BURMA EYES A GLOBAL FUND APPLICATION

C O N F I D E N T I A L SECTION 01 OF 03 RANGOON 000797 SIPDIS STATE FOR EAP/MLS, G, S/OGAC, OES, DRL, IO, INR/EAP BANGKOK FOR USAID HEALTH OFFICE, REO, ECON DEPT PASS TO USAID/AME E.O. 12958: DECL: 09/19/2018 TAGS: SOCI EAID PHUM KHIV PGOV SENV BM SUBJECT: BURMA EYES A GLOBAL FUND APPLICATION REF: A. RANGOON 786 ¶B. RANGOON 764 ¶C. RANGOON 308 RANGOON 00000797 001.2 OF 003 Classified By: Economic Officer Samantha A. Carl-Yoder for Reasons 1.4 (b and d) Summary -------------- ¶1. (C) The Burmese Government held its first Country Coordinating Mechanism (CCM) meeting on October 7, revising its existing oversight mechanism for health assistance on HIV/AIDS, tuberculosis (TB),and malaria with an eye toward a Global Fund Round 9 application. UN, NGO, and donor representatives present at the meeting reported that the Ministry of Health plans to submit a formal Global Fund application in January 2009. UN and GOB officials emphasized that there is a need for additional assistance on AIDS, TB, and malaria and that Burma meets the Global Fund's basic eligibility criteria. However, several NGO participants during the meeting highlighted that any application must address the GOB impediments that caused Global Fund to withdraw in 2005. End Summary. Preparing for a Round 9 Application -------------- ¶2. (SBU) The Burmese Government, laying groundwork for a possible Global Fund application, worked with other players to establish a CCM from a previous disease-oversight body in a meeting in Nay Pyi Taw on October 7. As their first action, the 25 CCM members (10 GOB officials, four UN officials, one bilateral donor representative, three local NGO representatives, four international NGO officials, one private sector representative and two people infected with HIV/AIDS or TB),who were elected by their peers the week before, used secret ballots to elect the Minister of Health as the Chair of the CCM and an official from the Myanmar Medical Association as the Vice Chair. (Note: the Global Fund recommended that both the Chair and Vice Chair be Burmese nationals from different organizations. End Note.) According to Julia Kemp, Health Officer from the UK's Department for International Development (DFID) and the lone donor representative to the CCM, the voting process was fair and transparent. John Hetherington, Country Director of Population Services International (PSI),separately echoed this view, noting that GOB officials did not approach any CCM members to lobby for votes. The results were tallied by representatives from UNAIDS (an expat) and the Ministry of Health. ¶2. (SBU) The CCM adopted new terms of reference (TOR), revising the TOR of the previous oversight mechanism for HIV/AIDS, TB, and malaria assistance under the 3 Diseases Fund (3DF). Kemp emphasized that while the new CCM meets the Global Fund's criteria, it would also provide oversight for the GOB's national disease strategies and the 3DF, which was established in 2006 after the Global Fund withdrawal. Keeping the 3DF in the CCM will provide for improved aid effectiveness, Kemp stated, as the CCM can monitor the variety of disease-response programs, identify funding gaps, and eliminate any duplication. Should the GOB receive Global Fund support, the CCM will oversee this program in conjunction with other national programs, ensuring complementarity among them, she observed. ¶3. (SBU) During the meeting, the CCM also reviewed the Call for Concept Notes, which had been circulated before the meeting. WHO and DFID recommended that the existing Technical Strategic Groups (TSGs) for TB and Malaria update the operational plans and gap analysis for those diseases to ensure that concept note priorities reflect the current RANGOON 00000797 002.2 OF 003 situation. The TSGs are comprised of GOB and NGO representatives and will advise the CCM on national plan priorities. DFID suggested that the Concept Notes include indicators to measure program results accurately. The CCM approved the Call for Concept Notes, agreeing that further amendments could be made through the TSGs for each disease. Views on the Meeting -------------- ¶4. (C) Kemp, Hetherington, and two other participants, Brian Williams from UNAIDS and Hans Kluge from WHO, told us they were encouraged by the Ministry of Health's efforts to comply with Global Fund eligibility requirements. Both Kemp and Hetherington underscored the transparency of the elections and the drafting of the TOR and Concept Notes. Williams and Kluge told us that the GOB, working with UNAIDS and WHO, expects to submit a Round 9 application in January. According to Williams, the Burmese Government understands that it would not be the primary recipient of the Global Fund, should an application be approved. The CCM has yet to establish the primary recipient criteria, but will do so in future meetings. Has the Environment Changed? -------------- ¶5. (C) We understand the UN argued at the CCM that Burma's operating environment has changed significantly since 2005, pointing to the success of the 3DF (Refs A and C) and the new opportunities for cooperation with the GOB created by Cyclone Nargis relief efforts. However, Birke Herzburch of Malteser, while acknowledging the 3DF's success in providing necessary treatments, noted in the meeting that a Global Fund application must address the operational concerns that existed in 2005. In response, the Minister of Health said that given the positive cooperation between international organizations and the GOB in the aftermath of Cyclone Nargis, he was confident that all of the operational issues could be resolved. ¶6. (C) Hetherington told us he spoke with the Minister of Health separately and noted that access to program sites in Burma remains a concern for several Global Fund Board members, including the United States and the Gates Foundation. He emphasized that the GOB needs to issue visas to donors and allow them to monitor their existing programs before submitting a Global Fund application. UNAIDS' Williams said he also raised the issue with the Minister, inquiring whether a letter from the UN would help with visa issuance. The Minister of Health acknowledged that visas have been a problem, but noted that it has been a "sensitive time" in Burma. Thant Kyaw, the Director General for International Organizations at the Ministry of Foreign Affairs, told Williams he would raise the issue within his ministry. ¶7. (C) Williams stressed the humanitarian need for Global Fund support in Burma, despite potential challenges. "While there is a higher cost to do business in Burma, those costs are outweighed by the number of lives saved by humanitarian assistance," he declared. He stressed that NGOs have been able and continue to do good work throughout the country. (Note: NGO's here routinely make this point to us as well. End Note.) He acknowledged that there are some obstacles, but argued that coordination with the GOB on a Round 9 application, the 3DF, and assistance post-Nargis prove that the environment is different than it was in 2005. Next Steps -------------- ¶8. (SBU) The next CCM meeting will be held in Nay Pyi Taw on RANGOON 00000797 003.2 OF 003 October 26. Julia Kemp with meet with donors prior to the meeting to hear views on the following agenda items and any other concerns: -Establishing a mechanism to create a steering committee, which will advise the CCM on policy issues; -Reviewing and re-endorsing the terms of reference for Burma's existing TSGs for HIV/AIDS, TB, and Malaria; -Beginning discussions on the criteria and appointment mechanism for the principal recipient of Global Fund monies; and -Undertaking an in-depth review of 3DF programs and successes. ¶9. (SBU) According to Kemp, DFID will encourage Global Fund representatives to meet and discuss with key USG interlocutors Burma's possible Round 9 application. Such a meeting, should the USG agree to it, would ideally occur before October 26. Comment -------------- ¶10. (C) The GOB appears committed to submit a Round 9 application and is pressing ahead with efforts to address Global Fund requirements. We will continue to emphasize to our UN, NGO, and donor interlocutors the need to resolve early on all outstanding concerns about Burma's operational environment. Post strongly recommends a meeting between appropriate U.S. officials and Global Fund representatives to allow the USG to express its concerns directly to the Global Fund Secretariat. Post also requests guidance for the next donors meeting, which DFID plans to host, ideally after a Global Fund/USG meeting occurs. DINGER