward or Cultural Revolution. The truth is that the country will go on paying a steep price for decades to come because of the lack of a free press and an accountable government.

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