3D FUND PROMOTING HEALTH CARE THROUGHOUT BURMA

UNCLAS SECTION 01 OF 03 RANGOON 000096

SIPDIS

SENSITIVE
SIPDIS

STATE FOR EAP/MLS;
PACOM FOR FPA
BANGKOK FOR USAID/RDMA HEALTH OFFICE, REO: JWALLER

E.O. 12958: N/A
TAGS: SOCI EAID PHUM KHIV PGOV SENV BM
SUBJECT: 3D FUND PROMOTING HEALTH CARE THROUGHOUT BURMA

REF: 07 RANGOON 419 QB) RANGOON 048

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1. (SBU) Summary. After getting off to a slow start, the 3
Diseases Fund (3DF),run by UNOPS, has started moving: 26
implementing partners are fulfilling 38 health contracts
worth $21 million in 300 townships throughout the country.
3DF activities target the most vulnerable and under-served
population groups, particularly those living in remote areas.
The 3DF will launch its small grants program in the next
month, and plans to issue 10-15 contracts to smaller local
NGOs for HIV/AIDS, TB, and malaria programs in rural areas.
While the Fund has secured $104 million in funding for a five
year period, 3DF needs additional funds to ramp up existing
health projects and provide improved health services to more
Burmese. End Summary.

3D Fund Rollout
--------------


2. (SBU) The 3 Diseases Fund (3DF),managed by UNOPS, was
established 2005 to reduce the burden of communicable disease
mortality and morbidity for HIV/AIDS, malaria, and TB in
Burma (Ref A). A consortium of six donors -- Australia, the
European Commission, the Netherlands, Norway, Sweden, and the
United Kingdom -- pledged a budget of $104 million over a
five year period. After a slow start, the 3DF signed
contracts worth $21 million with 26 implementing partners,
including UN agencies, international NGOs, and local NGOs, in
May and September 2007. According to 3D Fund CEO Mikko
Lainejoki, the implementing partners are now working on 38
different projects in 300 townships to promote the prevention
and treatment of HIV/AIDS, TB, and malaria among vulnerable
and under-served populations.


3. (SBU) Implementation of 3DF programs has gone well,
although there were some program delays due to the political
crisis in September, Lainejoki told us. While most of the 38
projects are well underway, several NGOs are working hard to
put other projects back on schedule. According to Lainejoki,
the Minister of Health, as well as Regional Commanders,
support the work of 3DF's NGO partners, including five
Burmese NGOs. The majority of 3DF's programs focus on
HIV/AIDS, although some of the implementing partners, such as
MSF-Holland or Population Services International, are also
implementing multiple contracts for TB and malaria.
Currently, 16 partners are working on HIV/AIDS projects, 10
partners have TB programs, and 7 partners are implementing
malaria programs throughout the country.


4. (SBU) During the first year, 3DF will to take over
management of projects that existed under the Global Fund and
the Fund for HIV/AIDS in Myanmar (FHAM),Lainejoki explained.
To date, 3DF programs have provided anti-retroviral
treatment for more than 10,000 people, as well as funded
doctors and clinics to enhance diagnosis of TB and malaria.
3DF plans to ramp up activities in coming years to improve
the quality of health care for Burmese in remote areas,
although it needs to secure additional funding, Lainejoki
admitted.

Empowering Local NGOS
--------------


5. (SBU) In the next few weeks, 3DF will open competition
for its second round of grants, this time focusing on smaller
grants for local NGOs. The maximum grant amount will be

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capped at $100,000, although the 3DF Board expects that the
average grant will be $30,000. The Fund plans to award
between 10-15 contracts in the next two months. NGOs do not
have to be registered with the GOB to be eligible for these
grants, Lainejoki told us, although they will have to partner
with NGOs that have MOUs with the GOB in order to implement
their project. 3DF hopes to use the small grant program as a
way to provide services to remote areas while simultaneously
building capacity for smaller NGOs.


6. (SBU) Providing money to small, unregistered NGOs may
prove to be a problem, 3DF Public Health Officer Ivonne
Camaroni explained. Burma has a poor banking system, with
few banks in rural areas. As a result, many people use
informal banking networks, such as the hundi system, to move
money. Additionally, NGOs must be officially registered with
the GOB to open a bank account in NGO's name. Thus, 3DF may
face difficulties providing funding to unregistered NGOs, she
admitted. Unregistered NGOs that partner with INGOs could
receive funding through the INGO; other NGOs might open
accounts in the name of the NGO Director to receive funds.
UNOPS is searching for ways to work within the Burmese
system, Lainejoki explained, and may also explore alterative
ways to award grants.

Funding Issues Remain
--------------


7. (SBU) During the next year, 3DF will seek additional
financial support for its program. According to Lainejoki,
the $105 million over five years will cover current
operations, but does not allow implementing partners to
revamp, improve, or expand current coverage. Ideally, the
3DF budget would increase by 20 percent each year in order to
expand services to all 325 townships and to focus on specific
components of HIV/AIDS, TB, and malaria prevention and
treatment, Camaroni explained. Until 3DF finds new donors,
its health care projects cannot expand, she concluded.


8. (SBU) Currently 60 percent of the Fund's budget goes to
HIV/AIDS projects, with malaria and TB each receiving 20
percent. Additionally, Fund projects focus more on
prevention rather than treatment. During 2008, 3DF will
conduct studies to determine whether the budget allocation is
appropriate given Burma's health care needs, as well as
determine how much money it will need to improve existing
programs. 3DF may also launch studies on disease burden,
incidence, and prevalence of HIV/AIDS, TB, and malaria
throughout Burma, Lainejoki noted. Currently, 3DF, per its
MOU with the Ministry of Health, has authority to conduct
these studies. Lainejoki was unsure whether the GOB's recent
request that NGOs minimize new surveys and assessments would
impact the 3DF's survey plans (Ref B).

Comment
--------------


9. (SBU) Although the Minister of Health is supportive of
health programs, the regime only spends 0.4 percent of GDP on
health care for the Burmese people, despite increased
revenues from oil and gas exports. Programs like the 3D Fund
and our humanitarian assistance to private NGOs, such as PSI
and International Alliance for HIV/AIDS, are vital to ensure
that ordinary citizens continue to have access to critical
health services. NGOs need more money to tackle diseases
like TB and malaria, which kill 12,000 and 3,000 Burmese

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annually, to ensure the infected receive proper treatment and
prevent multi-drug resistant infections from spreading
throughout the region. Until the political situation
changes, the Burmese people will rely on international donors
to try to stem the spread of infectious diseases. Denying
the assistance will not bring about political change.

VILLAROSA