Leaders Boost AIDS Education in Yunnan

Move is prompted by response to crackdown on drugs

FOR at least one major city in China, a nationwide narcotics crackdown has come as a mixed blessing: While reining in drug addiction, it has inadvertently spurred the spread of AIDS. In Kunming, the hub for narcotics smuggling in China, the police have rounded up dozens of drug pushers and forced up the street price of heroin from $14 to $24 a gram, say heroin addicts.

In response, drug users are resorting to a cheaper way for stimulation, taking the drug intravenously rather than smoking it.

Many of them are sharing needles despite the risk of contracting the HIV virus that leads to acquired immune deficiency syndrome, say Chinese officials. ``The problem of injecting [heroin] is new and is spreading inland from the border areas [Burma, Laos, and Vietnam],'' says John Peabody at the World Health Organization (WHO).

The growing popularity of intravenous drug use has raised the prospect that AIDS will spread eastward to the coast along China's heroin trafficking trail: from the Burma border to Kunming and other populous areas of South China, say Chinese and Western officials involved in drug enforcement.

In Yunnan Province, on the frontier with Burma, 368 people (of China's total of 379 cases) have been found to carry the HIV virus. All but two of the carriers are intravenous drug users, and 305 of them live in Ruili, a small town that is a channel for heroin smuggling out of the poppy-growing area called the ``Golden Triangle.''

The recent discovery of HIV on the border has induced China's leaders to intensify efforts to protect the country's 1.1 billion population from the virus, say Chinese and Western officials. AIDS had not been considered a major threat to China, because comparatively few mainlanders use drugs or are promiscuous.

Yunnan is better prepared to control AIDS than many other parts of the world. Indeed, just as the Yunnan AIDS prevention program is considered the model program in China, it should be considered an example for such efforts in the developing world, says Dr. Peabody, an epidemiologist.

``It's one of the most exciting programs in the world because there's such good cooperation now, good community involvement, and good collaboration between women's federations, police, public health, and ethnic minority committees,'' he says. The broad-based movement has made Yunnan ``one of the most promising areas to prevent the spread of HIV,'' Peabody said, after reviewing the program in Yunnan last month.

The third world badly needs a model program. Four out of five of the estimated 25 million people worldwide who are likely to carry the AIDS-causing virus by 2000 will live in developing countries, according to the WHO.

China's leadership also talks of the country's unrivaled ability to cope with the disease. And, as with other threats, the leadership has tried to turn public anxiety about AIDS to its political advantage.

``In Western countries, AIDS is a disease that is very hard to control,'' says Dai Zhicheng, director of epidemic prevention at the Health Ministry.

``In our country, because of the superiority of our socialist system, we can take comprehensive measures to control it,'' Mr. Dai said last month on prime time television.

China's officials have marshaled their sweeping apparatus to combat AIDS. Yunnan province has rallied a myriad of grass-roots organizations in AIDS surveillance and education from the provincial capital down to remote border areas. The same village and courtyard loudspeakers that shout the party line also warn of the disease.

The state will exert its extraordinary powers to ``isolate'' Chinese who are found to be infected with the AIDS-causing virus, Dai says.

In Yunnan, however, such Chinese will not lose their freedom of movement or be barred from contact with others, says Zhao Shangde, director of the province's AIDS program. Rather, they will be closely observed by their relatives and neighbors, he says.

DESPITE the claims of Beijing, low-level Chinese officials acknowledge that, in fighting AIDS, they are thwarted by the same snags confronting their counterparts abroad.

For example, a taboo on discussions about sex and widespread complacency over the threat of AIDS have frustrated Yunnan officials, says Mr. Zhao.

In Kunming, several heroin addicts, members of China's ``high risk'' group, express a belief that somehow they are immune to the disease.

``No case of AIDS has been reported in Kunming, so I can't get it - it's impossible,'' says an 18-year-old woman who pays for her heroin habit through prostitution.

The province has spent $596,000 in the past two years on education aimed at eradicating such groundless certitude. It has also tested the blood of 10,000 people, according to Zhao.

Yunnan hopes to receive $400,000 from the WHO this year and $6.28 million for the first half of this decade, he says.

Peabody declined to confirm the figures, saying the countries that sponsor the WHO have not yet approved spending such sums. The money will go toward stepped-up education, training of counselors, and surveys of drug users, prostitutes and their procurers, and people in other vulnerable groups.

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