Foreign Affairs

China's HIV Crisis

The Price of Prosperity

"To get rich is glorious," the late Chinese leader Deng Xiaoping once exhorted his people. Defending this reformist vision, he added, "If you open the window for fresh air, you have to expect some flies to blow in." In the two decades of breakneck economic development since China's embrace of gaige kaifang (reform and opening), both the promise and the peril of Deng's two maxims have become abundantly clear. Although China enjoys growing wealth, increasing per capita incomes, and rising living standards, it also suffers from environmental degradation and a host of social ills including political unrest, increased crime, and a fraying social safety net. China, like other developing nations, faces tough choices between the benefits and the costs of modernity.

Unfortunately for China, however, the very nature of its particular political, social, and economic systems exacerbates the dangers of opening up. The growing problem of HIV/AIDS in China is a glaring example of this phenomenon, and one with enormous implications. Once dismissed by Chinese officialdom as a Western problem, the spread of HIV/AIDS has only recently gained serious attention from Beijing. But it may be too late: China now faces a major epidemic, one that the government will find extremely difficult to combat.

Reprinted by permission of Foreign Affairs, March/April 2002.