Memorandum submitted by Martin Gordon OBE, Chairman of Barry & Martin's Trust

(Registered Charity 1062629)

 

1. Barry & Martin's Trust was established in 1996 by Martin Gordon in memory of Barry Chan. Its aim has been to cooperate between the UK and China on Aids education, prevention, treatment and care.

2. We envisaged at the beginning that we would sponsor exchanges of doctors and nurses between the UK and China. The Chelsea & Westminster Hospital, especially Brian Gazzard and Frances Gotch, expressed support from the outset; and at the Chinese end we were strongly welcomed by the Ministry of Health and the Chinese Academy of Preventive Medicine, who were just beginning to take the HIV epidemic seriously.

3. One of our earliest initiatives was to suggest to the Chinese Academy that they and Chelsea & Westminster and ourselves should sponsor a seminar in Beijing at which the principal doctors and officials concerned with Aids around China should meet with our group from London to discuss Aids prevention and care. This seminar took place in May 1997. The Chinese Academy was extremely cooperative and unusually contributed RMB 10,000 to the event. It is good to record also that the old ODA - well before the establishment of DfID China - contributed £5000 to the cost of printing our conference book in English and Chinese. This book remained a standard text book on Aids for several years in China.

4. Our 1997 seminar furnished our Trust with a great many contacts in the field of Aids which we continue to enjoy. Also in this early period, whch coincided with the handover of Hong Kong and the subsequent improvement in UK/China relations, we got to know the team from DfID which was exploring the possibility of establishing an operation in China which would concentrate on Aids and other diseases like TB and malaria. We had a good dialogue with DfID during this period, especially with Billy Stewart, Jane Haycock and Fiona McConnon.

5. Looking back over our 12 years work on Aids in China, I might describe the late nineties as the early period, the years 2000 to mid-2003 as the pre-SARS period, and from mid-2003 as the current period.

6. In the early period, the Chinese officials and doctors dealing with Aids felt overwhelmed with the difficulties which they faced. The funds available were extremely small - whether from China's domestic budget or from international sources; the commitment from top leaders of the Chinese government was luke-warm, and prejudices were entrenched against the high-risk categories of drug-users, sex workers and gays.

7. Moreover the Ministry of Health was the least powerful of all China's Ministries, and had difficulty persuading other authorities. For example the police would prosecute drug-users and would frustrate any efforts to provide clean needles, methadone etc; prostitution in the more liberated China was expanding rapidly; the peculiar Chinese source of HIV infection, from illegal blood donations, was spreading silently from Henan and adjacent provinces; and gays were totally hidden from official view - to use their own Chinese expression, they were "ghosts".

8. In all these circumstances, the early initiatives from the UK were outstandingly more effective, and more appreciated, than those from any other country or international institution. DfID was very visible to Chinese officials as it prepared for its major entry into China; and our Trust was cooperating with, and contributing to, the efforts of Save the Children and Voluntary Service Overseas. We encouraged them in their efforts to include Aids education in their work and we brought teams of doctors and nurses from London to cooperate with them in Aids workshops in the most vulnerable areas of China, eg Liuzhou in Guangxi, Anshun in Guizhou and Ruili in Yunnan. On top of this, our Embassy in Beijing was unfailingly supportive - especially Rod Wye and Simon Johnson in the early years - sometimes contributing from the Embassy's own resources in cases where small and timely grants were highly effective.

9. It is important to emphasise the work done in the early period. It may have taken DfID more than two years to proceed from study and preparation to actual implementation , but DfID could not have achieved its prime position in China's Aids programme without this early work. It is the nature of China that you cannot just fly in and start operating in a major way - whether you are doing charitable work or business. However important or rich you are, you have to spend time building up relationships and trust. Institutions who have entered China more recently in the same field, e.g. Clinton Foundation and the Bill & Melinda Gates Foundation, have found that the same rules apply, and that extended groundwork is necessary before one can operate effectively and reach out to those in need.

10. This characteristic of operating in China needs to be borne in mind in any consideration of the future of DfID in China. The goodwill engendered by the DfID-China project is more tangible than any other project of any foreign institution. Our Trust has cooperated over the years with many such foreign institutions, eg the Australian Red Cross, Ford Foundation, Clinton Foundation, Medecins sans Frontieres and the German Malteser - but the contribution from the public and private sectors of the UK far exceed those of other foreign groups - and this is categorically the opinion of the Chinese officials and doctors with whom we work.

11. The UK's efforts contrasted with those of the US government whose contribution was limited by Congress. USAID was a late entrant in this field, and concentrated mainly in the 'Greater Mekong' region. Private US foundations have been active in the post-SARS period, but in the early days the main US actions came from Ford and from Rockefeller's support for Dr. David Ho.

12. The outbreak of SARS in March/April 2003 was a turning point in China's public health. It was embarrassing for China that SARS originated in China and that the epidemic would have been better contained if they had been more open about it. This caused the Chinese to pay much more attention to public health issues. Wu Yi was appointed Minister of Health, and the Ministry was given more priority and funding, and other infectious diseases were acknowledged more publicly, especially HIV/AIDS.

13. The SARS outbreak also coincided with the change of the Chinese government leadership. The new President and Prime Minister of China had a more sympathetic public face than their predecessors, and on 1 December 2003 Wen Jiabao visited the Aids wards in Beijing, and a year later Hu Jintao did the same. It would have been difficult to imagine this happening under the previous regime.

14. In the more open atmosphere of 2003, those who had been working on Aids in the previous years were listened to. DfID's UK-China project was well developed in Chengdu and Kunming, and its example was a key influence on government policy and on the Global Fund as it arrived in China. Adrian Davis as head of DfID China and Martin Taylor in charge of HIV/Aids established many useful precedents for China. The Global Fund could not possibly have proceeded to implementation of its projects in China if it had not been based on the groundwork established by DfID.

15. From our Trust's point of view, our work has developed on the lines that our friends around China have needed. In the eyes of the Chinese government and media we are best known (a) for our annual Barry & Martin's prizes which reward excellence in Aids education, treatment and care, and (b) for reaching out to the gay community. In addition we cooperate with hospitals in Beijing, Chengdu and Xinjiang and elsewhere; we continue to sponsor exchanges of doctors and nurses between the UK and China; and we rebuilt the old missionary hospital in Dali Yunnan, in cooperation with the local government, and we continue to support it as a centre of excellence which is now widely recognised around China.

16. We have found that our consistency over 12 years has put us in a strong position with national and local officials, who welcome our efforts to combat prejudice and stigma, and enable us to help the people who have the responsibility to look after Aids patients and their families. We hope from the point of view of DfID that it can maintain in future the consistency which is has achieved over the last decade.

17. We would certainly expect the needs of the Chinese will change, and within our Trust we believe we have always to adapt to the changing needs. We are always keen to reach out to the poorest parts of China, the borders of China, and we are very conscious of the contrast between this hinterland and the glittering centres like Beijing and Shanghai.

18. We would see perfect sense in HMG proposing to China to cooperate in these social issues in Africa, and the Chinese might well be motivated to respond positively. China is no stranger to medical support for Africa. I remember being told 5 years ago in Wuhan that each province of China has responsibility to send doctors to different countries of Africa. The Province of Hubei, of which Wuhan is the capital, was sending 135 doctors to Algeria and 12 doctors to Lesotho.

19. We would also assume that the Chinese would wish to help and influence their neighbours in social matters, including Aids - countries such as Vietnam, Burma, Kazakhstan and even Korea.

20. We have always had as one of our Trust's objects the need to influence opinion in Beijing. If attitudes are to change in China, the lead must be given by the capital. The visits of top leaders to the Aids wards are examples of this. Also the academics are important in a society where Confucian principles envisage respect for teachers. We have found the professors very helpful in influencing the opinion of senior leaders.

21. A recent example of the good effects of the UK-China project in Chengdu came last November. We were co-sponsoring with the National CDC an Aids seminar at the Sichuan Provincial People's Hospital. Most unusually an Aids patient from a village some way from Chengdu came to address the seminar. He told us that UK-China had worked in his and all the surrounding villages and had completely altered attitudes and prejudices, so that the Aids patients could carry on living an ordinary life.

22. We have also appreciated the cooperation and exchange of information with DfID and our Embassy in Beijing and our Consulates General in Chongqing, Guangzhou and Shanghai. In China it is difficult to achieve anything unless the government is on your side - and it is a reciprocal part of this that our own government is seen to be supporting us.

23. In this context we do not seek government funding, and apart from the initial goodwill gesture from ODA in 1997 we have operated independently of government - and our friends in China appear to appreciate that we are truly an NGO, and that we are not influenced by governments or drug companies or any special interests. Nevertheless the stamp of approval from DfID and the Foreign Office is a necessary and welcome ingredient for our work.

 

20^th April 2008