Provinces Undermine Beijing's Goals on AIDS

"The government's AIDS policy is superficial," says medical activist Gao Yaojie, shown in a February photo. (By Greg Baker -- Associated Press)

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By Maureen Fan
Washington Post Foreign Service
Wednesday, September 19, 2007

MIANCHI, China -- Twice a week, just after school lets out in this small county in Henan province, a 13-year-old girl with a short bob and wide smile holds her parents' hands and walks two blocks down the street into the harsh fluorescent light of an emergency medical station.

There, she pulls back the waistband of her pants while a nurse dabs disinfectant, prepares a syringe and gives the girl's right buttock a quick jab. "It doesn't hurt," the girl said after a recent visit. "I'm used to it."

The girl, whose parents asked that her name not be used, has HIV, which they say she contracted through an unnecessary blood transfusion in 1995. Despite early symptoms suggesting she had the virus, doctors at the hospital that treated her said her problems were minor and unrelated to the transfusion. They gave her anti-inflammatory drugs and blister cream.

Not until March, when the family turned to another hospital in neighboring Shaanxi province, did doctors test the girl and determine she had HIV. "At the time, I almost collapsed. I just didn't want to live," said the girl's mother, who asked to be identified only by her surname, Li.

The girl's experience is hardly unique in China, where despite official pledges at the national level to care for people with the virus that causes AIDS, local hospital and government officials frequently express reluctance to do so. Some fear having to compensate people who contracted the virus through blood transfusions, a common method of HIV transmission in China. Others fear that the publicity of AIDS cases will hamper local investment.

Communist Party leaders long treated AIDS as taboo. In recent years, however, China has won praise from the West for campaigns to raise awareness. In 2003, the government promised free HIV testing and counseling for all who wanted it, and free antiretroviral treatment for the poor. That year, Premier Wen Jiabao made headlines after being shown on state television shaking hands with AIDS patients.

And yet hospitals like the one here in Mianchi County not only fail to offer to test for HIV, they deliberately misdiagnose and cover up the problem, according to experts and Chinese who have contracted the virus.

They say the gap between the national official position and the practices of local officials is the result of a political system that makes it difficult to impose reform at a grass-roots level. The central government has the means to curb the epidemic, they say, but the control and corruption inherent in a one-party system prevent courts and state-run news media from uncovering abuses.

The stakes are high. Experts fear that inaction by local officials in China is already contributing to spikes in the incidence of HIV-AIDS, which has spread from high-risk groups such as drug users and prostitutes to the larger public. There were 18,543 new cases of HIV reported in the first six months of this year, nearly as many as for all of last year, according to the official New China News Agency. China's estimate of 650,000 AIDS cases, among a population of 1.3 billion people, is extremely low, domestic and international AIDS groups say.

Here in Mianchi County, the lack of cooperation on AIDS issues extends to the judicial system. Henan province was the center of a scandal in the 1990s, when the selling of blood at unsanitary, often state-run health clinics led to an estimated 300,000 people being infected with HIV. Today, as many of those people seek compensation, they are being turned away by authorities who say that the national government's promise of free treatment has let local jurisdictions off the hook.

Zhou Xihong, a lawyer who has tried to help Henan families whose children have HIV, said the position of local officials was made clear to him when he went to court recently.

"They said AIDS patients can get free treatment, so the court doesn't have to process their cases," he said. "The rule is illegal. The right of action is the most basic right for people."


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