Arrest of AIDS activist underlines China's impending HIV crisis

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The furtive arrest of a prominent Chinese AIDS activist late last month may have been intended to quell public debate about China's AIDS crisis. But the disappearance of Wan Yanhai — best known for his harsh critique of the government's response to AIDS — has instead cast a spotlight on China's handling of its growing HIV problem.

HIV and AIDS have been spreading at an alarming rate in China. At a press briefing on 6 September, Qi Xiaoqiu, director general of the Department of Disease Control at China's health ministry, admitted that the number of people in the country infected with HIV could reach one million by the end of this year — up from 850,000 at the end of 2001.

But many experts think this is an underestimate. A report issued by the Joint United Nations Programme on HIV/AIDS (UNAIDS) in June gave estimates for 2001 of up to 1.5 million and warned that the number of people infected could reach 10 million by 2010.

In much of China, HIV has been spread by sexual contact or through intravenous drug use. But the soaring rates of infection in central inland provinces such as Anhui and Henan — where some villages have reported HIV infection in up to 80% of adults, according to the UNAIDS report — have largely been caused by the presence of the virus in unregulated blood supplies.

Wan, who was said by his wife and colleagues to be in the custody of security agents two weeks after his unexplained disappearance in Beijing, had been strongly critical of the government's handling of blood collections. He alleged that local officials were benefiting financially from illegal, unsafe collection of blood through paid donations.

Through his Beijing-based group, the AIDS Action Project, Wan organized petitions to urge the government to provide care for victims. The project's website also attempted to raise awareness of the problem by publishing 'death lists' of those who had died from AIDS in Henan. But in July, the project's office, which operated on a Beijing college campus, was closed down for allegedly not following the rules for non-governmental organizations.

There has been no official announcement that Wan is being detained. But a member of the AIDS Action Project reportedly contacted last week by state security agents says that the agents indicated Wan is being questioned about the contents of an e-mail he sent to a mailing list. The e-mail, which included an official government document describing the number of people suffering from HIV/AIDS in Henan, is classified as a “state secret”.

Wan's apparent arrest undermined some recent positive trends in Chinese AIDS policy. In August 2001, for example, the health ministry acknowledged for the first time that tens of thousands of Henan blood donors were infected through blood transfusions. Last year the government announced a US$150-million package to establish safe blood-processing and storage centres. And at last week's press briefing, Qi acknowledged China's need for more international assistance in combating the problem. This followed an agreement on 28 June with the United States to collaborate in AIDS prevention and research. Qi also said that China is considering ways to step up the production of medicine for treating AIDS.

“The Ministry of Health is making a lot of effort and has many interesting pilot programmes,” says Siri Tellier of the United Nations Population Fund, who headed the group that produced the UNAIDS report. “And they are becoming increasingly open and frank.”

But China is still sending out mixed signals. The UNAIDS report accused it of “discrimination, stigma, fear, lack of transparency, and the promotion of information that leads to ignorance and unsafe practices”. Xiao Qiang, executive director of New York-based Human Rights in China, brands the treatment of Wan and others as “outrageous”.

Such harassment does not necessarily reflect official Chinese policy, some observers say. “The government's programmes are not implemented in a consistent fashion,” says Tellier.

http://www.unaids.org/whatsnew/newadds/AIDSchina2001update.pdf

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Cyranoski, D. Arrest of AIDS activist underlines China's impending HIV crisis. Nature 419, 99–100 (2002) doi:10.1038/419099a

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