This statement is a year and a half old but as the Three Diseases Fund starts to operate it is worth pulling out to see that it is still relevant.

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Consensus Statement by Selected INGOs Working in Health in Myanmar
30th September, 2005

This consensus statement has been prepared and agreed by the following international NGOs working in Myanmar: AHRN; Burnet Institute; CARE/Myanmar; CESVI; GAA; MDM; AZG; MSI; PACT; PSI; Save the Children/Japan; Save the Children/UK; Save the Children/USA; World Concern and World Vision. They include all the INGOs that participated in the Country Coordinating Mechanism, and/or participate in the Technical Working Group for HIV/AIDS, and/or have been Sub-Recipients of the Global Fund projects. They are.

Statement:

We regret the loss of GFATM funds for addressing HIV/AIDS, TB and malaria in Myanmar, given the seriousness of these and other health conditions here and the extraordinarily low levels of national and international resources to address them.
We welcome donor interest in increasing funding for these priority health problems in Myanmar. Having worked here for many years, we know that it is possible to address these problems in a way that is responsible, effective and to-scale. We urge donors and others to learn important lessons from the efforts of the international community over the last several years to address HIV/AIDS, malaria and TB in Myanmar.

#1: It is possible to go to scale in addressing these and other health priorities in Myanmar. INGOs and the private sector are able to function, already achieve significant results, and could achieve far more with more funds. It is also possible to strengthen government health services through intensive support at the service-delivery level.
#2: Donors should accept direct responsibility for the allocation of their resources to specific organisations for specific activities, together with accountability for the results achieved. Funding for Myanmar is under strict scrutiny. Resource allocation decision-making by in-country multi-sectoral committees has been problematic, as demonstrated by both the FHAM and GFATM experiences. The mandate of specialised UN agencies is to support the government; INGOs are dependent on government for our ability to function; both constituencies are also dependent on the funds; neither is therefore in a position to make tough decisions about the allocation of resources. If funding is to increase, donors have to be convinced that their resources are used in an effective way and that results can be confirmed by independent monitoring. Donors that channel funds through a pooled funding mechanism should collectively designate one or more senior officials to take responsibility for fund allocations; they should be employed by the donor(s), manage a small secretariat in-country, and maintain strict independence. Funding decisions should be guided by national strategic plans and international standards. Organisations should be funded based on what they can do to achieve maximum demonstrable public health benefits for the Myanmar population.
#3: Arrangements to ensure accountability for the use of resources and the verification of results should be more rigorous than has hitherto been the case in

FHAM and GF.

Monitoring must be carried out by independent monitors answerable to donors, must extend to the level of beneficiaries, and must not be pre-announced. Systems for verifying accountability and results must apply equally to all implementing organisations. Independent and thorough monitoring will increase donor confidence and will make it possible for donors to make more funds available.

#4: Resources should be made available to national entities under the above conditions. We disagree as much with those who argue for “zero cash” to government as with those who propose irresponsible levels of funding. Government, like everyone else, should receive the right amount of support for important functions that they can best perform, commensurate with demonstrated capacity to account for resources and achieve verifiable results.
#5: Technical committees, led by government with support from the specialised UN agencies and participation from others, should exercise leadership on technical issues. These committees should take the lead on technical issues such as elaboration of national strategic plans for each disease, definition of protocols for diagnosis and treatment, epidemiological and behavioural research, etc. These committees should not be involved in making decisions about resource allocation to specific implementing partners, nor should they be responsible for monitoring their performance.
#6: A high-level forum should periodically review progress against national strategic plans. This forum should be led by the Ministry of Health and include participation of UN agencies, donors and NGOs.
#7: Implementing organisations should be able to rely on funding for at least three years at a time, subject to continued performance. Donor governments have recognised, in recent high-level declarations, that long-term commitments are especially important in difficult conditions such as in Myanmar.