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 Interview with
Dr. David Ho
CEO of the Aaron Diamond AIDS Research Center, Professor at Rockefeller University Medical School and Head of the China AIDS Initiative
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CBS CARES: How did the China AIDS Initiative come about and what are your objectives?
DR. HO: Well, we wanted to link together a number of organizations to help address the epidemic in China. We realized that the only effective way to approach this is in a comprehensive manner. This is because you cannot just address HIV as a biomedical problem. It comes with all sorts of attendant issues. You have to take on the issues of stigma and discrimination. You also have to address the human rights and legal aspects and the many other social issues that come along with HIV/AIDS. There's not one organization that has the necessary skills to do it all.
We increasingly realized that we have to link together groups that complement one another. We started to do that with some American organizations that have an interest in China. Very importantly, we also have to have local partners in China. That's why we have partnered with the Ministry of Health, a number of bureaus of health in the provinces, as well as universities and Chinese academies involved in this area.
CBS CARES: Did the Chinese government approach you or did you approach them?
DR. HO: No, we actually were rather proactive. The Ministry of Health initially signed an agreement with our institution on vaccine development. But we have substantially broadened that relationship over time, including partnering with the Chinese Academy of Medical Sciences, which is equivalent to the National Institutes of Health in the United States. Without endorsement by the Chinese government, it would be difficult to have an effective program in China.
CBS CARES: How did your PSA with Magic Johnson and Yao Ming come about?
DR. HO: It came when we were trying to get the Chinese government to take stock of the situation and support the many things we wish to do in China on HIV/AIDS. In 2003, we had engineered a big event that involved President Clinton at Tsinghua University in Beijing. That event made a big impact in my view because it allowed Clinton to send messages directly to the Chinese public. It also privately allowed him to speak to a number of the highest leaders. President Clinton said: "I'm here on a health mission, not on foreign policy." That shocked the Chinese leadership, to be frank.
So, I think those messages got through. We cannot take the whole credit. There are a lot of other organizations that have been working on advocacy for a long time. The collective outcome is that only a few weeks after President Clinton's visit the Chinese policy on AIDS took a dramatic turn in the right direction.
We want to sustain the momentum and that includes doing something that is more focused on the public. So we thought about using high profile figures. Magic Johnson has been under my care since before his public announcement. He was incredibly supportive about doing something to support our efforts. And since it's the China AIDS Initiative, we thought about a Chinese celebrity and Yao Ming was the obvious. He has such a high profile here, but you should see what he's like in China! I thought the combination was particularly powerful because we could put an American and a Chinese together, and a high profile infected person and an uninfected person together. I thought the dynamics between the two would be very powerful and they could effectively promote awareness as well as prevention and non-discrimination. So, Magic sent a message to Yao and David Stern, the NBA Commissioner, said he was very much behind it...and it happened.
CBS CARES: How informed are most Chinese people about AIDS?
DR. HO: In some surveys that have been done, half of the Chinese don't know the basic aspects about HIV/AIDS. That is simply not acceptable for a global plague that is also affecting China. We simply need to raise awareness and the PSA is part of that. Of course, there's self-interest here because we're trying to get a lot of things done in China. Unless we can make advances in correcting the mindset of the Chinese public our tasks will be so much more difficult.
CBS CARES: The AIDS epidemic in China has been described as a grave threat to both China and the world. Why is AIDS in China a threat to the world?
DR. HO: AIDS in China is part of the second wave of the AIDS epidemic--one that threatens China, India, Russia, among others. This wave will add a tremendous number of new AIDS cases in addition to what we already have around the globe today.
We know that China has had an epidemic of HIV/AIDS since 1989, beginning first in drug users and then followed by an epidemic that was spread because of certain blood selling practices in the central region of China. The World Health Organization estimates that there may be somewhere between 800,000 and a million infections in that country. Given the trajectory of the rising caseload, however, it is likely to hit the 10 million mark by the end of the decade. Obviously, that will add a tremendous load to the global pandemic.
CBS CARES: How accurate is the estimate of current infections in China? In a country with such a large population and 800 million people living in rural areas, how are they able to come up with an accurate number of infections?
DR. HO: In my view, these estimates of infections are not very accurate. Given that until fairly recently there were only 60,000 Chinese who had been confirmed HIV positive. That's, of course, a small number compared to the new estimate of 800,000 to a million, so it cannot be all that accurate. Nevertheless, whether it's half a million or two and a half million, you probably would approach it more or less the same way. I should also point out that the Chinese government recently has launched wide scale testing in several of the key provinces. It would not surprise me, if six months from now or a year from now, we would have numbers that are much more reliable
CBS CARES: If your China AIDS project is successful, to what extent do you think that you can reduce the 10 million projected infections by 2010?
DR. HO:
With an epidemic, the sooner we make an impact, the greater that impact will be. So, ambitiously, we'd like to affect the outcome by four or five fold if that's possible, but that depends on the actual number of current infections.
CBS CARES: When will it be too late to intervene in China?
DR. HO: I think we cannot afford to sit around for another year or two without many intervention programs.
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