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China Now Facing an AIDS Epidemic, a Top Aide Admits
By ELISABETH ROSENTHAL

BEIJING, Aug. 23 - Departing from the Chinese government's general reticence on the subject of AIDS, a senior official openly admitted today that China was facing an epidemic that threatened to outpace government efforts to control it.
The official, Deputy Health Minister Yin Dakui, also conceded the government's failure to develop effective education programs and the tendency of some local officials to cover up the extent of infection in their jurisdictions, allowing the disease to spread unchecked.
"Like many other countries we are also facing a very serious epidemic of H.I.V.-AIDS," Mr. Yin said, adding that the government had "not effectively stemmed the epidemic."
Mr. Yin's 90-minute news conference - the first by a top Chinese official on the topic - was the latest in a series of small steps suggesting that China is ready to address more openly a topic that has been mostly taboo.
At today's news conference, Mr. Yin insisted that China's epidemic of H.I.V., the virus that causes AIDS, was still relatively small - but he also released some alarming new statistics. Reported H.I.V. infections rose 67.4 percent in the first six months of 2001 compared with the same period last year, he said. And about 5 percent of drug users in China are now infected with H.I.V., up from less than 0.5 percent in 1995.
The government has decided to spend about $12 million annually for AIDS prevention and control, he said, as well as more than $117 million this year to improve blood safety. (By comparison, the United States government has budgeted $744 million for H.I.V. prevention in fiscal year 2001, according to the Centers for Disease Control and Prevention.)
Mr. Yin addressed some of the politically sensitive aspects of the AIDS problem, touching on China's shortcomings in dealing with the crisis forcefully and in time. "In some regions, leaders and the general public have not fully realized the hidden dangers of a large-scale epidemic," he said.
He also discussed, for the first time, an AIDS epidemic covered up in Henan Province, where tens of thousands of poor farmers have contracted AIDS by selling their blood using unsterilized practices.
Just last week, Mr. Yin held a widely publicized meeting with AIDS patients in the village of Wenlou, in Henan Province. It was the first time that such a high-level delegation had visited the area and the first time the situation had been featured in the mainstream state press.
Despite acknowledging a rapid increase in the number of people testing positive for H.I.V., Mr. Yin staunchly defended previous ministry estimates that 600,000 Chinese were infected with the virus at the end of 2000. And he repeated the goal, set by the central government this May, that China should contain the total number of H.I.V. cases to less than 1.5 million in 2010.
But a recent United Nations report estimated that already "above one million" Chinese had H.I.V. at the start of 2001, and that if current trends continue there could be 20 million by the end of 2010.
According to government data, almost 70 percent of those infected with H.I.V. are intravenous drug-users, although critics say that statistic may be partly a result of intensive testing in that group.
Government research found that the rate of needle-sharing among drug users in Jiangxi Province increased sharply in the 1990's, reaching 93 percent in 1999. Because health officials made inadequate efforts to stem the practice, H.I.V. spread quickly among addicts when the virus entered the population. Seventeen percent of drug users at one surveillance site are now infected.
Mr. Yin disputed accusations that the government had been previously unconcerned, noting that the government has had an office charged with overseeing sexually transmitted diseases and AIDS since 1996 and a plan for H.I.V. prevention and containment since 1998.
Mr. Yin became testy on the question of why the Health Ministry had not been more forceful in dealing with the epidemic among blood sellers in rural Henan Province. The bulk of H.I.V. cases there were contracted in the 1990's when poor farmers sold their blood at blood stations that, Mr. Yin admitted today, used unsanitary procedures.
Blood from farmers of the same blood type would be pooled and centrifuged to separate out the plasma, which was sold to make medicines like gamma globulin and albumin. The remainder of the pooled blood, mostly red cells, was reinjected into the farmers. This was to allow them to give blood more frequently, which many did several times a month for a fee of about $5.
While Mr. Yin blamed "underground and illegal plasma collection stations" for H.I.V.'s spread, he did not mention that many of these stations were owned or operated in collaboration with government bureaus, including the Chinese military.
The practice tailed off in the second half of the 1990's, in part because of a government ban on blood sales and in part because the farmers realized that it had infected them with a fatal disease.
But data on infection rates in the area remain sketchy, in large part because provincial officials have generally refused to let outside researchers conduct independent surveys, often forcing them to work undercover. Some Chinese journalists who have tried to report on the problem have been fired. Foreign journalists who have tried to visit the villages have been detained.
Because of widespread ignorance, people with AIDS generally face severe discrimination. Once a village gains the reputation of having an AIDS problem, its residents often have trouble selling their produce or even traveling on buses out of town.
Last April, the Henan provincial health department - together with the Health Ministry - tried to conduct a comprehensive survey of the village, although several people refused to participate. Of more than 1,600 people questioned, 568 reported that they had sold blood before 1995 and, of those, 244, about 42 percent, tested positive for H.I.V. Some previous studies had suggested rates as high as 60 percent for the village as a whole.