Gao Yaojie, who exposed AIDS epidemic in rural China, passes away at 95

Gao Yaojie, a Chinese doctor who defied government pressure in exposing an AIDS epidemic that spread across rural China through reckless blood collection, died Sunday at her home in upper Manhattan. She was 95.

Her death was confirmed by Andrew J Nathan, a scholar of Chinese politics at Columbia University who managed her affairs in the United States.

Gao's relentless efforts to expose and halt the epidemic of AIDS among poor farmers in the late 1990s brought her fame in China and acclaim abroad; among others, she was hailed by Secretary of State Hillary Clinton during the Obama administration. But Communist Party officials ultimately tried to silence Gao, and she spent her last decade in New York.

Even in exile and in faltering health, she continued to speak out about the hundreds of villages -- especially in her home province, Henan, in central China -- where residents flocked to sell blood at collection stations whose slipshod methods caused tens of thousands of deaths, if not more, from AIDS.

Officials concealed, ignored or played down the outbreak for years, and infected villagers received little help until the furor that had been inspired by Gao and several other Chinese doctors and experts prompted the government to distribute medicine.

"AIDS not only killed individuals but destroyed countless families," Gao said in an interview with The New York Times in 2016. "This was a man-made catastrophe. Yet the people responsible for it have never been brought to account, nor have they uttered a single word of apology."

Gao had retired from day-to-day medicine and was nearing 70 when she took up her second career as an AIDS educator. But her earlier life steeled her for the hardships that were to come.

Gao was born on Dec. 19, 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. She endured the famine caused by Mao's policies in the late 1950s, and she suffered detention and beatings during his Cultural Revolution. When her accusations of a cover-up of an AIDS epidemic brought house detention and pressure from the police and government officials, she said she had lived through far worse.

"She encountered a lot of ups and downs in her life, and all the adversity tested her spirit," said Chung To, a former investment banker from Hong Kong who founded the Chi Heng Foundation to help rural Chinese children orphaned or affected by AIDS. "Without her, the news of this outbreak might have been swept under the carpet for longer, and more people would have died."

Wang Shuping, a medical expert who was also instrumental in exposing the spread of AIDS in rural China, said of Gao in 2012: "Her biggest contribution was winning the attention of the news media. Local governments wanted to cover up many things, but they couldn't, because Gao Yaojie was brave and kept speaking out." Wang also moved to the United States and died in 2019.

Gao, a diminutive woman with a crackling laugh, walked with a limp, and not just because of advancing age. She was born to a relatively well-off landowner and his wife, and as a child her feet were bound with cloth for six years, in the painful traditional Chinese practice intended to create artificially dainty feet.

Her family settled in Kaifeng, an ancient city in Henan, and she soon showed an independent streak, choosing to study medicine at a local university. She graduated in 1953, married soon after and became a specialist in women's health.

Henan province was among the regions worst hit by the famine after 1958. Then fierce fighting broke out in the province in 1966 during the Cultural Revolution. Gao was singled out for ferocious beatings by Maoist radicals because of her "landlord" family background and her refusal to buckle. She said her knees never recovered from her being forced to kneel for hours on cold stone.

At one point, Gao tried to kill herself. Her youngest son was imprisoned for three years when he was 13, after he was falsely accused of insulting Mao. The suffering and a lasting rift with her son dating from that time left her bitterly critical of Mao's legacy.

"Unless Mao is dragged off his sacred pedestal, there'll be no hope for China," she told one interviewer in 2015.

Gao was a roving advocate for women's health in 1996 when she encountered her first patient diagnosed with AIDS, a woman from rural China who had been infected through a blood transfusion during an operation. The woman died about two weeks later.

Gao began investigating how AIDS had entered villages in Henan, visiting people's homes herself.

She and other medical workers discovered that hundreds of unscrupulous blood stations, often with official backing, were buying blood from villagers using methods almost guaranteed to spread infections. The stations extracted valuable plasma from the farmers' blood and pooled the leftover blood, which was then transfused back into villagers in need of the procedure. The vats of pooled blood proved to be a devastatingly effective way to transmit infectious diseases, including HIV, the virus that causes AIDS.

By 1995, Henan officials tried to shut down the practice. But an underground blood trade persisted, and Gao called for closing the blood stations, treating infected villagers and bringing officials to account.

She often ventured with a driver from her home in Zhengzhou, the capital of Henan, roaming for days to deliver advice, food and clothes to ailing villagers, as well as rudimentary medicine for fever, diarrhea and other symptoms of AIDS. In one village, she recalled, she came across a woman who had hanged herself after her husband died of AIDS. Her 2-year-old son was clinging to her feet.

"Gao Yaojie was crucial, because she saw what was happening in the villages and kept talking and talking about it," Zhang Jicheng, a former journalist from Henan who was among the earliest to report on the AIDS outbreak there, said in an interview. "Many people didn't understand why she did it, but she'd already been through so much that she wasn't afraid."

By the early 2000s, the AIDS scourge in rural China had become an international scandal, and Chinese officials' efforts to play it down were overwhelmed by anger at home and abroad. Chinese activists and journalists championed Gao, and she won a measure of praise in the country's news media and official welcome, at one point meeting a vice premier, Wu Yi.

But Gao's growing prominence bothered other Chinese officials, who regarded her as an embarrassment to them, especially when she refused to stop her campaigning. Henan officials tried to prevent her from traveling to the United States in 2007 to collect an award, only to be overruled by Wu.

Gao moved to the United States in 2009 and began giving talks and writing books about her experiences. Her skepticism about promoting condoms to prevent the spread of HIV and other sexually transmitted infections irritated many AIDS experts.

But the reservoir of respect for her led even critics of her views on preventing AIDS to regard her with affection.

Her husband, Guo Mingjiu, also a doctor, died in 2006. Gao is survived by two daughters, Jingxian Guo and Yanguang Guo; a son, Chufei Guo; a sister, Ming Feng Gao; three grandchildren; and, in China, three brothers and another sister.

In Gao's final years, in a West Harlem apartment, a group of Chinese students helped keep her company and edited her writings. She never returned to Henan, but she said she wanted her ashes to be taken there and scattered on the Yellow River.