The perils of being a dissidence in China

Before the Covid Pandemic in China, there was the AIDS/HIV pandemic which affected many people in the 1990s. Around this time, AIDS had already emerged in other parts of the world, including Europe and the United States, where cases were transmitted mostly through sexual contact. In China, however, people were infected after selling their blood and plasma or receiving contaminated transfusions. Over the following decade, as many as 300,000 people in Henan province, the epicentre of the plasma trade became infected, a scandal that was exposed by Dr Gao Yaojie, a local gynaecologist. A recent report in Al Jazeera says that she was China’s best-known whistleblower much before even the eye doctor Li Wenliang who warned China about the outbreak of Covid-19 and succumbed to the virus in early 2020. Dr. Gao’s decision to expose the source of China’s AIDS epidemic made her an exile for 14 years and she died last December at the age of 95, in New York. Recalling this whistleblower is an important part of the narrative on China where the Communist Party tightly controls information. Without such whistleblowers, the world would be less informed of the travails of the people of China.

Netizens in China mourned Dr. Gao’s death on the same Weibo “wailing wall” page where they had commemorated Dr. Li Wenliang. Dissidence in China over Communist Party rule or over basic freedoms has been a regular feature and every once in a while, an individual shines through. D. Gao Yaojie is one of them. Gao’s descent from prominence to relentless official persecution exposed just how ruthless China could be. Her only demand had been to have the freedom to speak out, to tell the whole world, the truth behind China’s AIDS epidemic. Even though the right to report wrongdoings is protected in the first constitution of the People’s Republic of China (PRC) of 1954, which states that “all the PRC citizens had the right to make oral or written reports of any power abuses to the authorities”, that right has limits and subject to control by the CPC.

Amongst others who also paid the price for whistleblowing, Dr Wan Yanhai, a health official-turned-advocate, was detained in 2002 after distributing a secret government document on 170 AIDS-related deaths. He told Al Jazeera in February 2024 that “As with Covid-19, in the case of AIDS, “the impulse to cover up is ideological: Beijing deems its Communist system the best in the world and brooks no fault”. Wan was barred from returning home to China in 2010 and lives in New York. That was the year Wan defied officials’ warnings and attended the Nobel Peace Prize ceremony in Oslo to honour Liu Xiaobao, the Chinese dissident scholar who eventually died in prison in 2017. Gao was a professional doctor, her aim was not to become a whistleblower. However, she became alarmed when she started seeing patients in Henan province with tumours that she knew were common symptoms of AIDS. Few had been tested for HIV, let alone diagnosed, until Gao insisted that this be done.

In her 2008 memoir, The Soul of Gao Yaojie, Gao wrote, “As a doctor I couldn’t turn a blind eye; I had a responsibility to do all I could to prevent this epidemic from spreading. However, at the time, I was unaware of the unfathomable forces underlying the widespread transmission of HIV.” Dr. Gao discovered that the plasma trade, especially in the rural areas where impoverished villagers needed to supplement their income, had become a vector for transmission. Once China banned most imported blood products, part of its attempt to frame the virus as having a “foreign” origin, pharmaceutical firms ratcheted up domestic demand, compounding the problem. A similar situation obtained during the Covid-19 pandemic!

Even the Chinese Red Cross and People’s Liberation Army-run hospitals got into the business. Local officials who profited told villagers that selling plasma was also great for their health. Dr. Gao said in her 2009 testimony to US Congress that “Bloodmongers told blood sellers: ‘Blood is like water in the well. It remains at the same amount no matter how much you have donated. Blood donation is like substituting old blood with new blood. It is good for the metabolism”. Many became HIV infected because dirty needles were routinely reused to draw blood. Half of the 3,000 villagers in one county in Henan province made ends meet with the blood money at the time; 800 developed AIDS, Gao noted in her memoir.

As the Financial Times reported in December 2023, the Aids outbreak she helped to expose (1996) grew out of the “blood economy” in dozens of villages in the Chinese province of Henan. This involved farmers seeking to supplement their meagre incomes by selling blood sometimes as often as twice a day, at counters run either by local health authorities or by illegal “bloodmongers” eager to cash in on the surging demand for plasma. To cut costs, the blood collected was often pooled at a central collection point, mixing several bloods into the same centrifuge. After the plasma had been extracted, the remaining blood was then transfused back into the donors so that they could recover and donate more. Once the centrifuges, syringes and needles became contaminated with HIV, the disease spread rapidly through local populations.

Gao Yaojie was born on 19 December 1927, in eastern Shandong Province. She grew up during the Japanese invasion of China and the civil war that brought the Communists to power under Mao Zedong. The New York Times reports that she suffered detention and beatings during Mao’s Cultural Revolution. When her accusations of a cover-up of an AIDS epidemic brought house detention and pressure from the police & government officials, she said she had lived through far worse. Subsequently, foreign media coverage of her work only gave Chinese officials further cause to keep her under surveillance. After her book tour to Hong Kong in 2008, officials even cut her off from her family members. Several months later, Gao escaped to the US with only a blood pressure meter and a floppy disk containing details and photos of patients. Gao was the oldest dissident ever to have fled China at the age of 81. Once in exile in the US, Dr. Gao continued to work to educate people about AIDS. As the yet-unsolved origins of the Covid-19 pandemic shows, the secrecy China enforces has had repercussions for the rest of the world. Across the globe, more than 7 million people have died from the “mysterious virus” that first emerged in Wuhan in late 2019, according to the World Health Organization. Obviously , China did not learn from the lesson of AIDS. That is the lesson to be learnt from the voices of Dr. Gao and Dr. Li.