Aizhixing often faced criticism from the public and the government because of its work with China's most marginalised groups. 'In general, our relationship with the government in past years was intense and shaky,' Dr Wan said.

But despite rocky relations with officials, the attention that Aizhixing and other NGOs have drawn to the spread of HIV/Aids is starting to pay off. Recently, significant shifts in government attitudes have given Aids activists hope that China can avoid what the United Nations last year ominously labelled 'China's Titanic Peril': the spread of HIV/Aids on a scale tantamount to many African nations.

The UN Aids Programme estimated that by 2010, China could have as many as 20 million Aids sufferers. However, in what Dr Wan called 'a step in the right direction', the central government has begun to take the threat of Aids more seriously by sponsoring several Aids conferences last month attended by world leaders and dignitaries, including former United States president Bill Clinton.

For Aids sufferers, however, the most important boost is the recent government endorsement of the creation of generic Aids drugs and, in a pilot project, the dispensing of drugs to Aids patients.

The pilot project promises free treatment with anti-retrovirals, the 'Aids cocktail' that can significantly extend a patient's life. The project will cover about 5,000 patients in four provinces by the end of the year and may be replicated across the country, according to officials. However, many of these patients would not have contracted the disease had they not taken part in the country's notorious blood-selling schemes.

In its application for US$100 million in UN Aids funding last year, Beijing acknowledged for the first time that at least 250,000 people in seven provinces had contracted Aids by selling blood. For activists such as Dr Wan, this admission was not enough to wipe the slate clean.

He called for guarded approval and financing of China's recent Aids initiatives. 'If you give China money, then you should require they add human rights protections. If you don't stand with the Aids activists and empower them, these funds may be corrupted,' Dr Wan said.

Medical experts such as Dr Wan fear that the drug treatment programme will suffer from myriad logistical problems. Recent reports suggest that many of those who began taking the anti-retrovirals have already quit, complaining of vomiting, headaches and other negative side effects.

Often, there are no doctors in villages to help patients take their medication daily, and even those at the nearby hospitals lack the training and lab equipment to monitor patients and fine-tune treatment.

Dr Wan believed that NGOs could help maximise treatment through 'greater education and training, the use of the internet and advocacy by NGOs who can monitor and follow up on the treatment programmes'.

However, in some cases, the government seemed unwilling to allow NGOs such as Aizhixing to watch too closely. 'We have submitted proposals to monitor the work, but [permission is] difficult to obtain,' Dr Wan said.

In the long run, the Aids drug experiments may also face more budgeting problems, particularly if the number of infected in China continues to climb. According to Dr Wan, 'China's new treatment policy is a great commitment and what we want to see, [but] cost-effective methods should also be used, like importing drugs from India, where medication costs 2,000 yuan (HK$1,880) annually [per person], as opposed to the current 6,000 yuan in China.'

Dr Wan said that this shift would make drug-treatment programmes more sustainable in the long term. He also feared that emphasis on anti-retrovirals might create a public perception of these drugs as cures.

Among those beyond the reach of drug benefits are Aids orphans who already have lost their parents and may also be sick. The Ministry of Health estimated that Aids orphans in China numbered at least 100,000. The National Centre for Aids Prevention and Control predicts that by 2010, the figure could reach anywhere between 138,000 and 260,000. Nevertheless, an Aizhixing survey found only 1.8 per cent of these children received government subsidies for education and basic needs.

While the government focuses its spending on anti-retroviral drugs, Aizhixing has begun to provide a range of services to Aids orphans. 'We will start a program by ourselves assisting children with daily expenses and keeping them in school, but we would rather see government-run foundations take the lead,' Dr Wan said.

'In dealing with the Aids crisis, we want to be a good helper to the government, if they are willing to take the leadership.'

However, he said that even these seemingly altruistic efforts were often thwarted. Dr Wan claimed that when Aizhixing tried to provide subsistence support and to disseminate information, 'at every step, we have faced harassment and have been under surveillance and warned to stay away, and the donations we collected for orphans were sometimes confiscated'.

Dr Wan said he had to resort to more 'controversial' methods of drawing attention and aid to his cause, such as inviting foreign reporters to severely Aids-stricken areas where media access was restricted. 'We try our best to be co-operative, but sometimes it is necessary to be unco-operative and we don't hesitate to criticise the government if we think it will help people,' he said.

But Dr Wan is not always critical of the government, and recent initiatives have led to a more harmonious relationship between his group and authorities. 'The government used to think we were confrontational. But it is changing its view and we now have a licence to continue our advocacy work in China.'

And for Dr Wan that means being able to carry out his work and spread information to the community. 'Without public involvement and community initiatives, China will be fighting a losing battle against the pandemic,' he said.