OPINION | Dirty Blood
On World AIDS Day, a day dedicated to raising public awareness of AIDS, the Chinese government alleged that the roots of AIDS infection in China are sexual transmission, drug uses, and prostitution. However, one major cause of widespread transmission of AIDS — the blood trade — is too sensitive to be brought to light.
In the 1990s, Henan, a central province in China with a population of 90 million, developed a plasma economy, and thereby millions of people were infected through unsafe blood transfusion, or blood pooling. With the discovery of a lucrative opportunity to export plasma, the Chinese government encouraged villagers to sell their blood with the slogan that “giving blood is glorious.” [1] Many blood stations, both public and private, were set up in Henan Province. The blood of villagers was pooled together for the extraction of plasma, which meant that, if a few were HIV-positive, the whole pool would be tainted. The re-injection of the remaining pooled blood cells back into the donors led to the widespread transmission of HIV. [2]
These poverty-stricken villagers had no idea of the risks. They rushed to sell their blood to get fast cash, unaware of the consequences of unsafe injection practices.[3]
Mr. Zhu, a farmer from an AIDS village where the majority of the residents contracted HIV and many died from it, told Liu Qian, a researcher from Henan Social Science Academy, “I am desperate! As an ordinary person, I have to pay the family-planning penalty and agricultural tax, and take care of my children, and my sick father. My life is very difficult, or I would not have sold my blood!” [4]
However, poverty was not the sole cause. Some Henan health officials and their families were implicitly involved in the blood industry and profited from it. According to pseudonymous AIDS activist He Aifang, Liu Quanxi, the director of the Henan Health Bureau, launched a big campaign to develop blood stations in 1993, alleging that selling blood would economically improve farmers’ living conditions. Liu invested his own capital in blood stations in Henan and invited his family members to set up blood businesses.[5] The circulation of the contaminated blood from these blood stations exacerbated the AIDS epidemic.
When blood donors were found to be HIV-positive, Chinese government officials, including Liu Quanxi, pressured outspoken local patients, doctors, other activists, and the media into silence. In the late 1990s, the provincial heath officials started to shut down blood stations that were sponsored by the government. This crackdown led to the emergence of the black market, and the farmers turned to “blood heads (xuetou)” to subsist.
In 2001, the Vice Minister of Health Bureau admitted the illegal blood collection centers and the involvement of some government officials, and maintained that the spread of HIV had been suspended. However, it was far from being controlled: the contaminated blood bank had crept into other provinces, hidden from official supervision. The epidemic is much severer than it appears, despite continuous efforts to stop it. The real number of those infected may be much higher than the estimate.
Pressured by the international AIDS conference in November 2001, the Chinese government initiated assistance policies to restrain the spread of AIDS, the “Six Ones Projects,” which aimed to improve infrastructure in 38 “key villages” with most severe infections and to subsidize infected families.
Nevertheless, the anti-AIDS projects did not produce the intended results. The public facilities in those communities were only used for showing visitors and the public that the government was determined to fight against AIDS. Many villagers reported that they received no financial aid. Corruption and embezzlement of donations were prevalent in Henan.
Strikingly, the health authorities responsible for the incident have not been punished, instead adopting these projects as propaganda tools to get themselves promoted to higher rankings. In 2003, Liu Quanxi was promoted to head a provincial committee on health, education, and culture for “his contributions to the development of the province’s sanitation industry.” [6] Many of those who assisted his cover-up were also elevated.
Many activists complain of continuing pressure to be silent. Liu Qian, who has been investigating the Henan blood crisis by field research approaches, in 2016, published Blood War (Xue Shang) in Taiwan, a book that is too sensitive to be published in Mainland China. Gao Yaojie, an 87-year-old AIDS activist, retired as a gynecologist, forced the government to admit the epidemic and educated rural people about the HIV in the 2000s, fled to the United States in 2009 to avoid the Chinese government’s harassment. [7]
Liu Qian and Gao Yaojie are among the many who blame the fact that China has never provided a full accounting of the infections. According to National Health and Family Planning Commission of China, by the end of 2014, the reported number of HIV infections was 501,000, and the primary causes of transmission were drug uses and sexual transmission.[8]Yet Gao believes that more than 10 million people may have contracted HIV, and states that the plasma trade is the primary root of infection.[9]
In recent years, the central government has been more open in admitting the extent of HIV infection and has provided more support to those who have been infected, but the implementation of the central government’s will has been ineffective because of local official’s obstruction. Furthermore, many villagers complain about the side effects of the free anti-retroviral drugs distributed by the government.
AIDS activists are not satisfied with the insufficient government efforts. In 2013, activists protested outside the Henan provincial government, blaming officials for their lack of response and inadequate financial assistance. Many activists and victims claimed that the leadership of China is afraid to mention the plasma trade, especially China’s prime minister, Li Keqiang, who was the Henan provincial governor between 1998 and 2004. They stated that although the AIDS epidemic occurred before Mr. Li’s arrival, Li is responsible for tightening the control on the media and silencing the speak-out.[10]
Who is to blame? At present, nobody has been held accountable for this man-made catastrophe. China has learned the price of economic development and the consequence of China’s socioeconomic transformation and is making compensations for those affected. In 2014, two decades after the incident, the Central Committee sent an investigative team to Henan to probe the blood scandal. In recent years, China has been working on preventative interventions of AIDS through progressive efforts, but there is still a long way to go. Challenges such as inefficient diagnosis, inadequate sex education, and the stigmatization of AIDS patients are still burdening for China.
References:
[1] Shocking Plasma Economy — A visit to Henan AIDS Village (骇人的”血浆经济”——走访河南”艾滋病村"). CCTV. Nov 29, 2016.
[2] Human Rights Watch. Locked Doors The Human Rights of People Living With HIV/AIDS in China. Vol. 15, no. 7. Human Rights Watch, 2003.
[3] Gill, Bates, Jennifer Chang, and Sarah Palmer. China's HIV crisis. Foreign Affairs (2002): 96-110.
[4] Liu, Qian. The Truth of the AIDS Incident in Henan Needs to be Known (河南艾滋病事件，真相必须大白). 2016.
[5] Human Rights Watch. Locked Doors The Human Rights of People Living With HIV/AIDS in China. 2003.
[6] Human Rights Watch. Locked Doors The Human Rights of People Living With HIV/AIDS in China. 2003.
[7] McLaughlin, Kathleen. The AIDS Granny In Exile. BuzzFeed News, 2013.
[8] National Health and Family Planning Commission of the People’s Republic of China. 2015 China AIDS Response Progress Report. p3. 2015.
[9] National Health and Family Planning Commission of the People’s Republic of China. 2015
[10] Blood Debts. The Economist. January 20, 2007.
