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Some related articles In Rural China, a Steep Price of Poverty- Dying of AIDS:

EIJING, Sept. 6 ・China took significant steps today in facing up to its growing H.I.V.-AIDS epidemic, raising its estimate of the number infected to 1 million and saying that it would manufacture a full complement of AIDS drugs if Western patent-holders do not lower their prices.

It was a striking reversal by Chinese health officials, who had previously insisted that, as a new member of the World Trade Organization, China had to be hypervigilant about respecting patents and would not permit the use of generic AIDS drugs.

But even as the government was articulating its new sense of urgency and commitment to action, it once against displayed the defensiveness that experts both in and out of China say has precluded an effective response to the crisis. China's Bureau of State Security confirmed that it had detained the country's most outspoken advocate for AIDS patients, Wan Yanhai, who disappeared in Beijing two weeks ago.

In their announcements today, officials for the first time publicly asked for international help with the country's AIDS problem, which they had insisted they could handle on their own.

"We need international organizations to help us in this battle to control AIDS," said Qi Xiaoqiu, director general of the Department of Disease Control at China's Ministry of Health. "We need more capital support and expertise."

It is unclear exactly why the government decided to take the plunge and talk more candidly, although China is in the process of submitting a $90 million grant application to the Global Fund for AIDS, Tuberculosis and Malaria and desperately needs to show some good faith efforts on AIDS to help its application.

That money is earmarked for dealing with the rural AIDS epidemic in central China, including cocktail therapy for AIDS sufferers, said someone who has seen an early draft. China's first application to the fund, seeking money to be used for AIDS prevention and treatment among drug addicts, was rejected earlier this year partly because of the government's closed attitudes about the problem, leading to unreliable statistics and other shortcomings.

Mr. Qi said that "drugs and other medicine are especially needed in places where there are a large concentration" of AIDS patients, referring to poor villages in central China's Henan Province, where large numbers of farmers contracted H.I.V. through unsanitary blood sales.

Last week China licensed its first domestically produced anti-AIDS drug, a version of the medicine A.Z.T. Mr. Qi said a shipment had already gone off to Henan, where it was being used by patients, although he did not say how many had access to the drug.

Dr. Wan, whose arrest was confirmed today, had posted on the Internet in late August a classified document prepared by the Henan Health Bureau, showing that officials in that province were well aware of a serious H.I.V. problem as early at 1995. Selling blood was officially banned in that year, although it continued for several years in a number of villages, people from Henan say.

Dr. Wan, who had been followed and harassed by security officials all summer, disappeared off a Beijing street on Aug. 24. He founded Aizhi Action, a small organization that ran a Web site and conducted AIDS advocacy work in China and and was to receive a prestigious Canadian human rights award this month. On Thursday state security officials told one of his colleagues that he was being held for revealing the secret report.

"Finally someone admits that Wan is in their hand," his wife, Su Zhaosheng, who is studying in Los Angeles, wrote in an e-mail.

The main focus of today's news conference was on the AIDS crisis among farmers in central China and on the need to provide patients with affordable drugs, two hard-to-solve problems that health officials had previously mostly sought to avoid.

At today's news, Mr. Qi emphasized that China was taking the epidemic seriously, calling the situation "very dangerous." He revealed that the Communist Party's Central Committee had commissioned a special study on the epidemic, the first time it has lavished that kind of attention on a disease. He said that the central government had already earmarked 80 million yuan, about $10 million, to be directed toward Henan to combat AIDS.

But perhaps the biggest breakthrough was Mr. Qi's indication that China would consider bypassing patents to produce its own cheaper versions of AIDS drugs, especially the expensive Western medicines used in the AIDS cocktail, if the major Western producers do not reduce prices by the end of the year.

Until now China had vehemently rejected that route; it has tried to get cheaper drugs only by negotiating discounts from foreign manufacturers.

China has stubbornly maintained this position even as many other developing countries, including Thailand, India and Brazil, have started to produce or buy generic versions of the drugs, making effective treatment affordable for victims in those countries and saving countless lives.

Earlier this year, the World Trade Organization basically granted countries the right to bypass drug patents if the medicines were declared essential to combating a national health emergency and were otherwise unaffordable.

To date, China's negotiations with drug companies have yielded only piecemeal results, bringing the price of the AIDS cocktail here from an exorbitant $8,000 a year to a merely unaffordable $3,000 to $4,000, not including the testing that being on such drugs involves. The same medicines, in generic form, cost about $300 in Thailand.

As a result, Mr. Qi acknowledged that only about 100 patients in China were now on the AIDS cocktail, and most of that had been donated by foreign groups.

"We are ready to negotiate with the pharmaceutical companies, but if affordable prices cannot be reached, we will need to go that other route," Mr. Qi said. When asked how much longer the Chinese were willing to negotiate, he said: "Until the end of this year."

To activists here, poor access to medicines has been particularly galling, since China has a strong pharmaceutical manufacturing industry, one that is notorious for expertise in copying expensive Western drugs. One Chinese company, Shanghai's Desano Co. Ltd, already legally makes the raw ingredients for many of the pills in the AIDS cocktail, which it then ships to India to be transformed into generic pills that are unavailable to Chinese.

That anger has been generally mounting among China's experts as well. "We need a group of drugs to treat patients now," Dr. Shao Yiming, one of China's leading AIDS specialists said recently on China Central Television. He added: "It's a dead end to wait for patents to expire. It's up to our government, under the appropriate circumstances, to invoke the W.T.O. clauses."

If Chinese manufacturers started producing generic medicines, it still remains unclear how much benefit patients might reap, since all hope to make profits from the venture. A spokesman for the Shenyang Dongbei Pharmaceutical Company, which is newly licensed to make A.Z.T., refused to say how much the newly marketed generic is selling for, calling that a "commercial secret."

At the news conference today, Mr. Qi also discussed in greater detail than ever before the AIDS epidemic's relationship to the selling of blood in rural China.

Based on government statistics, he estimated that in one severely affected part of Henan, Shangcai County, about 10,000 people had contracted AIDS and that 1,000 had died.

Poor farmers sold their blood for about $5 a bag. They were infected with H.I.V. because the government-affiliated blood stations often used highly unsanitary processing practices that involved harvesting the fraction of blood used to make medicines and then re-injecting a portion of pooled blood to the sellers.

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