Politics & Policy

Blind Red Eye to Devastation

China's AIDS problem.

It is common knowledge that the AIDS virus is devastating Africa. There is even concern that it is taking hold in parts of Russia, South East Asia, and Latin America. But Harvard University demographer and American Enterprise Institute fellow, Nicholas Eberstadt, has recently explained how China, the most populous county in the world, might also have a significant problem.

What makes the Chinese AIDS problem so potentially dangerous is the attitude of the Chinese authorities themselves. The official number of Chinese cases was one million in 2002, but according to Eberstadt’s estimations, based on internationally respected sources, it’s closer to two million, and maybe even higher.

Were China an open society, with a good track record in transparent sharing of health information, perhaps one would be skeptical of his figures. But the reality is that China recently hid much information about its SARS epidemic. The Chinese government restricted foreign access to data about the extent of the epidemic, it fired officials who wanted to come clean, and it failed to institute sufficient monitoring of hospital cases and infected travellers until it was too late. Thousands of cases and hundreds of deaths were the result. Yet, at a meeting at AEI late last year, Dr. Yu Yunyao, vice president of the Party University of the Central Committee, ignored the failures and said that SARS actually demonstrated the “success of [Chinese] leadership.”

Given the SARS shambles, one is likely to be more concerned about the veracity of Chinese government figures, and the honesty of officials representing that government. Even apparently independent figures within the universities are probably told to toe the line. Professor Jiang Xiaochuan, also of the Party University, backed the official figures. He defended the government’s record and claimed that Chinese officials have been concentrating on controlling “drug traffickers since much transmission occurs through them.” But he would not be drawn on the lack of public education about the transmission of the disease and how to avoid it.

Unfortunately, China has dodged the kind of leadership that has been evident in every country that has successfully brought AIDS under control. Uganda, Brazil, and Thailand are countries that have had some success in reducing both infection rates and the numbers of deaths from AIDS. Uganda, for instance, reduced its infection rate from over 22 percent to less than 6 percent by promoting abstinence, faithfulness to ones’ partners, and the use of condoms. The Brazilian government provided free drugs to those infected and educated the sexually active population in how to minimize the risks. From the king on down, Thailand has done similar work with generic drugs and education, coupled with considerable work on sex education from foreign medical experts.

Eberstadt’s implied criticism of the Chinese government appeared to be lost on many of the Chinese delegates attending the meeting. But without better and more effective leadership it is unlikely that numbers will be contained on the Chinese mainland. And there is currently not one political figure taking a strong position within the government.

According to Eberstadt, by 2010 there could be as many as thirty million cases in China, and by 2025, as many as 46 million. There could be sixty million Chinese dead from AIDS by 2025. The economic impact will be huge. With most AIDS victims being of working age, there is likely to be a significant slowing of GDP growth, which has been running at well over 5 percent annually for over a decade. With tens of millions of cases, GDP growth could be reduced by several percentage points, and ironically result in an increase of unemployment, even as so many job vacancies fall open. Those able to work will be unqualified to take up some of the senior jobs, productivity will fall, and the unqualified will then be unemployable.

Rather missing the point of forecasts, Dr. Xiaochuan said that it was premature to predict the situation in 2025. But then he proceeded to claim that “I don’t think the situation will be that serious.” Now Eberstadt, as well as most sensible people, is skeptical of predictions, even his own. But, as he pointed out, previous predictions for Africa have turned out to be understated. In a continent now with 28 million cases, few people in the early 1990s predicted that it would be anywhere near as bad as that by 2004. And like many African officials, Chinese ministers have continued to be in denial about the seriousness of AIDS.

China’s membership of the World Trade Organization and its impressive development have helped spur world growth over the past decade. But if China doesn’t control its burgeoning AIDS problem, then the world, and not just its own population, will suffer from lower growth, and also, as happened with SARS, run a greater risk of widespread infection.

Dr. Roger Bate is a director of health-advocacy group Africa Fighting Malaria and a visiting fellow of the American Enterprise Institute.

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