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February 07 The Politics of AIDSChanging State-Society Relations in China In support of Hu Jia and Zeng Jinyan, who tirelessly fight for the rights of the people...
In the face of the rapidly-escalating HIV/AIDs epidemic, the Chinese government has loosened some of its tight restrictions on social organizations. As a result, the number of non-government organizations (NGOs) and grass-roots groups working in the field of HIV/AIDS prevention has mushroomed in recent years, delivering services previously inconceivable. However, the state remains deeply ambivalent to this new social force and activists are often subject to severe obstacles and harassment. In this essay I attempt to give a brief overview of the present situation and explore how it affects the development of the state-society relations in China’s restrictive yet conducive political setup.
China faces one of the gravest humanitarian crises of our time – according to official figures the number of people living with HIV/AIDS has rocketed to 840,000 in 2004. The actual figure is almost certainly much higher, as the official statistics vastly underestimates the number of infections in Henan province, where tens of thousands of peasants, perhaps up to a million of them, contracted HIV in the late 1990s as a result of a government led blood-selling campaign. International experts have warned that China could have ten million people living with HIV/AIDS in 2010, if no preventive actions were taken promptly.
After the SARS scandal in 2003, China's policy makers are finally taking serious measures in public health, AIDS being one of the focuses of this new campaign. Premier Wen Jiabao called the fight against AIDS a top priority for the country and visited one of the AIDS villages in Henan in early 2004. The recognition of the rampant AIDS epidemic in rural Henan was accompanied with the government’s announcement of a nationwide programme dubbed as “four frees and one care”, namely, to provide free anti-retroviral drugs, free counseling, free prevention of mother-child infection, free education to AIDS orphans plus “economic care and assistance” to those affected by AIDS.
Meanwhile, senior officials are increasingly vocal in their support and tolerance of NGOs, as they realized the inability for the state apparatus to tackle all the social problems. In 2004, health minister Wu Yi held a private meeting with prominent activist Gao Yaojie and emphasized the importance of creating a better environments to mobilize the civil sector. More recently in 2006, vice health minister Wang Longde again encouraged NGOs to join in the fight against AIDS.
As a response to these calls, China’s NGO sector, especially those focusing on AIDS prevention work, has seen rapid growth in the past five years. These organizations share two common characteristics:
Firstly, as regulations regarding a conpulsory supervising body is no longer applicable, most NGOs have gained complete independence, both financially and administratively, from state control. Many of them are now partially funded by international NGOs and foundations. Even the grass-roots groups from the poorest parts of the country now commonly have some sorts of international connection. This independence enables the groups to carry out services previously not accessible to them due to regulatory restrictions.
Secondly, their practitioners and volunteers are mainly drawn from university students and young professionals in the urban area, most of whom under the age of 30. Unlike many of their GONGO (government controlled NGO) counterparts, they are much less bureaucratic, closer to the society, and well equipped with the skills to deliver frontline services. This is an important phenomenon as an increasing number of highly educated and liberal-minded professionals are choosing NGOs as a viable career path. In the years to come they could grow into a strong force behind the advocacy of civil liberties and democratization.
Thirdly, the NGOs specializing in AIDS, like many other social organizations, remain largely invisible. Although a few of them have been invited to local policy discussions, most exercise a conscious depoliticization and self-censorship, for their survival relies solely on the unspoken government consent. In doing so NGOs attempt to steer away from offending the authorities and portray themselves as partners rather than opponents to the government. Unlike the environmental movement, however, even the largest AIDS groups are still far from successfully building up informal connections with government figures and exerting any significant political leverage. On the contrary, the low-profile has severe adverse effects on publicity, brand building, fund raising, and organizational development.
Indeed, self-censorship does not always translate into government trust and the tolerance of senior officials is often contradicted by frequent repression at the local level. The first and foremost obstacle is the NGO registration regulations. According to law, NGOs are required to register with the Ministry of Civil Affairs. In practice, only GONGOs or a handful of NGOs with very strong and usually informal ties with the government are able to register as non-government and non-profit organizations. The majority of NGOs now existing in China have to register with the Business Administration in the form of companies, research centres or clubs. The financial bar is correspondingly higher and filters out many start-ups and small groups. The renewal of licenses is often at the discretion of local officials, thus if a group is deemed offensive to the authorities they could face serious punishment. In rural areas, many grass-roots groups are unregistered at all and face great difficulties in fund raising and mobilizing resources.
The central policy makers have already noticed the bottleneck created by the outdated regulatory restriction and the Ministry of Civil Affairs was reportedly considering modifying the registration rules to better accommodate the growth of NGOs and the country’s fight against AIDS in general. Unfortunately no actions have been taken so far and registration remains a major problem for many NGOs.
A second problem is the tension between local and central government authorities, which arises from the growing gap between China’s rich coastal cities and landlocked western provinces. Most of the new AIDS groups are in the more prosperous cities such as Beijing and Shanghai. But a large part of China’s AIDS epidemic is in the rural areas – for instance, the peasants in Henan, and drug addicts and sex workers in underdeveloped regions. But those areas are the ones with the greatest political restraints. As the old Chinese saying goes, “heaven is high, and the emperor is far away.” National policies on AIDS are usually poorly implemented, due to corrupt local officials who see HIV/AIDS as an embarrassment that threatens their own promotion and external investment in their poverty-stricken constituencies.
In Henan province, villagers living with AIDS have got together to form local groups to provide care and support to fellow families struggling with AIDS. Yet such efforts have without exception met with official bans. There are continued concerns about the lack of adequate facilities to take care thousands of children orphaned by AIDS, as well as the corruption and embezzlement in nationally and internationally funded aid projects. All those public criticism of government authority are treated as a direct political challenge and firmly suppressed. Villagers who seek to petition to higher authorities are often detained or put under house arrest.
Apart from relying on fear of force, authorities in Henan have resorted to censorship and manipulation of the media to maintain a positive public image and to stop the spread of "negative" information of their mismanagement of the crisis. In February 2007, activist Gao Yaojie was put under house arrest to prevent her from receiving an award in the US. At the same time the provincial newspaper ran a headline that the deputy provincial governor had visited Dr Gao, commended her brave work and sent best regards for the New Year!
This and other measures are by no means restricted to Henan province. It is only the province’s vocal activists and its proximity to Beijing that enables them to attract significant media attention. There are many more quieter but more successfully repressive provinces still beyond our knowledge.
Yet another problem facing AIDS activists in China is the marginalization of the people they work with - injection drug addicts, sex workers and gay men. This high risk population is falling victim to a profound social discrimination. There are laws that promote arbitrary detention by police without trial in the case of drug users and sex workers. This means activists working with them also face a range of risks.
The official moral rhetoric of the “socialist spiritual civilization”, though not explicitly so, blames Western influence and corruption as the cause for the spread the HIV in society, inferring the said high risk group as wicked and immoral. The crackdowns on drug users, sex workers and the censorship of on-line homosexual chat rooms have closed an important channel to access and share valuable information with the marginalized communities. The demonization has further marginalized people who need the most support and creates an unhealthy social atmosphere that deems anyone with AIDS as dirty and immoral. As a result, some estimate that as many as two thirds of the people who contracted AIDS through blooding transfusion are trying to hide their identities in order to escape social stigma. This problem won’t be solved until the government formally acknowledges blood transfusion as a major source of infection and redirects the anti-AIDS campaign from its present moral-centric state.
As China becomes more diversified and pluralized, the state alone is incapable of dealing with all the social issues and the emergence of an independent civil society seems almost inevitable. We have seen that the Chinese government has indeed taken actions to encourage the development of NGOs to help in its anti-AIDS campaign but at the same times puts various obstacles in the path, which severely hamper the growth of a civil society that can effectively fight against AIDS. Put in a greater prospective, China is already more tolerant of AIDS NGOs than groups working in other fields, who faces even tougher restrictions and harassment.
The relations between the state and social organizations in China have always been a mixture of cooperation and confrontation. On the one hand the uncontrolled growth of NGOs could potentially give rise to an opposition or rival force that threatens the legitimacy of the Party’s rule, on the other hand, encouraging collective voluntary actions would help solve social problems and lower the risk of social instability. Perhaps only time will tell whether this balance will be broken in the future with the further development of a civil society in China. (18 January 2008) Comments (4)
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