Former President Clinton warned Monday that the hard-won progress China has made in building its economy and expanding its middle class could erode if its AIDS problem isn't brought under control.
"China has come too far to see the future of millions of its people derailed over this," he told delegates at a conference on AIDS and SARS at Tsinghua University in the Chinese capital. "You need leadership and resolve."
Faced with serious threats of infectious diseases, China is at a crossroads on how to respond, delegates said. On the one hand, the recent severe acute respiratory syndrome crisis has made clear that complacency on health-related issues carries a high price. Beijing has increased resources in recent months for AIDS patients and has promised to reduce bureaucratic barriers to effective treatment.
At the same time, however, AIDS patients still bear enormous stigma in China, and no senior officials have thrown their clout or prestige behind efforts to tackle the problem.
"The top leaders could help everyone by articulating their position clearly," said David Ho, president of the New York-based Aaron Diamond AIDS Research Center, which hopes to test an AIDS vaccine in China, the world's most populous nation. "This is a giant tanker that takes time to put in the right direction."
Clinton sought to lead by example, breaking from the script during a largely predictable question-and-answer session by calling HIV carrier Song Peng Fei to the podium, shaking his hand and praising him for his bravery in speaking out. Song, the first Chinese in the country to publicly admit he had HIV, has received little support from government officials.
Clinton also held meetings with senior Chinese leaders Monday during which he was expected to raise the issue. At the conference, Clinton called for more affordable drugs to fight AIDS. "This medicine issue is an international scandal," he said. "Money shouldn't determine who lives and dies from AIDS."
Despite the conference's joint billing for AIDS and SARS, delegates said the far greater long-term threat appeared to be AIDS. The pneumonia-like SARS disease killed about 800 people in the last year, mostly in China, and crippled tourism and business, but AIDS kills that many worldwide in a two-hour period. A related concern is that improper administration of drugs in China will lead to new strains of HIV, the virus that causes AIDS, that are highly resistant to medicines.
About 840,000 people in China have been infected with HIV, according to government statistics, although some independent analysts put the figure at nearly twice that. The figures are still modest relative to China's 1.3 billion population, but the rate of growth among certain groups is alarming, including sex workers, drug users in Yunnan province and people who have had contact with infected blood donors in Henan province. Some experts believe China could have 15 million cases by the end of the decade if serious steps are not taken.
Fujie Zhang, treatment division director with China's national center for the control and prevention of AIDS and sexually transmitted diseases, outlined several steps China had taken recently to tackle the problem. These include slashing customs duties on imported drugs, exempting promising drugs from clinical trials and granting subsidies to rural clinics, he said.
Last week, China announced it would give free AIDS treatment to 5,000 HIV and AIDS patients unable to afford it and would allocate $820 million for AIDS treatment.
But the scope of the problem, like so many others in China, is enormous, linked intricately to other complex issues such as rural poverty, superstitions and inadequate education.
"We must educate the general public about the lies by quacks and charlatans," said Gao Yaojie, a doctor credited with blowing the whistle on an HIV epidemic in Henan province. "Many HIV patients stick with superstitions, believe they can call people from the underworld -- and think they can be cured."
Gao said her patients are shunned and otherwise mistreated by their communities. They go to one funeral after another, she said, and no one will accept children who have been orphaned by the disease.
On the Internet on Monday, several hundred people posted comments on Clinton's speech. "I've never seen a Chinese leader shake hands like this with AIDS patients, ever since I was born," said one. "This is greatness."
A few were less complimentary. "He's not a doctor," said another. "What is he here for?"