Ministry of Health Ranks HIV/AIDS Deadliest Infectious Disease in China, Government Harassment of Advocates Continues

December 18, 2009

December 1, 2009, marked the 22nd annual World AIDS Day. HIV/AIDS was first officially reported in China in 1985, but reached epidemic proportions in rural areas in the early to mid-1990s due in part to tainted blood transfusions conducted at makeshift blood and plasma donation stations set up by enterprising businessmen and government officials. Medical procedures in these facilities reportedly were deficient: needles and tubes reportedly were reused, blood from multiple donors was mixed, and once plasma had been removed, re-injected into donors of the same blood type. Such practices reportedly resulted in the spread of blood-borne diseases including HIV. HIV/AIDS continues to spread throughout China today through a variety of channels. Many who provide assistance to or who advocate on behalf of people living with HIV/AIDS in China face government pressure, including harassment and other forms of abuse, as detailed below.

Current statistics

In February 2009, the Ministry of Health (MOH) announced that HIV/AIDS had become the deadliest infectious disease in China. The MOH and UNAIDS estimate the number of people living with HIV in China to be between 560,000 and 920,000, and the number of people living with AIDS to be between 97,000 and 112,000, according to a November 24 MOH report. These estimates far exceed actual statistics cited in the same report. UNAIDS reported in November that "it is estimated that fewer than one in three people living with HIV in China have been diagnosed." While problems surrounding diagnosis―including general social stigma, fear, and discrimination―discourage individuals from getting tested (see UNAIDS China Stigma Index) and may obstruct statistical accuracy, "under-reporting" of cases in China also is a major problem, according to a February 28 article in the international medical journal, The Lancet.

Transmission of HIV/AIDS in China

HIV/AIDS is spreading today in all of China's 31 provincial-level jurisdictions through a variety of channels, according to international AIDS charity AVERT's Web site. Dr. Gao Yaojie, Chinese gynecologist and whistleblower of the 1990s HIV/AIDS epidemic in rural China, suggested in her written statement for a December 3, 2009, Commission roundtable that "rampant" underground "blood trading" may be the main avenue of HIV/AIDS transmission in China. This mode of transmission, however, is not mentioned in the UNAIDS November AIDS Epidemic Update. The report instead charges that "heterosexual transmission has become the predominant mode of HIV transmission," and that a low rate of condom usage in the sex industry plays a key role in HIV/AIDS transmission in the region. According to the report, "In China, 60% of female sex workers do not consistently use condoms with their clients." Other key modes of transmission mentioned in the report include needle-sharing among intravenous drug users, unprotected sex between men who have sex with men (MSM), unsafe practices in the migrant worker population, and mother-to-child transmission. According to a May 1 address by Joanne Csete, Director of the HIV/AIDS and Human Rights Program at Human Rights Watch, government harassment of potential HIV/AIDS advocates makes it difficult to obtain an accurate picture of the epidemic in China. Csete remarked that "the government consistently has sought to suppress the history of massive HIV infection through state-run blood plasma collections, of which we are likely never to know the true scale and the true cost in lives. This history has made HIV even more taboo in public discourse, as though sex and drugs didn't make it taboo enough."

Government Response to Civil Society Action

While non-governmental organizations and individual activists play an important role in HIV/AIDS education, prevention, and treatment in China, official treatment of them often is harsh and repressive. According to the Commission's 2009 Annual Report (p.203), the Chinese government continues to exert control over advocates' right to associate with strict requirements that limit organizations' ability to legally function independently from the government. Individual HIV/AIDS activists also continue to face serious obstacles in their work, including arbitrary detention, harassment, surveillance, intimidation, restrictions on travel, and other violations of their fundamental human rights. Examples of HIV/AIDS activists who have been subjected to such government pressure in the past year include:

  • In February 2009, authorities attempted to prevent Dr. Gao Yaojie from meeting with U.S. Secretary of State Hillary Clinton, according to Dr. Gao's written statement for a December 3 Commission roundtable. Authorities cut her telephone line in May following news that she was to receive a French human rights award for women, according to a November 29 ChinaAid statement. Dr. Gao left China for the United States in August, hoping to find a "peaceful environment" in which to finish her three books and reveal "the truth about the AIDS epidemic in China," according to the statement.
  • On August 4, Asia Catalyst reported that Chinese police seized the passport of an unnamed Chinese AIDS advocate and prevented him from leaving the country to attend the International Conference on AIDS in Asia and the Pacific, to which he was invited by UNAIDS. According to the report, he was warned that if he spoke to the media and international organizations, he would "face the same fate as Hu Jia."
  • HIV/AIDS advocate Hu Jia continues to serve a three-and-a-half year prison sentence for "inciting subversion of state power." He is expected to be released on June 26 or June 27, 2011. On November 17, 2009, Hu's wife Zeng Jinyan reported on her blog that she and her daughter were still under "soft detention" in their home, and were being monitored by seven or eight domestic security protection officials sitting outside the building.
  • On December 2, Chinese Human Rights Defenders reported that Beijing authorities detained Henan activist Tian Xi, who reportedly was infected with HIV in 1996 through a hospital blood transfusion, after he unfurled a banner outside of the Ministry of Health on November 19. Officials then forcibly returned him to his home in Gulu township, Xincai county, Henan province, where he remains under 24-hour surveillance, according to the report.

For additional information on the spread of HIV/AIDS in China and government pressure on advocates, see Section II―Public Health in the Commission's 2009 Annual Report.