China’s HIV/AIDS pandemic, in its first 1985 manifestation, was termed a ‘foreigner’s disease’. Patterns of infection in neighboring nations resulted in a more concerted approach. In contrast to other countries, China denied the extent of the epidemic for 15 years. According to WHO and various health officials, all past and current estimates of HIV infection in China are extremely conservative with the actual figures being as much as 25 times those that have been reported internally. Infections could reach ten million by 2010. Many of the programs reportedly established by 1990 are just now being put into place. The most essential need is for an effective surveillance program, along with a health education campaign. As in all Third World countries, major obstacles interfere with the implementation of such programs. The more serious of these hindrances consist of highly diverse populations, most of whom are simultaneously very mobile. The fact is that, while China superficially appears to be in a relatively advanced epidemic stage, the country is similar to Africa in that it is most likely pre-pandemic.