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China's Other Health Cover-up

The recent SARS epidemic has shown both the old face of the Chinese political system, and perhaps a new face. Beijing's dark side has been exemplified by its knee-jerk resort to draconian measures, including threats to execute "intentional transmitters" of SARS, arrests of those who send text messages "spreading rumors" about the epidemic, and the jailing of a doctor who accidentally infected his family with the virus. These measures have no place in a public health emergency, no matter how grave.

There has, however, been one ray of hope since the outbreak of SARS. Since April, the Chinese Communist Party has fired the national director of the Ministry of Health, the mayor of Beijing, and over 100 other health officials for underreporting SARS infection rates. The cover-up of local infection rates contributed significantly to the spread of the disease. While senior Chinese officials called for an end to "delay, cover-up or missing cases," World Health Organization officials continued to express concern about underreporting. But for the first time, Beijing appears to be holding officials to account for lying about an epidemic.

Now that the precedent has been set, the party should also look into the massive HIV/AIDS blood scandal in Henan province. In Beijing, government officials have admitted they covered up the numbers of those infected with SARS. In Henan, no action has yet been taken against officials responsible for an even worse cover-up, over the spread of HIV to at least one million men, women and children through a contaminated blood sales network. Henan officials banned international and Chinese journalists trying to report on the epidemic, harassed doctors who tried to speak the truth, and, worst of all, blocked access to AIDS organizations offering much-needed services to whole villages of dying farmers and their children.

In Beijing, officials were fired. In Henan, they were promoted. Take Liu Quanxi, head of the Henan provincial Ministry of Health. AIDS activists and Chinese press claim that Mr. Liu aggressively developed Henan's for-profit blood collection stations in the 1990s. As the Chinese government has since acknowledged, such stations, common in rural China, inadvertently transmitted HIV to large populations because they used a system that pooled and extracted valuable plasma while reinjecting red blood cells to donors. This collection system, along with the use of unclean needles and equipment, fuelled the rapid spread of the virus among whole villages. Yet this February, Mr. Liu was named to a deputy directorship of a people's congress committee on health, education and culture, and was praised for his "important contributions to the development of the province's sanitation industry."

Chen Kuiyuan was the Henan Communist Party chief from 2000-02. During his tenure, international and Chinese journalists who tried to visit Henan were detained by police and expelled. Outspoken critics of the blood collection scandal, such as retired Dr. Gao Yaojie, reported harassment by local officials, and were ordered not to speak to the press about Henan's epidemic. Chinese NGOs offering help were questioned by police, and their tapes of interviews with villagers were confiscated. In January, Mr. Chen was named president of the Chinese Academy of Social Sciences, China's premier research institute.

Why would anyone lie about such a vast epidemic? The answer was simple: Covering up the spread of a stigmatized disease like AIDS might help to ensure that investment continued to pour into impoverished provinces like Henan. The Henan blood scandal sent a clear message to other local officials: if you have an epidemic, cover it up, and you'll be rewarded. Beijing officials who lied about SARS made what appeared to be a safe bet. Fortunately, this time they lost.

Hu Jintao's new government has a chance to change the shameful record set by its predecessors. Thanks to SARS, the Henan scandal, and the poisoning of dozens of children by snacks sold in unclean street stalls, Chinese popular indignation on Internet bulletin boards about the cover-up of public health crises is at an all-time high.

Now is the time for China's leadership to launch a thorough investigation of officials in Henan and hold those responsible accountable. The party's Central Commission for Discipline Inspection is one body that could do this job. The mandate of this commission has expanded over the past five years, growing from simple cases of government corruption to regulation of the for-profit medical industry.

No doubt Beijing's recent change of policy is due in part to the international panic about SARS. Many programs, business ventures and conventions were cancelled. Had the Henan blood scandal drawn the international condemnation that SARS has, imagine how quickly the central government might have responded.

Brad Adams is Executive Director of Human Rights Watch's Asia Division.

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