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China: AIDS Spreads As Authorities Sharpen Their Struggle

(RFE/RL) PRAGUE, October 18, 2006 (RFE/RL) -- A senior Chinese health official says China is becoming "like Africa" in that HIV/AIDS is beginning to spread through the community. The official, deputy head Hao Yang of the bureau of diseases prevention at the Ministry of Health, says that there are 190 new cases of AIDS every day in China, and that now it must be considered a "generalized epidemic."

Hao says HIV/AIDS is no longer centered only on high-risk groups like prostitutes, homosexuals, and intravenous drug users.

Instead, it is spreading through the broader community by means of heterosexual sex. Hao told Reuters that half of new AIDS cases now occur in the general community, and almost 1 percent of pregnant women in high-prevalence areas are infected -- a statistic he characterized as "very high."

The government in Beijing, recognizing the difficulty of overcoming AIDS, is aiming to at least contain the total number of infections by 2010 to roughly double the current total.

Hao's comparison of China with Africa was a reference to the way AIDS has long been transmitted through the whole of society in many African countries, producing the highest rates of infection in the world.

Systemic Problems

Ole Hanson, an adviser to the United Nations UNAIDS office in China, told RFE/RL that the Chinese health system needs an overhaul to allow it to cope with AIDS and a number of other infectious diseases -- such as tuberculosis, bird flu, Malaria, and hepatitis.

"It is well recognized, both by the Chinese authorities and other stakeholders, that the health sector is in dire need of reform -- there are problems with financing, [and] there are some problems with poor people's access to health care, especially in rural areas," Hanson said.

The Chinese authorities initially underestimated the importance of AIDS. But they have committed increasing effort and resources to the fight in the last few years. Hanson says the task is daunting.

"In a huge country like China, with a lot of economic problems, it's very difficult to control an epidemic like AIDS," Hanson said.

Reporting Gap

Official figures put the number of people infected by HIV/AIDS in China as 650,000, a comparatively small figure given China's population of 1.3 billion people. But there is thought to be underreporting of new cases -- particularly from rural areas, where some officials are reluctant to admit a problem, and where sufferers seek to avoid stigma.

"Where the problems might arise is on a local level, where local counties and provinces -- although some provinces are very progressive and active in the fight against AIDS, and I can mention here Yunan, Sichuan, Guangxi, and Guandong -- they have a lot of progressive intervention programs. But some other provinces are not quite on the same page, and are less eager to engage and to allocate funds in the fight against AIDS," Hanson said.

The government in Beijing, recognizing the difficulty of overcoming AIDS, is aiming is to at least contain the total number of infections by 2010 to roughly 1.5 million, about double the present total.

Low Awareness

One problem has been the lack of information and public awareness about the disease. A recent survey showed that one in five Chinese had never heard of AIDS.

Authorities are not always sympathetic to efforts to increase public awareness. Police in Harbin were angered by a public lecture staged by the local branch of the Center for Disease Control, at which dozens of prostitutes were given free condoms. According to the "Beijing News" newspaper, the police found the lecture inappropriate.

AIDS is one of the newer diseases that have reached global proportions in just a few decades. But a senior research fellow at the Center for Disease Control, Wang Ruotao, told a medical conference in Beijing on October 13 that China is unusual in that it suffers both the modern "lifestyle" ailments and ancient afflictions.

Wang said the rapid industrialization of the past two decades has produced illnesses of the advanced urban world -- like heart disease, high blood pressure, diabetes and cancer -- while in the countryside the traditional diseases remain as they were for thousands of years.