Over 20,000 new HIV positive cases have been reported in China since 2002, but estimates of a far greater number of unknown cases present a huge challenge in dealing with the epidemic.

The number of officially reported incidences has now reached 89,067, including 20,786 people with AIDS, according to a Ministry of Health report released in Beijing on Tuesday.

Yet China and the UN estimated last year that there could be more than 840,000 people with HIV. This was based on a reckoning that 0.07 percent of the population was likely to be infected.

A major reason for the sharp increase in reported cases since 2002 is enhanced HIV screening of commercial blood and plasma donors in Henan Province and of injecting drug users in Yunnan Province.

Henan completed a review this year of 280,000 commercial blood donors from the early 1990s, and 25,000 people with HIV/AIDS were identified.

Since the increase only refers to reported infections from the 1990s, it cannot be a basis upon which to judge the ongoing expansion of the epidemic, said Qi Xiaoqiu, director of the Disease Control Department of the Ministry of Health.

The exact expansion rate is still unknown, he told China Daily as the report was released, but experts say the expansion rate is likely to be more than 30 percent annually.

The assessment was completed by a special working committee on HIV/AIDS control under the State Council and the UN Theme Group on HIV/AIDS.

The ministry says that it does not know how many of the individuals who have been registered as HIV positive are still alive.

The ministry and related departments say they have been working to strengthen various control measures, such as offering free treatment, and fighting against sources of infection, including illicit drugs and illegal blood collections.

There is great urgency, since the epidemic is spreading quickly in the country, Wang Longde, vice minister of health, said.

There is a lot of evidence that the virus is not limited to people in so-called "high-risk groups."

More and more people in the wider population, women especially, are being infected through unprotected sex.

According to the Ministry of Health, the prevalence of HIV among injecting drug users is between 5 and 8 percent. In the Ili area of Xinjiang Uygur Autonomous Region, the rate has reached 89 percent.

Except for Tibet Autonomous Region, all areas of the Chinese mainland were found to have people infected with the virus through commercial blood donations.

Yet, alarmingly, the reports show that only about 10 percent of people with HIV/AIDS have been registered.

"The reality is that we still do not know where the 90 percent are, which bring us great difficulties in controlling the disease," said Hao Yang, vice director of the Disease Control Department.

There has not been a nationwide survey and many people hesitate to be tested, even though it is free in many places, Hao noted.

An effective monitoring and reporting network is still under construction, with more than 1,000 surveillance spots being set up in the past year.

Thirty-four clinics and 50 spots to provide methadone and clean syringes for drug users have also been built, though figures for the number of people using these services were unreported.

More than 10,000 people with AIDS have been given free anti-retroviral therapy this year.

Total central government spending on HIV/AIDS amounted to about 390 million yuan (US$47 million) in 2003. The budget for 2004 was 810 million yuan (US$98 million).

(China Daily December 1, 2004)