Last week the Ministry of Health announced nationwide HIV testing for people who sold blood in the 1990s in an effort to detect Aids patients at an early stage. Local health departments have until mid-April to do it. According to the ministry, the mainland has 840,000 HIV carriers - 11,844 of them in Henan. UNAids estimates that 20 million mainlanders could be infected with HIV by 2010.

At least 80,000 people have full-blown Aids across the mainland. Those infected by blood sales in the mid-90s are now at 'the peak of death', when HIV often turns into Aids.

Dr Ho directs the China Aids Initiatives. It was formed by several organisations last year to help control the mainland's Aids epidemic. His programme is supported by the Ministry of Health and the Bill Clinton Foundation. He said it was encouraging to see the central government grow more transparent about the crisis in Henan.

'We know that problem is bad in some villages but precisely how bad is not known,' he said. 'The Chinese government is doing an extensive survey, testing hundreds of thousands of people, which is good. I really commend them for doing this. It is a very progressive move.'

His group started a cocktail therapy programme for about 100 patients in Yunnan province a few years ago and can now extend it to Henan.

Dr Ho, whose creation of the cocktail therapy saw him named man of the year by Time magazine in 1996, was in Hong Kong last week to raise funds.

He said that although the number of patients to benefit from the Henan programme would be small, it would have great impact as a model for other efforts.

'We set up in certain locations the proper team, the proper treatment protocol, the proper training and then this could be copied by other people,' he said.

The ministry will provide the drugs, which cost US$300 to $400 a year for each person. Pregnant patients and the very sick would be given priority. The Initiatives will provide technical expertise. Without this assistance, most Aids patients in Henan face a horrific, ignoble death.

'It is very hard to describe unless you see it,' Dr Ho said. 'If you go there and talk to the people, you get a feeling that's very hard to describe. It is a very poor place. Many of them have no toilets, no running water.

'And you listen to these people try to struggle with their lives. Every time I come back from there I have a heavy heart.'

What worries the medical team most is the backward health-care infrastructure in Henan might not be able to support a large-scale project at the moment.

'Treatment is more complicated than just drugs,' Dr Ho said. 'You need doctors and nurses, tests to monitor the progress - and those tests are not available in most parts of Henan.'

The blood tests are aimed at discovering the amount of virus in a patient's body and the patient's immunity level, in order to assess the effectiveness of the therapy.

Support for the patients is key, with the team adopting a 'peer-monitoring' model.

'For every 10 patients, they form a group and they help each other, make sure they take the medicine and share any problems,' Dr Ho said. 'It is not like people are hungry and you give them food. Most people know what to do with food. But with medicine, it is much more sophisticated. The patients must fully understand and comply fully.'

Some have described the Henan situation as a 'black hole' - hopeless no matter how much effort is put in - but Dr Ho disagrees.

'That is an overly pessimistic view, but I would agree the challenge is rather large,' he said. 'You have to begin somewhere.

'Like the old Chinese saying, the long journey begins with a single step. It is time-sensitive work, but if you do nothing, it would only be worse.

'In America, there is a very famous saying, 'Every noble task is seemingly impossible at first'. If it's worth doing, it must be done and you have to get started.'