中国爱滋病统计：下对上保密 The High Cost of Selling Blood As AIDS Crisis Looms in China, Official Response Is Lax 中国爱滋病统计：下对上保密 【多维新闻社11日电】多维社记者周维诚报道/《华盛顿邮报》11日发表长篇文章介绍中 国爱滋病患者的悲惨处境以及中国爱滋病流行的严峻形势。中国官方最新统计数字说，全 国有二万多名爱滋病毒携带者，但卫生部副部长估计至少有六十万；专家警告，几年之内， 中国爱滋病毒携带者可能达到1000万。(chinesenewsnet.com) 文章指出，甚至中国官员都认为关于爱滋病人及其病毒携带者的统计数字不可靠。爱滋病 统计数字也同经济信息一样，被有野心的、腐败的或者胆小怕事的官员用来掩盖失败。许 多地区拒绝上报爱滋病真实数字，许多地区阻止中国研究人员进行试验或者进行防止爱滋 病的活动。(chinesenewsnet.com) 卖血和吸毒是中国爱滋病最大的传染渠道。中国云南省邻近“金三角”，是毒品流入中国的 必经之地，同时也是中国吸毒者和爱滋病病毒携带者比例最高的地方。图为一名中国缉毒 警在中缅边境的木康边检站钻进一辆油罐车进行检查，另外两位警察则在旁边协助。 (多 维社资料) 文章说，世界上其它地方的爱滋病主要是通过性滥交传染，但在中国，尤其是河南、河北、 安徽、陕西、湖北等地有卖血传统的农村，最主要的传染渠道是血贩子污染的针头。 (chinesenewsnet.com) 文章说，在河南省上蔡县访问爱滋病患者是一趟悲惨之旅：在暗淡的烛光下，她的脸就像 一个死亡面具：苍白、憔悴、没有表情。她的眼睛空洞。她那深沉的咳嗽发自充满粘液的 肺。她已经不能走路，整天躺在床上，盖著一床脏得发黑的被子。由于免疫系统跨掉，她 的褥疮也发生感染。由于她患爱滋病，她的家庭已经穷到丈夫没有十美元检查是否也被感 染。(chinesenewsnet.com) 文章说，过去这名叫刘银花的妇女和丈夫曾经依靠卖血脱贫、盖房子、支付医药费挽救了 儿子的生命。但刘也像中国中原地区数千名卖血者一样，感染了爱滋病毒。由于血贩子通 过多次使用的针头，把收集血液混合起来，抽出血浆之后，将剩馀部分再注射到卖血者的 静脉里，刘被爱滋病毒感染。(chinesenewsnet.com) 由于刘这样的病人，中国专家担心爱滋病流行。根据中国官方统计数字，吸毒是爱滋病感 染的最重要渠道；性传染，主要是卡车路线和大城市的妓女传染，只占一小部分；与全世 界其它地方都不一样的地方是卖血者传染的爱滋病比例高达百分之二十。 (chinesenewsnet.com) 中国缺乏关于爱滋病的知识和可靠数字，部分原因是政府长期忽视。例如，1996年中国政 府仅仅开支275万美元防止爱滋病，占印度的三分之一，占泰国的三十分之一。但去年科 学家警告，爱滋病流行所造成的损失可能抵消经济改革的收益时，政府领导人开始重视爱 滋病危机。(chinesenewsnet.com) 但几个月的了解显示，政府的决定、文化传统和政治习惯在某些情况下，仍然在加重危机， 继续妨碍解决问题的努力。(chinesenewsnet.com) 去年9月，卫生部发表的官方统计数字说，全国有20771名爱滋病毒携带者，比一年前增 长百分之三十七；741人患爱滋病，自1985年以来397人已经死亡。(chinesenewsnet.com) 但在同一天，卫生部副部长殷大奎说，中国爱滋病形势严峻，如果防治措施成功，估计到 年底爱滋病毒携带者人数将达到60万；如果不成功，将达到100万。中国研究人员说，他 们预计爱滋病毒携带者数量可能在几年之内达到1000万。 The High Cost of Selling Blood As AIDS Crisis Looms in China, Official Response Is Lax By John Pomfret Washington Post Foreign Service Thursday, January 11, 2001; Page A01 CHENGLAO, China -- In the flickering light of a skinny candle, her face looks like a death mask: pale, drawn, immutable. Her eyes are hollow. Her deep cough resonates through mucus-filled lungs. She cannot really walk anymore and spends her time lying on a bed, wrapped in a cotton comforter black with dirt. The collapse of her immune system means even her bedsores are infected. Largely because of her AIDS, her family is so poor that her husband cannot afford $10 to test himself for the disease. Things were not always this way. Time was when Liu Yinhua and her husband, Wang Deshan, thought selling their blood would pull them out of poverty. It built their house, and at one point the profits paid for medical care that saved their son's life. But Liu, like thousands of other poor farmers here in China's central plains, contracted AIDS by selling blood to dealers who reused needles, mixed blood products and, after separating out the plasma, reinjected infected blood into her veins. Partly because of people like Liu, Chinese experts worry that an AIDS epidemic is erupting here, 15 years after the country's first recorded death from the disease. Drug users account for most of the cases, according to official statistics. Sexual transmission of the AIDS virus -- via prostitutes along truck routes and in major cities -- is responsible for a small percentage. But unlike in other areas with high infection rates, such as Africa, many Chinese with AIDS -- up to a fifth of the total -- contracted the disease by selling their blood. Knowledge and solid numbers about AIDS here are sketchy, in part because the government has spent years ignoring its looming AIDS crisis. In 1996, for example, the government spent $2.75 million on AIDS prevention, one-third of India's spending and one-thirtieth of Thailand's. But the leadership woke up to the crisis late last year after several Chinese scientists warned that the potential economic losses from an AIDS epidemic would erase the gains made by economic reforms. Still, a months-long attempt to understand China's AIDS crisis indicates that government decisions, cultural traditions and political customs have in some cases worsened the crisis and continue to retard efforts to deal with it. Statistics in China on AIDS and HIV, the virus that causes AIDS, are considered unreliable even by Chinese officials. AIDS statistics, just like economic information, have been used by ambitious, corrupt or scared officials to cover up failure. Many regions refuse to report true AIDS figures; many of those same regions have blocked Chinese researchers from testing and carrying out AIDS prevention campaigns. The Health Ministry released its official statistics in late September: 20,711 HIV carriers, up 37 percent from a year earlier. It said 741 had AIDS and 397 AIDS patients had died since 1985, when China's first AIDS death occurred. But the same day, Deputy Health Minister Yin Dakui called China's AIDS situation grim and predicted 600,000 people would be infected with HIV by the end of the year if prevention and treatment were successful and 1 million if they were not. He Xiong, an AIDS prevention official, believes China already has at least 1 million HIV-infected people. Chinese researchers say they expect that number to balloon to 10 million in a few years. A Journey of Sadness Zhao Pinfu is well-known in the villages around Chenglao, where he operates a small health station. Wherever he goes, local farmers come out to greet him, calling him by his given name. Zhao has been instructed by local officials not to help anyone who comes to the area to study AIDS problems. "They say it's bad for investment. They say it's bad for China's name, but this problem is killing people," he said. "Someone is responsible for this problem. Someone really should pay." A trip with Zhao through a section of Shangcai County in southern Henan province, a region of small wheat and onion farms 600 miles south of Beijing, is a journey of sadness. "In that one 15 people died, there seven, there eight." Zhao is pointing left, right and straight ahead to hamlets split by small streams, covered in fallen leaves. "Just a few months ago a woman came to me. She was eight months pregnant. She was experiencing nonstop diarrhea -- that's a sign for us that it's AIDS. We tested her. She was positive. She got rid of the child. She died a little later." While AIDS is generally contracted through sex or drugs in the rest of the world, it came into Chenglao and the rest of Shangcai County by blood. For decades people from Shangcai and other counties in Henan, Hebei, Anhui, Shanxi and Hubei provinces relied on selling blood to pad out a lean year or to live a little better in a fat one. China's government used to force its citizens to give blood, but after economic reforms in 1978 donations fell off and a market in blood emerged. Farmers in Chenglao, for example, said they have been selling blood since the early 1980s. Before a government crackdown in 1996, they said, they routinely made $250 a year for about 80 sales of one to two pints each, equal to their income from farming. The blood market got a massive boost in 1993, according to a senior Chinese scientist, when then-Health Minister Chen Mingzhan approved a plan to export blood products to earn foreign exchange. Demand shot up. Foreign firms began buying Chinese blood, as did Chinese blood companies, many linked to the Chinese army. Middlemen appeared, called blood heads, who bought blood from farmers and sold it to hospitals, blood banks and blood product companies. "This decision created a massive new demand for blood," the scientist said, speaking on condition of anonymity. "Blood heads rushed into these villages and began using new techniques to get more blood faster. Blood companies were right behind them pressing them for more blood." One technique involved removing the valuable plasma from the blood and then returning the blood to the sellers' veins so they could give blood again sooner. To save time and money, blood heads would often hook several sellers of the same blood type up to one machine, taking their plasma but mixing their blood. When AIDS entered this equation, the results were disastrous. No testing was done for HIV in the beginning. Shangcai County is now believed to have as many as 10,000 HIV carriers, a local health official said. The senior scientist said his figures indicate hundreds of thousands of blood donors all over China were infected in this way. He and other researchers say the blood market was a major catalyst for the AIDS explosion in China. In 1993, China had 10,000 HIV-positive people, he pointed out. They were overwhelmingly drug addicts and sex workers, considered easy to control. By the end of 1994, a year after the export craze began, the problem had exploded. And by 1998, AIDS, which had once been confined to Yunnan, Beijing, Shanghai and Guangdong, had spread to all 31 provinces and major cities in China. Officials first noticed a problem when batches of blood from Guan County, near Beijing, turned up carrying the AIDS virus at the end of 1994. The National People's Congress passed laws in 1995 and 1998 seeking to halt the selling of blood and reestablish the donor system. But many Chinese do not like giving blood, considering blood sacred. So blood banks and hospitals -- and China's vast pharmaceutical industry -- are still short. Blood selling continues. And testing, while in theory mandatory, is still not widespread. Chinese newspapers and magazines began reporting on the connection between AIDS and blood sales in August with publication of a shocking article in the official China News Weekly. Southern Weekend, one of China's most popular weeklies, devoted a full edition in November to AIDS and the tribulations of infected blood sellers in Henan. The Health Ministry does not publicly acknowledge the importance of blood selling to the AIDS problem. But in its latest statistics, researchers say, lies a secret. Those statistics say 72.1 percent of Chinese with HIV were infected by sharing needles for drug use and 6.8 percent were infected through sex. The cause of remaining 21.1 percent is labeled "unknown." That, according to Southern Weekend, is a euphemism for blood. "Of course they won't acknowledge it," the senior scientist said, "but they made serious mistakes. One day, just like in Japan, France, Canada and other countries where HIV entered the blood banks, these people will pay." Sex Industry Growing Throughout the 1,600-mile trip from Guangzhou to Beijing along Highway 107, China's main north-south artery, the roadside is dotted with dance halls and brothels servicing truckers. The Chengang Hotel is one of them, run by a former officer in the People's Armed Police. "This place is amazing!" confided Liu Tieming, a trucker from Tianjin. "Really amazing. The girls do anything you want!" Although the Health Ministry says only 6.8 percent of those carrying HIV in China got it through sex, He Xiong, the government AIDS prevention official, says sexual transmission is rising, especially on China's richer east coast. One reason is that Chinese are increasingly embracing a more relaxed lifestyle. Premarital sex is the norm now for China's urban middle class. And China's sex industry is growing fast. A U.N. study found 57 percent of prostitutes in China say their partners never use condoms. The figure is 70 percent in Beijing. Another study showed men were willing to pay more for sex without condoms. "Chinese men don't like them," said a woman of 19 who called herself Flower Bud and works at the Chengang. "What can we do about it?" According to a recent Chinese poll taken in 60 cities, only 3.8 percent of the population understands how HIV enters the body; 80 percent, if they know of AIDS, think one contracts it through the air. A survey of doctors in eight cities indicated medical professionals know little more about AIDS than other citizens. Now, however, Chinese actors and other stars are speaking out about AIDS. Backed by the United Nations and the World Bank, China has launched education projects with sex workers in certain areas and is distributing condoms. Another step is distributing single-use needles or orally administered heroin substitutes to drug addicts. But police have slowed that measure, arguing that it encourages drug use and does not necessarily prevent AIDS. A Teenager's Ordeal Song Pengfei was barely a teenager when he received a transfusion of tainted blood from a blood head in his home town in Shanxi province after a doctor mistakenly cut into an artery during a routine medical procedure. Two years ago, the waif-like teenager became one of the first Chinese to publicly acknowledge he is infected with HIV, a bold move in a society still struggling with how to deal with the issue. At first China's media embraced the boy and there was hope among Western AIDS specialists that Song could play a role similar to that of Ryan White, the young hemophiliac AIDS patient in the United States who died in 1990. But in April 1999 the hospital in Shanxi that had been paying for his medical treatment cut Song off, saying it did not have the funds. After reports appeared about Song in the Western media, an American charity, the Phelex Foundation, stepped in; it is paying for the "cocktail" of drugs designed to suppress AIDS from a Saving Song Pengfei Fund. In October 1999, when Song traveled to Malaysia for an international conference on AIDS to highlight China's blood supply problems, the Health Ministry launched an investigation to determine how he was invited and how he was allowed to leave China. A whispering campaign began, charging that Song was being used to denigrate China. China's state-run media do not write about Song anymore. "Before, the government said AIDS was only a problem for prostitutes and drug users. The rest of China wasn't supposed to have AIDS," said Song, who lives in a drafty one-bedroom apartment with his mother and father in Beijing. "But I was an example of how AIDS is inside the rest of China." "This child had the courage to stand up and say, 'I have AIDS,' " said his father, Song Xishan. "You should encourage him. You should use him as a model of how not to get AIDS, a reminder of the dangers. Instead, they politicized the issue, not us." Song's case illustrates how China's political sensitivities and government fears about liability have held back efforts to control the spread of AIDS. Chinese researchers, for example, have been blocked for years from testing for HIV in Henan and other provinces. Tipped off by a student about the problem in southern Henan, a doctor from Wuhan, Gui Xien, went to villages in July 1997. He tested 11 people; 10 tests came back positive, Chinese media say. He then offered a county health department free AIDS tests. The health department refused. Gui sneaked back into villages two months later and did follow-up tests. Of 140, about 80 came back positive, the media reports said. Gui addressed a report to the Henan provincial government, which ignored it. In October 1999 he went to Beijing with the results of subsequent tests; only after one of China's vice premiers, Li Lanqing, wrote comments on the side of his paper did Henan acknowledge that it had a problem. Back in Chenglao, Wang Siying and his wife, Liu Sanyi, who have sold blood for 30 years between them, have pulled their 14-year-old daughter out of school because they cannot afford tuition. Their 9-year-old son will probably drop his studies, too. In September, Wang, a 38-year-old former soldier, noticed a ring of blisters around his waist. A low-grade fever set in. Wang got himself tested. He unfolded a piece of rice paper: HIV positive. "Blood built my house. Blood built all of the houses of this village," Wang said. "Now blood is killing us." ? 2001 The Washington Post Company