Wall Street Journal - November 14, 2007
Marilyn Chase, marilyn.chase@wsj.com

While the number of HIV-infected people in China is relatively small -- about 650,000 in a population of 1.3 billion -- a confluence of health, economic and social factors make it vulnerable to a pandemic. The spread of a disease as debilitating as AIDS in a trade and manufacturing juggernaut such as China would likely have ripple effects around the globe.

The Gates Foundation's help in curbing the spread of AIDS could be crucial given Beijing's official resistance to dealing with the marginalized populations most likely to contract it, and societal reluctance to confront the drug use and sexual promiscuity associated with HIV transmission. In addition, China needs technical assistance and other outside expertise to mount an effective awareness and prevention campaign.

"A more widespread AIDS epidemic would have tremendous consequences for China and the rest of the world," said Bill Gates, the Microsoft Corp. cofounder who launched the foundation with his wife. "But it can be averted if we move quickly to expand prevention efforts."

With an initial foundation grant of $50 million and China's chipping in funds of its own, the partnership will push prevention in 12 major cities, including Beijing, Shanghai and Guangzhou, and the island province of Hainan. The aim will be to find people at high risk of AIDS and refer them to voluntary counseling and testing centers, which will offer education and tools to avoid the deadly virus. For people with HIV, the program will stress not passing it on.

The $35 billion Gates Foundation, which was created to tackle problems affecting global health, education and family issues, usually prefers to design its own programs and to put them into practice by teaming with nonprofits. But Beijing's centralized control made it necessary to collaborate with health, security and Communist Party agencies; indeed, it took four years of diplomacy by Mr. Gates before Beijing would permit his organization to register as a foreign foundation. Work with grass-roots groups and nongovernmental organizations -- whose activism often incurs official wrath in China -- will come later.

The dynamic social and economic climate that is enriching China and opening it to the world is also cause for concern on the AIDS front. Rates of infection among gay men there are rising, 50% of drug users are infected in some provinces, and large-scale migration is fueling a booming sex trade that officials fear could be a bridge for HIV into the general population. Neighboring India, which has undergone a similar transformation in recent decades, currently has 2.3 million HIV-infected people.

To be sure, Beijing has made strides on its own. This year it boosted funding for AIDS programs to $150 million, which among other things fund free HIV drugs and methadone-maintenance clinics for heroin addicts, who can contract the virus from shared needles.

But the Gates Foundation also brings more-ambitious methods to the effort, including a mass-media campaign meant to put a skittish Chinese public at ease. The Gates-funded AIDS Media Project has produced television spots showing Houston Rockets basketball star Yao Ming and former Los Angeles Laker Magic Johnson -- who is HIV positive -- shooting hoops and sharing takeout food to emphasize that casual contact with infected people is safe. Next week, stations will begin airing a new public-service announcement starring action-film star Jackie Chan.

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