The Three Diseases Fund
49. The Three Diseases Fund (3D Fund) has been developed
by a group of donorsAustralia, the EC, the Netherlands,
Norway, Sweden and the UKto address HIV/AIDS, TB and malaria
within Burma. The 3D Fund follows the withdrawal of the Global
Fund to Fight AIDS, Tuberculosis and Malaria in 2005 because of
restrictions placed on the UN and INGOs by the Burmese authorities.
The Burmese regime agreed the proposal to establish the 3D Fund
in June 2006 and a Memorandum of Understanding was signed with
the United Nations Office for Projects and Services (UNOPS)the
Fund Managerin October 2006. The Fund is not aimed specifically
at IDPs but DFID pledged that, "As Three Diseases Funded
projects are developed, DFID and our partner donors will work
hard to ensure that IDPs suffering from tuberculosis, malaria
or HIV/AIDS are able to benefit from international assistance."[96]
DFID's commitment to the
Fund totals £20 million over 5 years, or £4 million
per yearnearly half of DFID's current annual budget for
Burma of £8.8 million.
50. Witnesses acknowledged that DFID had played a
leading role in developing the 3D Fund and welcomed it as a desperately
needed effort to fight infectious diseases in Burma.[97]
However, a major concern was articulated about the Fund in relation
to its ability to reach IDPs. Witnesses doubted that the Fund
would reach the most vulnerable people, many of them IDPs, in
Burma's border areas.[98]
Dr. Thomas Lee, who has worked for the last decade on Burma's
borders, pointed out that Burma's malaria burden is highest on
its four borders (see Map 2, page 26). A 2006 survey found that
nearly half of all deaths in eastern Burma are due to malaria,
and that adult malaria incidence in the region is nearly twice
as high as the national average.[99]
Christian Aid told
us that on the Burma-China border, HIV prevalence is "at
crisis point."[100]
Whilst no independent mapping
of services provided by INGOs working in Burma has been conductedwhich
adds further urgency to our recommendation in paragraph 45 that
a review of assistance should be carried outit is clear
that these border zones, many of them conflict areas, are the
very areas that NGOs are least likely to reach and hence where
populations are most in need of assistance.[101]
51. Funding from the 3D Fund is unlikely to reach
the border areas. Grant recipients are required to have a Memorandum
of Understanding (MoU) with the SPDC, but as the regime does not
allow aid to reach many ethnic and conflict areas, it is unlikely
to agree an MoU with local groups working in these areas. Cross-border
groups will also not be permitted to sign an MoU. [102]
52. Several witnesses believed that the priority
now is to create a complementary strategy to the 3D Fund that
is capable of reaching the most vulnerable people, including IDPs.
The Burma Campaign UK and Christian Solidarity Worldwide were
concerned that, to their knowledge, none of the NGOs working on
the ground were consulted on alternative mechanisms that could
be used to reach people that the 3D Fund is going to miss.[103]
Dr Thomas Lee told us that there is capacity to provide healthcare
in the border areas, were funding opportunities available: "On
all three borders there are substantial indigenous local health
organisations that do have the infrastructure and the capacity
to provide standard interventions for infectious disease."[104]
Dr Lee described the woeful underfunding of essential healthcare
services on the eastern border, with 80% of the costs for the
malaria programme on which he works near the border used up by
simply providing drugs and diagnostic tests, leaving hardly any
funds for salaries, transportation and logistics.[105]
Whilst we welcome the Three Diseases Fund, and believe that
DFID deserves credit for helping to develop it, in its current
form it will not reach sufficient numbers of IDPs or other vulnerable
groups living in border and conflict areas. We recommend that
DFID build on its leadership role in helping to develop the Fund
by supporting the creation of a complementary mechanism that makes
funding available to organisations providing healthcare in the
border areas.
Developing a humanitarian dialogue
with the regime
53. If in-country assistance to IDPs is to improve,
it will be necessary to develop a humanitarian dialogue with the
regime. A number of stakeholders that we spoke to during our visit
to the Thai-Burma border told us that the Burmese authoritiesespecially
at senior levelswere currently in denial about poverty.
(There were some exceptions to this: for instance, the Minister
of Education had shown some awareness of the poor education situation.)
This made the kind of dialogue or shared analysis of poverty that
DFID and other members of the international community would normally
undertake with a government very difficult. In turn, this means
that taking development and humanitarian programmes to any kind
of scale is a real challenge for donors.
54. We wholeheartedly endorse the need to avoid showing
support for the SPDC. However, we believe that
undertaking limited, narrowly-focused discussions on poverty and
humanitarian concerns with the regime could help develop a shared
understanding of how best to assist IDPs.
As Ashley South, a consultant specialising in displacement in
Burma, told us:
"I think the idea of the SPDC engaging with
the international community on discussions on democratisation
in the broadest sense is not very realistic, but perhaps one or
two specific issues could be identified, for example humanitarian
dialogue, and [...] forced migration and displacement."[106]
Mr. South pointed out that there are examples of
successful dialogue with the SPDC, notably regarding forced labour,
as a result of which a trial victim complaints system for forced
labour has been established between the International Labour Organisation
(ILO) and the regime.[107]
55. Dr. Zarni from the University of Oxford thought
that DFID should "definitely take any opportunity to engage
in policy discussion with the regime at all levels", but
that the UK's "difficult historical relationship" made
it problematic for DFID to take a leading role and that it would
be more effective for DFID to support other actors, possibly the
UN, to develop a humanitarian dialogue with the regime.[108]
The UK Government needs to tread very carefully before beginning
any kind of dialogue with the State Peace and Development Council
(SPDC). However, we believe limited engagement on specific poverty
and humanitarian issues should begin and that the most sensible
approach would be for DFID to do this as part of a group of international
actors, under the banner of the UN.
66 See Paragraphs 49-52. Back
67
Ev 138 [UN OCHA] Back
68
DFID Assistance for Burmese Refugees and Internally Displaced
People, DFID, March 2007, p 15. Back
69
Ev 89 [Ashley South] Back
70
Ev 62 [DFID] Back
71
Ev 117 [Peace Way Foundation: Burma Issues] Back
72
Ev 62 [DFID] Back
73
Ev 123 [Save the Children (Burma)] Back
74
Ev 123 [Save the Children (Burma)] Back
75
Ev 123 [Save the Children (Burma)] Back
76
Q 75 [Dr Thomas Lee] Back
77
Q 123 [Linda Doull] Back
78
Ev 138 [UN OCHA] Back
79
Ev 112 [Mae Tao Clinic, Back Pack Health Worker Teams and Burma
Medical Association] Back
80
Ev 138 [UN OCHA] Back
81
Ev 63 [DFID] Back
82
Ev 68 [Burma Campaign], Ev 77 [Christian Solidarity Worldwide]
and Q 92 [Ray Hasan]. Back
83
Ev 68 [Burma Campaign] Back
84
Ev 73 [Christian Aid] Back
85
Q 93 [Ray Hasan] Back
86
Q 40 [Mark Farmaner] Back
87
Ev 138 [UN OCHA] Back
88
Ev 138 [UN OCHA] Back
89
Q 137 [Ashley South] Back
90
Ev 138 [UN OCHA] Back
91
Q 99 [Ray Hasan] and Q 10 [Benedict Rogers]. Back
92
Q 101 [Linda Doull] Back
93
Q 93 [Ray Hasan] Back
94
Q 99 [Ray Hasan] Back
95
Q 188 [Gareth Thomas MP] Back
96
Ev 66 [DFID] Back
97
Ev 69 [Burma Campaign] and Q 92 [Ray Hasan]. Back
98
Q 6 [Benedict Rogers] and Ev 98 [Burma Campaign]. Back
99
Ev 110 [Mae Tao Clinic, Back Pack Health Worker Teams and Burma
Medical Association] and Back Pack Health Worker Team, Chronic
Emergency: Health and Human Rights in Eastern Burma (2006), p.10. Back
100
Q 91 [Ray Hasan] Back
101
Q 62 [Dr Thomas Lee] and maps submitted by Dr. Thomas Lee (unprinted
background paper). Back
102
Ev 69 [Burma Campaign UK] Back
103
Q 10 [Benedict Rogers] and Q 6 [Mark Farmaner]. Back
104
Q 58 [Dr Thomas Lee] Back
105
Q 58 [Dr Thomas Lee] Back
106
Q 132 [Ashley South] Back
107
Q 132 [Ashley South] Back
108
Q 151 [Dr Zarni] Back