Although they're probably unaware of it, tens of thousands of residents of Henan, China owe their lives to Shuping Wang. Her legacy — altered procedures for blood collection in China to prevent the spread of HIV, HBV and HCV — comes from years of relentless work that was both politically and personally dangerous.
In the early 1990s, Wang was working at the Zhoukou Center for Disease Control and Prevention, researching viral hepatitis. She was also assigned to supervise the collection of blood plasma. Henan province was building a business around plasma collection and distribution; plasma is use commercially for products ranging from cosmetics to therapies for cancer and hemophilia. As a researcher specializing in blood-borne pathogens, Wang quickly realised that the plasma collection procedures were not safe. Blood from donors was pooled and re-infused to them after the plasma was extracted. Equipment was re-used without sterilization. And although donors were screened for HBV, they were not screened for HCV or other 'unknown' agents. As she wrote on ChinaChange, 34% of the samples from donors that she tested initially were HCV-positive. According to a recent article in The Washington Post, >80% of the population of Henan was HCV positive by the time blood collection policies changed.
By this time, another viral pathogen was earning worldwide recognition. In the 1980s, an unusual number of homosexual men in New York were developing Kaposi's sarcoma. This rare cancer can develop in people with immune deficiency, and these men were some of the first victims of the AIDS epidemic. The subsequent discovery of HIV as the causative agent in AIDS had implications around the world, including Henan. By the 1990s, the HIV infection rate amongst drug users in nearby Yunnan province was in the range of 40-80%: HIV was very likely to already be in Henan, and was not being screened for during plasma collection.
Wang sprang to action. Using her own money and initiative, she started testing plasma donors for HIV. Her reported HIV infection rate amongst these people was 13%; from that she estimated that about 500 people were contracting HIV and/or HCV every day at plasma stations around the province. She reported her findings to health officials in Hennan to no avail. In fact, her lab was destroyed and she was physically assaulted by people trying to cover up the emerging tainted blood scandal. Fortunately, she was unbowed, and eventually found sympathetic ears higher up in Beijing with Zeng Yi, President of the Chinese Academy of Sciences. Her cries for help did not go unheard, and policies of safe blood collection, including testing for HIV, were eventually implemented in Henan. And although she was personally chased out of Henan, eventually moving to the USA, by then she had already left her mark on Henan and its residents.
Infection prevention, and those who ensure that appropriate policies are in place, is an unsung hero of infectious diseases. The millions of lives and hundreds of millions of life-years saved by vaccination alone are a good reminder that ounce of prevention is worth a pound of cure. Shuping Wang's contributed 'ounce' weighs heavily on the HIV stage. Her life is also celebrated on the dramatic stage: The King of Hell's Palace, a moving rendition of her story, was recently performed at The Hampstead Theatre. It serves as a reminder (or, for me, an introduction) to the life of this amazing woman. Shuping Wang died during the run of this production, but her story and her contribution live on.