China has stepped up its campaign to clamp down on illegal sales of blood in its bid to halt the spread of Aids. Chinese television this week reported fears that contaminated blood plasma had been imported from South Africa, while other media reports have highlighted the dangers of black markets in syringes and blood donations. No one knows the true extent of HIV infection in rural China, from where most of the paid blood donors come, and hence the full extent of the problem. The Ministry of Health says there have been only 18,143 recorded cases of HIV infection and 670 Aids patients. It is generally estimated by the Government that the real figure may be 500,000 HIV cases although, other experts have put the total as high as four million. Since 1998, the Government has tried to enforce a new law on blood donations to protect patients, to define the responsibilities of health authorities and stop the illegal trade in blood. The Legal Daily recently reported a key test case in which a nine-year-old child was awarded 380,000 yuan (HK$353,000) in damages after the Health Bureau in Xinye county, Henan province, was taken to court. The child was infected with HIV during a blood transfusion after being injured in a fall in 1996. The family, which only succeeded in bringing their case to court in 1998, had originally sought more than 10 million yuan in damages. Henan is a centre for the illegal blood plasma market and many villagers have become infected through careless blood transfusion technology. In some areas, five per cent of blood donors have been infected with HIV. Blood from numerous donors is combined in a centrifuge to extract plasma and the unused red cells are returned to donors. Often the machinery is not cleaned between donations. Another cause of infection is the thriving market in used syringes. The Ministry of Health launched a campaign this week to enforce new regulations banning a flourishing industry in Zhejiang, Jiangsu and six other provinces. One million sub-standard syringes are shipped daily from just one region in Zhejiang, which has about 50 small factories. This week, the China Daily said police had destroyed 10 tonnes of disposable syringes and detained 13 people accused of collecting used syringes from hospitals. Villagers washed them and resold them in new packaging. In Wujin city, Jiangsu, authorities also confiscated five million sub-standard disposable syringes. The Health Ministry has denied that China has imported contaminated blood supplies from South Africa but a black market continues to flourish. China is experiencing a shortage of blood because of a general reluctance to donate blood. Ninety per cent of blood used in hospitals comes from a vast army of professional donors who give blood two or three times a week. For some villages, blood donations are the chief source of non-farm income. Earlier this month, the Beijing Youth Daily reported on a blood market which operated in Taihe county, Guangdong. Reporters found 400 donors crammed into a dormitory. Most of them were drug addicts and prostitutes and there is believed to be a high incidence of hepatitis and syphilis among donors. Top Aids researcher Professor Zeng Yi, of the Chinese Academy of Sciences, complained in June that the Government was not taking the problem seriously enough and warned of an impending epidemic.