Provinces Undermine Beijing's Goals on AIDS

A man who answered the phone at the Henan High People's Court acknowledged that the court's refusal to take such cases was an unofficial policy but said that there was no formal document outlining the practice. In China, it is not unusual for an internal directive to be handed down instructing judges -- all of whom are appointed by the Communist Party -- not to take certain cases.

"Courts in Henan stopped getting involved in AIDS cases two years ago," said the man, who gave his surname as Wang. "It's hard to deal with AIDS cases. There are many people who have contracted AIDS in Henan, and it has gone beyond hospitals' capability to compensate them. This is the business of the state government."

Nonprofit AIDS groups have exploded in number from about 50 seven years ago to more than 300 today, but their ability to effect change is limited. Local governments do not trust the groups because they are not directly under the control of the authorities. Meanwhile, officials who welcome international aid are often suspicious of domestic nongovernmental organizations that receive funding from foreign groups.

As a result, many nonprofit groups are struggling to avoid government scrutiny. That task is made more difficult during a politically sensitive time -- the Communist Party Congress is next month, and the Summer Olympics in Beijing are less than a year away.

Not every province has failed to use caution or heed the central government's AIDS policies. In July, Hunan province decided to require entertainment industry workers to have AIDS tests every three months because the percentage of people infected with HIV through sex has more than tripled since 2005, according to the New China News Agency.

In Hubei province, the aid group Doctors Without Borders has been running an HIV-AIDS program in the city of Xiangfan since 2003. In a sign of its success, it will be handed over to local health authorities by the end of March 2008, said Luc Van Leemput, head of mission of the group's Belgian section. But in Henan, the group has tried for many years to develop an assistance program without ever getting a green light.

International nonprofits donate money to China with the instruction that it be spent for work with local or domestic groups, but little of the money is actually reaching the grass-roots organizations, activists say. In a system that lacks transparency, money just disappears.

Central government officials "should be very strict about implementing their policy. If they don't establish a transparent policy, how do you know that the money at a local level will be used properly?" said Wan Yanhai, a former Health Ministry official who is now a leading AIDS activist and who was detained by Beijing public security officials last November. The money currently available is "far from enough to allow NGOs to have meaningful and comprehensive, preventative programs. Most of the money is taken away by government or government-controlled NGOs, and no one knows how it's being spent."

Aside from this, nonprofits' operations are being restricted at local levels. Last month, two AIDS conferences were canceled in the southern city of Guangzhou and one in Henan province. In addition, two offices of an AIDS group in Henan were shut down by police. The director of one of the offices was taken into custody; employees at the other were threatened with violence.

"Two police officers came to our office, threatening that I should leave 'as soon as possible,' " said Zhu Zhaowu, manager of the group, China Orchid, in Kaifeng. "When I asked why, they said that the public security situation in Kaifeng was not very good, and we should be careful in case some bad guys from underground organizations endanger us."

As nonprofit groups struggle to help, many Chinese with AIDS struggle to survive.

For now, Li, the mother of the 13-year-old with HIV, depends on loans from relatives and neighbors to help pay for her daughter's care. She has demanded compensation from the hospital but has not received it. She has been told she can't file a lawsuit. And she gets no free medicine. National policies have not reached her family.

The explanation, according to Henan's best-known AIDS activist, is simple. "The government's AIDS policy is superficial. It cannot really be implemented," said Gao Yaojie, a retired doctor who exposed the blood-sale problems in the province. She was allowed to fly to the United States in March to receive an award only after international pressure.

"There is a saying in the countryside," Gao said. "The village tells lies to the township government; the township tells lies to the county government; the county tells lies to the state council; the state council issues a document; the document is read by all levels of the government. After they finish reading it, they go into a restaurant, and the document is never put into practice."

Researchers Jin Ling and Li Jie contributed to this report.