HIV could blunt progress in China, Clinton warns
Authors: Jonathan Watts
Journal: The Lancet (2003)

Former US president Bill Clinton warned China this week that its growing HIV epidemic could put a brake on the nation's impressive economic development. He was speaking on Nov 10 at one of two recent AIDS symposiums in Beijing, where the government has recently begun to open up about the prevalence of the disease, the risks that it poses to business, and the need for more drugs and outside assistance. “China is moving in a positive direction. The headlines are hopeful and the future looks bright”, Clinton told a conference on AIDS and severe acute respiratory syndrome (SARS) at Tsinghua University. “But the weight of 15 or 30 million people living with HIV and AIDS could blunt a lot of your progress, especially if the burden falls most heavily on young people.” The scale of China's epidemic is unknown. After more than a decade of dismissing the disease as a foreign problem and covering up domestic cases, the central government now estimates that 840 000 people have contracted HIV among a population of 1·3 billion. With reported infection rates rising at 30% per year, the UN estimates that China will have 10 million cases by 2010. But some non-governmental organisations forecast a 50% higher figure, saying that officials are still hiding huge outbreaks—particularly those caused by huge blood-selling operations in Henan and other provinces in the 1990s. As well as the human cost, the symposium focused on the effect of the disease on business—an approach designed to appeal to China's new president, Hu Jintao, who has put a priority on creating a “well-off society”. David Ho, executive director of the Aaron Diamond AIDS Research Center (New York, USA), said the government must act quickly to prevent a health crisis from becoming an economic crisis. “A large and comprehensive societal response is in order”, Ho said. A similar theme was chosen by a workshop the previous week, organised by Harvard University, UNAIDS, and the World Economic Forum, which aimed to foster partnerships between governments and businesses to remove the stigma of AIDS and lessen its effect on the workplace. In one presentation, John Ruggie, director of Harvard University's Center for Business and Government, warned of the dangers of delay. “Unless China acts decisively, it will find itself on an African trajectory, just 15 years behind. In Africa, governments and businesses are looking back at what they should and could have done—in China, there is still time to avert the worst-case scenario.” Shen Jie, director of the National Center for HIV/AIDS Prevention and Control of China, assured attendees that Beijing was aware of the risks and had begun to issue free medicine to poor patients. “AIDS has become a serious social and public- health issue and requires immediate, strong actions from all sectors of society”, said Shen. “Chinese leaders regard AIDS as a national strategic issue that has a significant impact on people's welfare, social stability, and economic development.” “As the world's most populous country, China's experiences and lessons in ADDS prevention and control should have significant implications for the rest of the world.”