China’s Blood-Borne HIV Catastrophe Revisited

The 1990s blood-borne HIV epidemic in China cost tens of thousands of lives. This article traces the political origins of and early responses to this catastrophe, drawing on published documents, especially government publications. Government-business collusion, which has been emphasized in the literature, cannot alone account for the catastrophe nor for the government’s reaction. In the 1980s, the Chinese government promoted the domestic blood-product industry to keep AIDS, which was considered a foreign disease, out of the country and adopted the broadly accepted and efficient technology of plasmapheresis. However, it neglected the early warning signs of hepatitis cross-infection, thus failing to prevent the spread of HIV. This article also reveals that, complementary to the conventional focus on delayed reactions in Henan, health officials in Hebei initially reported the outbreak of HIV to their superiors in February 1995 and, in response, the central government in fact intervened. Nevertheless, infected victims—let alone the public—were not alerted to this communicable disease, which resulted in a second wave of transmission. This study implies that preemptively the Chinese government did not deem it necessary to act when risks were (mis)identified as noncritical, and reactively it withheld information from the public while coping with the emergency. As a result, the governance of health and safety was compromised.