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RUEKJCS/SECDEF WASHDC C O N F I D E N T I A L SECTION 01 OF 02 RANGOON 000237 
 
SIPDIS 
 
STATE FOR EAP/MLS, G, S/OGAC, OES 
PACOM FOR FPA 
BANGKOK FOR USAID HEALTH OFFICE 
DEPARTMENT PLEASE PASS TO USAID/AME; DEPT OF HHS; NSC 
 
E.O. 12958: DECL: 04/27/2019 
TAGS:              
SUBJECT: BURMA: URGING THE GOB TO ADDRESS GLOBAL FUND ACCESS 
 
REF: A. RANGOON 207 
      B. 08 STATE 131926 
 
RANGOON 00000237  001.4 OF 002 
 
 
Classified By: Economic Officer Samantha A. Carl-Yoder for Reasons 1.4 
(b and d). 
 
Summary 
------- 
 
 1.  (SBU)  With the June 1 deadline fast approaching, the 
Ministry of Health (MOH) and WHO technical advisors continue 
to revise the MOH's draft Round Nine Global Fund application. 
  Embassy Rangoon, USAID, and other donors reviewed and 
provided comments on the first draft; we expect to review the 
second draft in early May.  The proposal is strong 
technically, but in Embassy Rangoon's opinion fails 
adequately to address issues of access and the 2005 Global 
Fund withdrawal.  According to DFID, the Minister of Health 
will write a cover letter to the Global Fund Secretariat that 
will guarantee the Global Fund grant will be afforded the 
same treatment, including on access, as the existing Three 
Disease Fund (3DF) program.  Additionally, the 3DF will 
provide a separate document to the Global Fund Secretariat 
detailing its operational experience in Burma, including 
access to project sites, visas, and fund flow.  Embassy 
Rangoon will continue to encourage the MOH and the Country 
Coordinating Committee (CCM) to address specifically within 
each disease proposal the issue of access and other concerns 
that prompted the Global Fund withdrawal.  End Summary. 
 
Reviewing the Proposals 
----------------------- 
 
 2.  (SBU)  Per Ref A, Embassy Rangoon, USAID, and other 
donors reviewed and commented on the Ministry of Health's 
first Global Fund (GF) Round Nine draft application.  We 
recommended several technical improvements to the specific 
disease proposals, although according to U.S. and other 
experts the proposals generally are sound from a technical 
standpoint.  However, the current drafts of the individual 
HIV/AIDS, TB, and malaria applications fail to address 
adequately the issue of access, as well other issues that 
prompted the Global Fund's 2005 withdrawal.  They include no 
clear commitments from the MOH or GOB and lack specifics on 
the processes to be followed for visas and in-country travel 
authorizations, for example.  During meetings with other 
donors and WHO, we reiterated the USG's position on the GOB's 
Global Fund application (Ref B) and strongly urged them to 
join us in conveying to MOH the need explicitly to address 
prior GF experiences and explain how the situation has 
changed.  We also recommended that the final proposal include 
information on specific GOB commitments and procedures to 
ensure access. 
 
Dealing with Access 
------------------- 
 
 3.  (SBU)  According to Julia Kemp, DFID Health Advisor and 
donor representative to the CCM, the Ministry of Health is 
committed to providing "free and unfettered" access to all GF 
program sites.  During meetings with the Global Fund 
Secretariat in February, the Minister agreed that in terms of 
access, procurement, financial flows, and exchange rate 
issues -- with which the Global Fund had problems in 2005 -- 
 
RANGOON 00000237  002.4 OF 002 
 
 
a new GF grant will be afforded the same treatment as the 
Three Diseases Fund.  We noted that this information was 
lacking from the draft documents and urged the CCM to ensure 
MOH and WHO incorporate language to this effect into the 
individual disease proposals to ensure that all implementing 
partners are on the same page.  Kemp agreed to raise the 
issue with the CCM. 
 
 4.  (C)  Kemp also noted that per the Global Fund 
Secretariat's request, the 3DF will provide separate 
documentation as part of the MOH application detailing the 
3DF operational procedures, as well as experiences working 
with the Ministry of Health.  The Secretariat is particularly 
interested in evidence that the MOH's procedures have enabled 
the 3DF to successfully work in Burma.  Kemp, who often 
represents DFID on the 3DF Board, would not confirm whether 
the 3DF would endorse MOH's procedures, but stated the 3DF is 
compiling evidentiary documentation to submit directly to the 
GF, without MOH's prior review. 
 
 5.  (C)  Kemp stated that per Global Fund policy, access to 
program sites must only be guaranteed for implementing 
partners, the Global Fund, and any third party designated by 
the Global Fund.  Donors do not fall under the GF access 
requirements, she noted. 
 
Comment 
------- 
 
 6.  (C)  We understand the GF Secretariat wants confirmed 
"free and unfettered" access to program sites, not 
necessarily to the entire country.  This approach is 
understandable, since it is unrealistic to seek access to 
some of Burma's more sensitive and dangerous regions where no 
assistance flows.  We understand that MOH has already vetted 
and agreed to the program sites listed in the proposals. 
However, MOH cannot deliver visas or travel authorizations, 
which are officially the purview of the Foreign Ministry but 
are often ultimately approved by others:  the Foreign Affairs 
Policy Committee in the case of visas and the Ministry of 
Defense and the relevant regional military commander for 
expat in-country travel.  We don't know whether MOH has 
cleared the list of GF program sites with other GOB entities. 
 In accord with Washington guidance (Ref B), we will continue 
to work with donors, WHO staff, and MOH to attempt to ensure 
that the CCM adequately addresses access issues and other 
Global Fund concerns in each of the proposals.  DFID, as 
donor representative to the CCM, told CCM members that donors 
would not sign the final proposal until the access issues 
have been clearly identified and addressed.  We expect to 
review and comment on the second round of drafts in early 
May, and will forward them to the Department as soon as they 
are received. 
 
DINGER