AIDS Violence Flares in China

By Laurie Garrett

STAFF WRITER

August 3, 2003

In recent months, AIDS patients in China have been beaten, jailed, harassed and denied medicines that could extend their lives, say prominent AIDS and human rights activists.

The episodes appear to defy the hope that arose during the country's SARS crisis, as several political leaders and opinion makers called for across-the-board changes in how the nation deals with health issues, particularly HIV.

At least 1.5 million people in China are infected with HIV, according to government estimates, and in the SARS aftermath many observers were optimistic that a new openness would be forthcoming about AIDS - and that the rights of HIV patients would be taken seriously.

"Many people thought things would get better after SARS," Chinese AIDS dissident Wan Yan Hai said in an interview last week. "But it hasn't happened."

Indeed, violence has flared in recent weeks in China's Henan province, where an estimated 1 million peasants became infected during the 1990s after selling their blood to government-run clinics and then being transfused with pooled, contaminated blood.

Wan, who was jailed for a month last summer in China for revealing information about the country's HIV crisis, now runs the AIZHI Action Project, a clearinghouse for Chinese AIDS information, and splits his time between Beijing and New Haven, Conn. Information he has released about recent events has, in part, been confirmed by Human Rights Watch, the Philadelphia-based AIDS Policy Project and Western reporters based in Beijing.

For years, China denied having significant numbers of AIDS and HIV cases. Under international pressure over the last two years, the government has conceded the numbers are larger, but few experts accept the official estimate of 1 million to 1.5 million. The staff devoted to official HIV efforts is too small to conduct meaningful surveillance for HIV, so even the official numbers are guesswork, top officials say. Foreign journalists are denied access to areas of known concentration of HIV, and local party officials punish villagers who provide information about the epidemic.

The recent events began on May 18 when, Human Rights Watch says, about 100 AIDS patients tried to speak to a World Health Organization team investigating SARS cases in a Wenlou village hospital in Henan. As a protest began against discrimination by doctors and nurses against HIV-positive patients, police moved in, beating and arresting leader Yang Nidan, who is HIV-positive, in view of journalists.

The episode occurred as the Chinese government was finishing an application to the Global Fund to Fight AIDS, Malaria and Tuberculosis, seeking $100 million for treatment and prevention efforts. Two earlier applications had been rejected for failing to demonstrate that the country had a plan for HIV control. This new application contained a detailed plan, including giving top priority to Henan Province's Shangcai County, where an estimated 30 percent of all adults are HIV-infected.

"Just before the Chinese government delivered its [new] application to the fund, the trouble began," Wan said.

Tensions were rising in rural areas over an unrelated problem that ultimately affected the political climate in Henan: family planning. Local communist party officials in Shangcai County raised tax rates on families in which more than one child had been born since 1991, adding a penalty of 3,000 yuan per child (about $366) for farmers whose incomes average less than $400 a year. Many farmers refused to pay, and local Communist Party cadres were deployed to exact payment forcibly, removing television sets, refrigerators and other valuables from peasants' homes.

In one case, they seized the car of a farmer, Zhao Sian, who could not pay the fee because the encephalitis illness of one of his children had bankrupted the family. When he "stole" back his car, a fight broke out, involving hundreds of villagers who sympathized with Zhao, and he was charged with stabbing a party boss.

Thousands of villagers marched on the jail in April to demand Zhao's release; their leaders included two known AIDS activists.

During the second week of June, several people died of AIDS in Shangcai County and their funerals fanned emotions already high because of the new tax. Officials turned back village representatives pleading for assistance.

On June 19, five AIDS patients, including two in the April uprising, pleaded with officials in the Henan provincial capital, Zhengzhou, for food, financial support for orphans, school payment assistance for ailing families and medicine. All five were arrested.

When villagers marched on the People's Assembly Hall in Zhengzhou, police taped the five detainees' mouths shut and beat them.

On June 21, hundreds of police raided the sleeping Xiadiguan village, where residents, many dying of AIDS, were beaten and 18 arrested, charged with kidnapping the police chief during the April protests.

The following night, police attacked Xiongqiao village, where more than 100 of the 600 residents are HIV-positive, Wan said.

International organizations have pleaded with the Chinese government to stop the Henan violence. Last week, a coalition of leading HIV scientists and AIDS luminaries sent a letter to China's Premier Wen Jiabao, charging, "The harassment of people with HIV/AIDS and their advocates diminishes China's ability to halt its AIDS epidemic, which ... threatens to rival the epidemics in Africa and India in the near future."

Katie Krauss of the AIDS Policy Project asked, "Do they really expect the world community to hand them $100 million?" in Global Fund support.

In the 1990s, the blood trade was running full tilt and was considered a route for HIV transmission. Wan said farmers gave blood once a week, earning about 2,000 yuan a year. The blood banks removed commercially sellable proteins and factors from the blood, then pooled what remained and injected it into the donors. Though the practice was outlawed in 1996, blood businesses continue to thrive and spread HIV, according to a top health ministry official in Beijing who spoke on condition of anonymity. The official insists that local Communist Party leaders continue to profit from the illegal trade.

"The peasants are so very, very poor, they still follow those blood banks and give their blood to make money," the official said.

Reuse of syringes has also been identified as contributing to infection. Hospitals and "barefoot doctors" - paramedics who provide basic medical treatment at the village level - tend to reuse them.

Human Rights Watch charges that Liu Quanxi, who headed Henan Health Department, ran the region's blood business during the 1990s. He was promoted in February to be deputy director of the Chinese Communist Party's health committee. Chen Kaiyuan, who headed up the Henan Communist Party and blocked all media access to the AIDS-plagued villages, arresting locals who gave information to foreign reporters, was recently named president of the Chinese Academy of Social Sciences.

"Persecuting HIV-positive protesters is doubly outrageous given that the state was complicit in their infection in the first place," charges Joanne Csete, director of the HIV/AIDS and Human Rights Program at Human Rights Watch.

All of this comes against a dramatically different background of political and legal action taken to deal with SARS. Though the Chinese leadership initially tried to cover up the SARS epidemic, once "openness" became the watchword, hundreds of officials lost jobs or faced demotions for blocking dissemination of accurate information. President Hu Jintao instructed that all SARS treatment was supposed to be free, and discrimination against SARS sufferers was declared illegal.

Even as Chinese scientists search for the source of the SARS virus in a well-funded national campaign, HIV research occupies low prestige, and some HIV labs have switched to SARS work. And Beijing officials, speaking on condition of anonymity, said the HIV/AIDS work force of China, a nation of 1.3 billion, is only 200.

"I don't think our government will treat AIDS as it did SARS," Wan said. "SARS attacked the capital city and affected political stability. AIDS is chronic, though severe."

Because AIDS is not an acute, immediate killer, Wan continued, it is easier to ignore than SARS. And most AIDS patients in China are poor, politically ignorant peasants who "don't understand the rule of law and human rights."

A skinny Beijing college student named Li Dan discovered just how cut off the Henan villagers were when he visited the region, video camera in hand, three years ago. His film depicting the agony of untreated AIDS prompted concern that peaked in late 2002, when the U.S. Central Intelligence Agency issued a report estimating China has 1.5 million to 3 million HIV-infected. In January, a Center for Strategic and International Studies fact-finding group concluded that within seven years, China could have 20 million HIV-positive citizens.

Li, now a 25-year-old graduate student in astronomy, is risking his freedom and career to fight on behalf of the farmers of HIV-plagued villages across rural China.

"The way this government thinks is, 'If you are poor, so very poor as the farmers are, why should we put money into your treatment and protection? You can't return the investment to society,' " Li said, speaking through a translator.

He says the virus is spreading via the nation's enormous sex trade. Girls and young women have abandoned the poverty of village life in recent years, moving into cities to make better lives for themselves. Most get jobs in "wash houses," where they scrub men's hair and clandestinely provide sexual services.

Published studies show that HIV has spread throughout China, with infection rates soaring among prostitutes and "wash house" girls. But government officials speak of HIV as a problem confined to Henan blood sellers and intravenous drug users in Yunan Province.

"In the long run, we do see that more openness and transparency will be there," regarding HIV in China, insists Dr. Sun Gang, head of the UN AIDS Programme in Beijing. "But we still need more proof of it in the short run."