To: Rolla Coasta who wrote (2202 ) 7/7/2001 2:01:54 PM From: LTK007 Read Replies (1) | Respond to of 23908 Friday, July 06, 2001 - 12:00 a.m. Pacificseattletimes.nwsource.com Guest columnist China's AIDS policy misguided, dangerous By César Chelala Special to The TimesChina's prohibition for Dr. Gao Yaojie to attend a recent award ceremony in the United States is the latest example of the Chinese government's mistaken policy on AIDS. Together with other actions, it shows that by trying to avoid publicity about AIDS and ignoring the rapid spread of the HIV infection, the government will contribute to the spread of the infection rather than to its elimination. Unless there is a dramatic change in outlook, and in policy, on how to combat HIV/AIDS, the infection will have a devastating impact on the health of the Chinese people and on the economy of the country. Dr. Yaojie, the third winner of the Jonathan Mann Award for Health and Human Rights from the Global Health Council - a nonprofit organization based in the United States - was to have received the award at a special ceremony hosted by U.N. Secretary General Kofi Annan. The award was a recognition of Dr. Yaojie's untiring efforts to combat the spread of the HIV infection among poor farmers in Henan Province, a farming region in central China. With 90 million inhabitants, Henan's AIDS situation has become a focus of attention for public-health experts. In Henan, as well as in many other rural areas throughout China, most farmers have become infected with HIV because they had been selling their blood at collection stations lacking minimal safety procedures. Particularly at illegal blood stations, blood is collected from a number of donors with the same blood type at one time. Afterwards, the blood is pooled, the components needed for medical use are separated and the remainder is divided up and re-infused into the original donors. This totally unsafe procedure exposes donors to six to 12 other donors every time they sell their blood, and facilitates the spreading not only of HIV but of the hepatitis virus and other serious diseases. Although China has been successful in several public-health areas such as nutrition, and in the systematic monitoring and elimination of endemic and epidemic diseases, sexually transmitted diseases - and the HIV infection - are still taboo subjects that have not been properly addressed. In the case of HIV, chronic blood shortages have created a huge demand for underground collection centers, where farmers are rounded up by "blood pimps," who bring up to 50 or 60 people at a time to the blood stations. Public-health experts believe that among the factors favoring the rapid spread of the HIV infection are China's huge migrant population, people's lack of knowledge about prevention, the existence of drug abuse and prostitution, the growing number of people with venereal diseases - which favor HIV transmission - and unsafe blood transfusions. In addition, secrecy and the inability of the central government to implement effective policies in the provinces, as well as lack of accountability and corrupt government officials, aggravate the problem. As a result, the pace at which HIV infection has been spreading in China has accelerated markedly in the last few years. Although the Chinese government states that there are only 22,517 HIV-infected people in the country, public-health experts estimate that the number of infected people may easily be over one million. In spite of that, in 1999, the total budget for AIDS prevention was a few million dollars, an amount much lower than that of smaller countries such as Vietnam or Thailand. A report by a committee of Chinese experts presented to the Chinese leadership earlier this year stated, "Owing to government indifference, AIDS prevention and control is gravely ineffective." Billboards promoting the advantage of prevention through the use of condoms posted in several cities were declared "indecent" and destroyed, and television ads promoting the use of condoms were removed from the air. Slowing the spread of HIV infection requires several actions: an acknowledgement by public-health and government officials of the seriousness of the situation; massive education campaigns on the best ways of preventing the transmission of the infection; safe conditions for blood donations, and the provision of sterile syringes to control the spread of the infection among drug addicts. Unless Chinese authorities take immediate steps to remedy this situation, they will realize that their real enemy is not outside their borders but inside their own Wall. Dr. César Chelala, an international medical consultant based in New York, is author of the Pan American Health Organization publication "AIDS: A Modern Epidemic." Copyright © 2001 The Seattle Times Company