TCS Daily

AIDS and Authoritarianism

By Roger Bate - November 11, 2003 12:00 AM

It is common knowledge that the AIDS virus is decimating Africa and is taking hold in parts of Russia, South East Asia and Latin America. But perhaps even more worrisome, the most populous country in the world is developing a significant problem with HIV/AIDS, one that's exacerbated by a host of other factors.


Last week at a meeting at the American Enterprise Institute, Harvard Researcher and AEI fellow, Nicholas Eberstadt, explained what's happening. 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 Dr. Eberstadt's estimations, based on internationally respected sources, it's closer to two million, and maybe higher.


Were China an open society, with a good track record in transparent sharing of health information, perhaps one would be more skeptical of Dr. Eberstadt's figures. But the reality is that China recently hid much important information about its SARS epidemic. The Chinese Government restricted foreign access to data about the extent of the epidemic, it fired officials that wanted to come clean, and it didn't institute sufficient monitoring of hospital cases and travellers with infections until it was too late. Thousands of cases and hundreds of deaths resulted.


Despite this, Dr. Yu Yunyao, Vice-President of the Party University of the Central Committee, told the AEI audience that the recent SARS episode showed the "success of [Chinese] leadership." And Professor Jiang Xiaochuan, also of the Party University backed the official Government figures on HIV/AIDS. He defended the Government's record and said that the Chinese officials have been concentrating on controlling "drug traffickers since much transmission [of HIV] occurs through them" in China.


Responsible government action based on open assessment of the problem is the key to combating HIV/AIDS. Dr. Eberstadt used the examples of Uganda, Brazil and Thailand as countries that had had some success in reducing infection rates and death from AIDS. All three benefited from significant leadership from the heads of Government as well as their health and education departments. Uganda reduced its infection rate from over 30% to less than 20% by promoting abstinence, faithfulness to ones' partners and the use of condoms during sex. The Brazilian Government provided free drugs to those infected and educated the sexually active population in how to minimize their danger. 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 lacking such leadership appeared to be lost on many of the Chinese delegates at the meeting. But without that leadership it's 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 30 million cases of AIDS in China, and by 2025, as many as 46 million. The economic impact will likely be huge as well. 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% per annum for over a decade. With tens of millions of cases, GDP growth could slow by several percentage points, and ironically lead to an increase of unemployment, even as so many job vacancies become open. Those able to work will be unqualified to take up some of the senior jobs that become vacant, productivity will fall, and the unqualified will then be unemployable.


Dr. Xiaochuan -- rather missing the point Eberstadt's forecasts -- said that it was premature to predict the situation in 2025, but then proceeded to claim that "I don't think the situation will be that serious." Dr. Eberstadt, as well as most sensible people, is sceptical of predictions, even his own. But as he pointed out the predictions in Africa have been shown to have been understatements. In a continent with 28 million cases, few people in the early 1990s predicted that it would be anywhere near as bad as that by 2003. And like those in many African countries, 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 has been a fillip to world growth over the past decade. If it doesn't control its burgeoning AIDS problem the world, and not just its own population, will suffer from lower growth, and also, like SARS, a greater risk of widespread infection.

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