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Viewing cable 07RANGOON588, THREE DISEASES FUND OMITS PRIVATE SECTOR TREATMENT

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Reference ID Created Released Classification Origin
07RANGOON588 2007-06-18 10:03 2011-08-25 00:00 UNCLASSIFIED//FOR OFFICIAL USE ONLY Embassy Rangoon
VZCZCXRO8060
OO RUEHCHI RUEHDT RUEHHM RUEHNH
DE RUEHGO #0588/01 1691003
ZNR UUUUU ZZH
O 181003Z JUN 07
FM AMEMBASSY RANGOON
TO RUEHC/SECSTATE WASHDC IMMEDIATE 6184
INFO RUCNASE/ASEAN MEMBER COLLECTIVE
RUEHBJ/AMEMBASSY BEIJING 1450
RUEHBY/AMEMBASSY CANBERRA 0346
RUEHKA/AMEMBASSY DHAKA 4558
RUEHLO/AMEMBASSY LONDON 1958
RUEHNE/AMEMBASSY NEW DELHI 3894
RUEHUL/AMEMBASSY SEOUL 7441
RUEHTC/AMEMBASSY THE HAGUE 0622
RUEHKO/AMEMBASSY TOKYO 4993
RUEHCN/AMCONSUL CHENGDU 1144
RUDKIA/AMCONSUL CHIANG MAI TH 1004
RUEHCI/AMCONSUL KOLKATA 0007
RUEATRS/DEPT OF TREASURY WASHDC
RUEHGV/USMISSION GENEVA 3157
RHEHNSC/NSC WASHDC
RUEKJCS/SECDEF WASHDC
RUEKJCS/JOINT STAFF WASHDC
RUCNDT/USMISSION USUN NEW YORK 0803
RUEHBS/USEU BRUSSELS
UNCLAS SECTION 01 OF 02 RANGOON 000588 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
STATE FOR EAP/MLS; 
PACOM FOR FPA 
 
E.O. 12958: N/A 
TAGS: ECON EAID TBIO PGOV BM
SUBJECT: THREE DISEASES FUND OMITS PRIVATE SECTOR TREATMENT 
OF TB 
 
REF: RANGOON 0419 
 
RANGOON 00000588  001.2 OF 002 
 
 
1. (SBU) Summary: Population Services International (PSI) did 
not receive funding from the Three Diseases Fund (3DF) to 
continue its effective TB treatment program in Burma.  The 
3DF instead chose to support the TB programs of the World 
Health Organization and the Myanmar Medical Association 
(MMA).  The MMA, a local professional association, will use 
the funds to refer patients to the public health sector, 
while PSI's program would have treated 33,000 patients 
through its chain of already successful private clinics over 
a three year period.  PSI representatives attribute the 
decision primarily to a preference by Fund consultants to 
build the capacity of the public sector.  We should consider 
adding funding for TB in Burma to show the viability of 
private delivery.  End summary. 
 
PSI LOSES FUNDING 
----------------- 
 
2. (U) On June 15, 2007, PSI Country Director John 
Hetherington and Communications Manager Sam Conner briefed 
Charge on the results of the 3DF's first round of funding for 
TB.  The 3DF was established by Australia, the EC, the 
Netherlands, Norway, Sweden, and the UK to support activities 
in Burma's national programs for malaria, TB and HIV/AIDS.  A 
board, made up of donor representatives and regional health 
experts approved the first round of grants for projects to 
begin in 2007 (reftel).  The 3DF Board did not approve PSI's 
$2 million, three-year TB proposal, which would have 
continued treatment of TB patients through its network of 
private health clinics.  PSI estimated that 85% of the 33,000 
low income patients it would treat if funded could die, and 
each patient could infect up to ten additional people with 
TB. 
 
3. (SBU)   Hetherington attributed the 3DF Board's decision 
to a number of factors, including the incorrect perception 
that PSI's clinics compete with government clinics, time 
constraints that prevented the Board from a thorough analysis 
of proposals, and the Board's assumption that PSI could 
easily find other sources of funding.  He also said that the 
Board may have wanted to show support for at least one 
government body, and therefore decided to award the money to 
the MMA, to build its capacity in setting up a referral 
service.  Hetherington predicted that the 3DF would not meet 
its goals of reducing TB morbidity, mortality and 
transmission.  The 3DF had originally committed to support 
existing programs and has agreed to fund all of the other 
existing TB programs, just not PSI. 
 
RUSHED PROCESS LED TO UNINTENDED RESULTS 
---------------------------------------- 
 
4. (SBU) Hetherington said he believed the rushed process was 
the source for a number of unintended actions.  One Board 
member told him that they had only 24 hours to review and 
approve all the proposals recommended by a panel.  He told us 
that a Board member privately admitted to him that the Board 
mistakenly approved $450,000 less than it intended for PSI's 
HIV/AIDS program, but could not take corrective action. 
Hetherington acknowledged that PSI might receive funding in 
March from the 3DF's 2008 round. 
 
5. (SBU) The 2002-2003 Nationwide Drug Resistance Survey 
showed 4% multi-drug resistant TB among new patients and 
15.5% among previously-treated patients.  More recent 
information indicates that number has grown.  The clinics 
 
RANGOON 00000588  002 OF 002 
 
 
supported by PSI in seven states and divisions handled 11% of 
the 2005 TB caseload.  Excluding drugs, PSI's cost is $40 per 
patient treated, compared with the public health sector's 
$117.  PSI's TB funding will end in March 2008.  Hetherington 
predicted that existing donors will put all their funding 
into the 3DF, and cease all direct bilateral support of INGOs 
for malaria, TB and HIV/AIDS projects.  The U.S. is currently 
the only donor that funds a PSI health project - in HIV/AIDS 
- outside of the 3DF. 
 
6. (SBU) Comment: 3DF's start-up delays and decision making 
process have been, as one UN rep admitted, "messy."  The 
donors wanted to get projects going on the ground as quickly 
as possible and planned to iron out difficulties as they 
arose.  The Board's decision not to fund PSI may have been a 
conscious effort to build capacity in the public health 
sector, which is the preferred practice of 3DF donors.  PSI 
has proven its network of private clinics can effectively 
deliver quality health care to those most in need.  The 
United States already supports PSI's HIV/AIDS projects.  Post 
has repeatedly requested additional funding for TB and 
malaria.  Our funds could support already proven projects 
that demonstrate the effectiveness of humanitarian assistance 
delivered by private providers, as opposed to Burmese 
government entities being supported by other donors.  End 
comment. 
VILLAROSA