At the time, HIV/AIDS had already emerged in other parts of the world, including Europe and the United States, where cases were transmitted mostly through sexual contact. In China, however, people were infected after selling their blood and plasma or receiving transfusions contaminated in the trade.

Over the following decade, as many as 300,000 people in Henan province, the epicentre of the trade, were infected – a scandal exposed by local retired gynaecologist Dr Gao Yaojie.

Long before eye doctor Li Wenliang sounded the alarm on COVID-19 and succumbed to the virus in early 2020, Dr Gao was China’s best-known whistleblower. Her decision to expose the source of China’s AIDS epidemic made her an exile for the last 14 years of her life. She died last December at the age of 95 in New York.

Despite official erasure (Baidubake, China’s Wikipedia equivalent, says Gao settled overseas on a visiting fellowship), Chinese netizens mourned Gao’s death on the same Weibo “wailing wall” page where they commemorated Li.

Gao’s descent from national prominence to relentless official persecution exposed just how ruthless Beijing could be, even at a time when it was seen as opening up to the world.

“All she wanted was the freedom to speak out, to tell the whole world the truth behind China’s AIDS epidemic and to keep a record for history,” said former journalist Lin Shiyu, who edited most of the books Gao published while in exile in the US. “That was why she fled China.”

As the yet-unsolved origin of the COVID-19 pandemic shows, the secrecy Beijing enforces has repercussions for the rest of the world. Across the globe, more than 7 million people have died from the “mysterious virus” that first emerged in Wuhan in late 2019, according to the latest figures from the World Health Organization.

Gao did not set out to be an activist, much less a whistleblower. She became alarmed when she started to see patients in Henan province with tumours that she knew were common symptoms of AIDS. Few had been tested for HIV, let alone diagnosed, until Gao insisted.

“As a doctor I couldn’t turn a blind eye; I had a responsibility to do all I could to prevent this epidemic from spreading. However, at the time, I was unaware of the unfathomable forces underlying the widespread transmission of HIV,” Gao wrote in her 2008 memoir, The Soul of Gao Yaojie. “Had I known, I might not have been able to muster the courage.”

Soon enough, she discovered that the plasma trade – especially prevalent in rural areas where impoverished villagers needed to supplement their income – had become a vector for transmission. Once Beijing banned most imported blood products, part of its attempt to frame the virus as having a “foreign” origin, pharmaceutical firms ratcheted up domestic demand, making the problem worse.

Even the Chinese Red Cross and its People’s Liberation Army-run hospitals got into the booming blood business. Local officials who stood to profit told villagers that selling plasma was also great for their health. Many were infected with HIV because dirty needles were routinely reused to draw blood.

Half of the 3,000 villagers in one county in Henan province made ends meet with the blood money at the time; 800 developed AIDS, Gao noted in her memoir.

‘Officially controlled process’

As much as Gao’s fight to expose the source of transmissions and to staunch the blood trade rankled local officials, the central government recognised her efforts. When provincial officials put her under house arrest in 2007, the health minister intervened so Gao could travel to the US to receive an award.

Even though “whistleblowing” is translated literally into Chinese, the idea is not new, and the right to report wrongdoings was protected in the first constitution of the People’s Republic of China (PRC) of 1954. This stated that “all the PRC citizens had the right to make oral or written reports of any power abuses to the authorities”, according to political scientist Ting Gong in her 2000 paper titled Whistleblowing: what does it mean in China?

But that right has limits.

“In China, whistleblowing is an officially controlled process,” Gong noted.

The tide soon turned on Gao and others. Dr Wan Yanhai, a health official-turned-advocate, was detained in 2002 after distributing a secret government document on 170 AIDS-related deaths.

As with COVID-19, in the case of AIDS, “the impulse to cover up is ideological: Beijing deems its communist system the best in the world and brooks no fault”, Wan told Al Jazeera in February from New York after being barred from returning home to China since 2010. That was the year Wan defied officials’ warnings and attended the Nobel Peace Prize ceremony in Oslo to honour Liu Xiaobo, the Chinese dissident scholar who eventually died in prison in 2017.

For Gao, accolades worldwide and foreign media coverage of her work only gave Chinese officials further cause to rein her in.

After her book tour to Hong Kong in 2008, officials stepped up their surveillance and even cut her off from her family members. Several months later, Gao escaped with only a blood pressure meter and a floppy disk containing details and photos of patients.

At 81, Gao was the oldest dissident ever to have fled China. Barely one month after her death, prominent economist Mao Yushi set a new record. Mao, whose liberal think tank known for advocating market reforms was shut down by officials, shared pictures on social media of his 95th birthday celebrations in Vancouver, Canada, not long after he fled China.

Gao kept writing books into her last days.

“She was used to running around to tend to her patients. She felt useless merely writing on a notepad,” said Lin. Yet, Gao never took her final years in exile for granted.

“The US is no paradise,” wrote Gao, but she added: “Had I never left [China], I wouldn’t have lived past 90.”