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U.N. Publicly Chastises China for Inaction on H.I.V. Epidemic
By ELISABETH ROSENTHAL
BEIJING, June 27 ? The United Nations today issued a stinging public criticism of China's lackluster efforts to face its rapidly accelerating epidemic of H.I.V. infection and AIDS, saying the country is "on the verge of a catastrophe."
In a new report, "H.I.V./AIDS: China's Titanic Peril," the Joint United Nations Program on H.I.V./AIDS criticized Chinese officials on many fronts, from the lack of adequate education programs to the absence of treatment for people infected with H.I.V.
"We are now witnessing the unfolding of an H.I.V./AIDS epidemic of proportions beyond belief, an epidemic that calls for an urgent and proper but as yet unanswered quintessential response," the report said, noting that the lack of action meant China could have the largest number of people infected with H.I.V. in the world within a few years.
While much of the report circulated as an internal document among United Nations agencies late last year, its very public release today at a large news conference in Beijing signaled a new willingness by the United Nations to press China into action.
It also reflected widespread frustration among United Nations agencies, international nongovernmental groups and medical experts here that although China officially acknowledged its H.I.V. epidemic last August, it has been slow to create or cooperate in the programs that would effectively control its spread.
The Friday issue of Science magazine has an essay that is similarly critical, by two respected academics with extensive knowledge of China's AIDS problem. They amplify many of the concerns in the United Nations report, specifically taking China's leadership to task.
"Without the highest level of national leadership and directives by the Chinese Communist Party and the state it is unlikely that local governments will implement prevention and care programs," says the essay by Joan Kaufman, who formerly worked for the Ford Foundation in Beijing, and Jing Jun, a professor at Qinghua University.
Both the United Nations report and the Science article said China could limit its AIDS epidemic but only with urgent action.
China estimates there are 850,000 people infected with H.I.V., up from 600,000 last year, although, as the Science article notes, "most agree that these numbers are too low."
The United Nations report sidestepped the sensitive issue of how many people were infected, more or less accepting China's statistics, placing the number of infections at the end of 2001 between 800,000 and 1.5 million. It said 10 million could be infected by 2010 if the epidemic is not checked.
But some United Nations officials say privately that there could be as many as 6 million cases already in China, with 20 million expected by the end of the decade if nothing is done.
There is little good data from some rural areas where the disease is widespread, in part because national H.I.V. surveillance in China focuses on only four groups: drug users in detention, sex workers in detention, people who have had sexually transmitted diseases diagnosed and pregnant women in cities.
A large and ill-defined number of poor farmers in central China have been infected with H.I.V. through unsanitary and slipshod practices at rural hospitals and at blood collection stations.
During the 1990's, blood stations in Henan Province collected blood from dozens of patients at a time, centrifuged the pooled blood to separate the desired components and returned the leftover pooled fraction to donors. In this way, the virus was passed to large numbers of poor peasants who sold their blood for about $5 a bag to supplement their meager farm income.
In some poor villages in the province more than 50 percent of adults are infected and some experts have put the number of infections in the province alone at more than a million. Such people "have little or no access to even the most basic treatment such as first-line antibiotics, let alone counseling, antiretroviral therapy and hospital care," the United Nations report said.
There has also been no surveillance of gay men in China, even though Beijing's two hospitals that care for people infected with the virus that causes AIDS say that a third of patients fall into this category.
"The virus is still spreading and we need to marshal all our resources in a very different way if we want to stop the virus," said Kerstin Leitner, the United Nations chief representative here.
At the news conference today, Ms. Leitner and other United Nations officials took pains to praise the progress that had been made, noting, for example, that China held its first international conference on H.I.V. and AIDS last year. And the report held up a few examples of successful projects, mostly sponsored by foreign nongovernmental organizations.
But it found far more cause for concern than for optimism, deploring widespread ignorance about H.I.V. and discrimination against those who carry the virus. It noted that patients who had tried to complain were "sometimes even opposed by local authorities."
The report highlighted a law in Chengdu forbidding people with H.I.V. to work at hotels, restaurants, travel agencies, beauty salons, swimming pools and public baths, for example. It also noted that China's five-year action plan against H.I.V. and AIDS fell far short of the United Nations goals for combating the worldwide spread of the epidemic.
By ELISABETH ROSENTHAL
BEIJING, June 27 ? The United Nations today issued a stinging public criticism of China's lackluster efforts to face its rapidly accelerating epidemic of H.I.V. infection and AIDS, saying the country is "on the verge of a catastrophe."
In a new report, "H.I.V./AIDS: China's Titanic Peril," the Joint United Nations Program on H.I.V./AIDS criticized Chinese officials on many fronts, from the lack of adequate education programs to the absence of treatment for people infected with H.I.V.
"We are now witnessing the unfolding of an H.I.V./AIDS epidemic of proportions beyond belief, an epidemic that calls for an urgent and proper but as yet unanswered quintessential response," the report said, noting that the lack of action meant China could have the largest number of people infected with H.I.V. in the world within a few years.
While much of the report circulated as an internal document among United Nations agencies late last year, its very public release today at a large news conference in Beijing signaled a new willingness by the United Nations to press China into action.
It also reflected widespread frustration among United Nations agencies, international nongovernmental groups and medical experts here that although China officially acknowledged its H.I.V. epidemic last August, it has been slow to create or cooperate in the programs that would effectively control its spread.
The Friday issue of Science magazine has an essay that is similarly critical, by two respected academics with extensive knowledge of China's AIDS problem. They amplify many of the concerns in the United Nations report, specifically taking China's leadership to task.
"Without the highest level of national leadership and directives by the Chinese Communist Party and the state it is unlikely that local governments will implement prevention and care programs," says the essay by Joan Kaufman, who formerly worked for the Ford Foundation in Beijing, and Jing Jun, a professor at Qinghua University.
Both the United Nations report and the Science article said China could limit its AIDS epidemic but only with urgent action.
China estimates there are 850,000 people infected with H.I.V., up from 600,000 last year, although, as the Science article notes, "most agree that these numbers are too low."
The United Nations report sidestepped the sensitive issue of how many people were infected, more or less accepting China's statistics, placing the number of infections at the end of 2001 between 800,000 and 1.5 million. It said 10 million could be infected by 2010 if the epidemic is not checked.
But some United Nations officials say privately that there could be as many as 6 million cases already in China, with 20 million expected by the end of the decade if nothing is done.
There is little good data from some rural areas where the disease is widespread, in part because national H.I.V. surveillance in China focuses on only four groups: drug users in detention, sex workers in detention, people who have had sexually transmitted diseases diagnosed and pregnant women in cities.
A large and ill-defined number of poor farmers in central China have been infected with H.I.V. through unsanitary and slipshod practices at rural hospitals and at blood collection stations.
During the 1990's, blood stations in Henan Province collected blood from dozens of patients at a time, centrifuged the pooled blood to separate the desired components and returned the leftover pooled fraction to donors. In this way, the virus was passed to large numbers of poor peasants who sold their blood for about $5 a bag to supplement their meager farm income.
In some poor villages in the province more than 50 percent of adults are infected and some experts have put the number of infections in the province alone at more than a million. Such people "have little or no access to even the most basic treatment such as first-line antibiotics, let alone counseling, antiretroviral therapy and hospital care," the United Nations report said.
There has also been no surveillance of gay men in China, even though Beijing's two hospitals that care for people infected with the virus that causes AIDS say that a third of patients fall into this category.
"The virus is still spreading and we need to marshal all our resources in a very different way if we want to stop the virus," said Kerstin Leitner, the United Nations chief representative here.
At the news conference today, Ms. Leitner and other United Nations officials took pains to praise the progress that had been made, noting, for example, that China held its first international conference on H.I.V. and AIDS last year. And the report held up a few examples of successful projects, mostly sponsored by foreign nongovernmental organizations.
But it found far more cause for concern than for optimism, deploring widespread ignorance about H.I.V. and discrimination against those who carry the virus. It noted that patients who had tried to complain were "sometimes even opposed by local authorities."
The report highlighted a law in Chengdu forbidding people with H.I.V. to work at hotels, restaurants, travel agencies, beauty salons, swimming pools and public baths, for example. It also noted that China's five-year action plan against H.I.V. and AIDS fell far short of the United Nations goals for combating the worldwide spread of the epidemic.
