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Report to the Committee on Foreign Affairs, House of Representatives:

United States Government Accountability Office:

GAO:

April 2007:

International Organizations:

Assistance Programs Constrained in Burma:

GAO-07-457:

GAO Highlights:

Highlights of GAO-07-457, a report to the Committee on Foreign Affairs,
House of Representatives

Why GAO Did This Study:

Burma is one of the world's most impoverished and isolated countries.
The United Nations (UN) and other international organizations have
become important sources of outside assistance to the country. In
recent years, UN entities have increased their funding for activities
aimed at addressing Burma's problems. However, Burma's military regime
has imposed restrictions on international organizations' activities in
Burma. GAO (1) identified principal efforts of the United Nations and
other international organizations to address Burma's problems and (2)
described the impact of the regime's recent actions on these efforts.
We reviewed UN, U.S., and Burmese official documents and interviewed
UN, U.S., Burmese, and nongovernmental organization officials in the
United States and Burma. We also visited UN project sites in Burma.

What GAO Found:

The United Nations and other international organizations have
undertaken numerous efforts aimed at addressing Burma's most pressing
problems, which include forced labor, harsh prison conditions, ethnic
conflict, an HIV/AIDS epidemic, and poverty. The International Labor
Organization (ILO) and the International Committee of the Red Cross
(ICRC) have sought to monitor forced labor and prison conditions in
Burma by allowing victims to voice their complaints without
interference from the regime. The UN High Commissioner for Refugees
(UNHCR) and ICRC seek to assist populations in conflict areas near
Burma's border with Thailand. International organizations also attempt
to provide food to vulnerable populations, promote local economic
development, improve health conditions, and strengthen the Burmese
educational system. For example, several UN entities provide assistance
to combat HIV/AIDS, malaria, tuberculosis, and drug abuse, as well as
to improve reproductive health.

Burma's military regime has blocked or impeded activities undertaken by
many international organizations in Burma over the past 3 years. In
2004, the regime distanced itself from these organizations and began
adopting increasingly restrictive policies. In 2006, it published
formal guidelines to restrict international activities in Burma. These
guidelines, which have yet to be fully implemented, contain provisions
that UN officials consider to be unacceptable. The regime's
restrictions have had the greatest impact on international efforts to
monitor prison conditions, investigate claims of forced labor, and
assist victims of ethnic conflict. The regime has blocked ICRC efforts
to monitor prison conditions and, until recently, ILO efforts to
address forced labor. The regime has also restricted UNHCR and ICRC
efforts to assist populations living in areas affected by ethnic
conflict. To a lesser degree, the regime has impeded UN food,
development, and health programs by restricting their ability to (1)
move food and international staff freely within the country and (2)
conduct research needed to determine the nature and scope of some of
Burma's problems. Despite these restrictions, several international
organization officials told us they are still able to achieve
meaningful results in their efforts to mitigate some of Burma's
humanitarian, health, and development problems.

We asked the Department of State and officials of international
organizations to comment on a draft of this report. State commented
that the draft report was thorough, accurate, and balanced. The United
Nations' country team for Burma did not dispute our specific findings
regarding the regime's restrictions but expressed concern that that we
had not noted that it had achieved "a significant opening of
humanitarian space on the ground." We believe that this statement is
not consistent with information provided to us earlier by UN officials,
who stated that conditions in Burma had deteriorated since the 2004
purge within the regime. Other comments and our responses to them are
contained in appendixes II, III, and IV.

[End of section]

Contents:

Letter:

Results in Brief:

Background:

International Organizations Are Undertaking Wide Range of Efforts to
Address Burma's Problems:

Burmese Military Regime Has Blocked or Impeded Activities of Many
International Organizations:

Concluding Observations:

Agency Comments and Our Evaluation:

Appendix I: Scope and Methodology:

Appendix II: Comments from the Department of State:

Appendix III: Comments from the UN Country Team:

Appendix IV: Comments from UNAIDS:

Appendix V: GAO Contact and Staff Acknowledgments:

Figures:

Figure 1: Burma7:

Figure 2: Reported UN Expenditures in Burma, 2002-2005:

Figure 3: Participants in a UNDP-Sponsored Small Banking Project near
Bassein:

Abbreviations:

FAO: Food and Agriculture Organization:

ICRC: International Committee of the Red Cross:

ILO: International Labor Organization:

UN: United Nations:

UNAIDS: Joint UN Program on HIV/AIDS:

UNCT: United Nations Country Team:

UNDP: United Nations Development Program:

UNFPA: United Nations Population Fund:

UNHCR: United Nations High Commissioner for Refugees:

UNICEF: United Nations Children's Fund:

UNODC: United Nations Office on Drugs and Crime:

WFP: World Food Program:

WHO: World Health Organization:

United States Government Accountability Office:
Washington, DC 20548:

April 6, 2007:

The Honorable Tom Lantos:
Chai

rman:
The Honorable Ileana Ros-Lehtinen:
Ranking Minority Member:
Committee on Foreign Affairs:
House of Representatives:

Burma is one of the world's most impoverished and isolated
countries.[Footnote 1] With a per capita national income level below
those of neighboring Bangladesh and Laos, Burma suffers from high
infant and maternal mortality rates, epidemic-level HIV/AIDS
infections, and widespread production of illegal drugs. Burma's
isolation is largely the result of policies pursued by a succession of
authoritarian military regimes that have ruled the country since 1962.
According to the U.S. government, these regimes are responsible for
Burma's mismanaged economy, human rights abuses, use of forced labor,
human trafficking, and military campaigns against ethnic minority
groups. During Burma's last election in 1990, Burmese citizens voted to
oust the regime in favor of the National League for Democracy, led by
Aung San Suu Kyi.[Footnote 2] However, the regime confined her and many
other League members, and continued to rule despite international
condemnation of its actions. The regime's repressive policies have
prompted the United States and other Western nations to end their
foreign aid programs to Burma and enact a range of sanctions.

In 2006, the Burmese regime announced new restrictions on international
organizations operating in Burma. These organizations have become
important sources of outside assistance to Burma's approximately 54
million people as Burma has become increasingly isolated.[Footnote 3]
They include the United Nations (UN), the International Committee of
the Red Cross (ICRC), and various international nongovernmental
organizations. The regime's actions have raised concerns regarding the
extent to which these organizations will be able to continue their
assistance efforts.

In this report, we (1) identify the principal efforts of the UN and
other international organizations to address Burma's problems and (2)
describe the impact of the regime's recent actions on the activities of
these international organizations. To address these issues, we examined
documents relating to programs conducted in Burma by the UN Country
Team (which includes 10 UN entities located in that country) and the
restrictions imposed on them by the Burmese regime.[Footnote 4] In New
York and Washington, D.C., we met with officials of the U.S.
Departments of State (State) and the Treasury, the United Nations, the
World Bank, and the International Monetary Fund. We also met with the
Burmese UN mission in New York. In Rangoon, Burma, we met with
officials of UN entities, ICRC, and several international
nongovernmental organizations who asked that we not identify their
organizations in this report. In addition, we met with officials of the
U.S. embassy and of the leading democratic organization in Burma. In
and near Rangoon and Bassein, Burma, we met with recipients of UN
assistance. We also traveled to Nay Pyi Taw (Burma's newly built
capital) to meet with officials from the Burmese Ministry of National
Planning and Economic Development and the Ministry of Health. In
Bangkok, Thailand, we met with officials from three additional UN
entities that operate programs in Burma from Thailand,[Footnote 5] as
well as with representatives of other donor nations.

We conducted our work from May 2006 through February 2007 in accordance
with generally accepted government auditing standards. More details on
our scope and methodology can be found in appendix I.

Results in Brief:

The United Nations and other international organizations have
undertaken numerous efforts to address some of Burma's most pressing
problems. These efforts include programs aimed at mitigating the
effects of prison conditions, forced labor, and conflicts in Burma's
ethnic areas. ICRC has attempted to monitor prison conditions in Burma,
while the International Labor Organization (ILO) has sought to allow
victims of forced labor to file complaints without interference from
the regime. The UN High Commissioner for Refugees (UNHCR) and ICRC have
worked to assist the population in conflict areas near Burma's border
with Thailand. International organizations are also attempting to
provide food to vulnerable populations, promote local economic
development, improve health conditions, and strengthen the Burmese
educational system. For example, two UN entities have provided food and
agricultural support to vulnerable populations, while the UN
Development Program has created village-and township-level community
development and small banking groups. Several UN entities have provided
assistance to combat HIV/AIDS, malaria, and tuberculosis, as well as to
improve reproductive health and combat the manufacture and use of
dangerous drugs. The UN Children's Fund is working to address health
and educational problems affecting Burmese children.

Burma's military regime has blocked or impeded activities undertaken by
many international organizations in Burma over the past 3 years. After
ousting the former Prime Minister in 2004, the regime distanced itself
from the international organizations and began adopting increasingly
restrictive policies. In 2006, it published formal guidelines to
restrict international activities in Burma. These guidelines, which
have yet to be fully implemented, contain provisions that UN officials
consider to be unacceptable. The regime's increased restrictions have
had the greatest impact on international efforts focused on prison
conditions, forced labor, and ethnic conflict. The regime has blocked
ICRC efforts to monitor prison conditions and frustrated ILO efforts to
monitor forced labor for four years before signing an agreement with
ILO in February 2007. The regime also significantly restricted UNHCR
and ICRC efforts to assist populations living in areas affected by
ethnic conflict. To a lesser degree, the regime has also impeded UN
food, development, and health programs by restricting their ability to
(1) move food and international staff freely within the country and (2)
conduct research needed to determine the nature and scope of some of
Burma's problems. Despite these restrictions, several international
organization officials told us they are still able to achieve
meaningful results in their efforts to mitigate some of Burma's
humanitarian, health, and development problems.

We requested comments on a draft of this report from the Secretary of
State and cognizant UN and ICRC officials. We received written comments
from State, the UN Country Team in Burma, and the Joint UN Programme on
HIV/AIDS (UNAIDS), which are reprinted in appendixes II, III, and IV,
along with our responses to specific points. State commented that the
draft report was thorough, accurate, and balanced and that it would
continue to encourage the regime to lift its unnecessary and
unreasonable restrictions on international organizations. The UN
Country Team agreed that international agencies are able to achieve
meaningful results in Burma despite what it termed "a difficult and
complex environment." However, while it did not dispute our specific
findings about the regime's restrictions, the UN Country Team expressed
concern that our draft report did not note that the United Nations and
its partners had achieved "a significant opening of humanitarian space
on the ground" over the past decade. This statement is in cont

rast to
information UN officials had provided earlier stating that conditions
had deteriorated since the 2004 purge within the regime. The UN Country
Team also noted that on February 26, 2007, ILO and Burma had signed an
agreement establishing a complaints mechanism for victims of forced
labor. We have updated our report to reflect this change, which took
place after we submitted our draft report for comment. The UN Country
Team also said our report did not adequately reflect the nature of the
UN entities' work and the differences in their mandates. We believe we
fairly describe the entities' work in our first objective. While our
draft report noted that UNDP has a restricted mandate prohibiting it
from working with the government, we added language stating that other
UN entities' mandates do not have similar restrictions. UNAIDS
commented that it appreciated our recognition of progress despite
difficulties but added that the draft report could contain more
evidence of this progress. We believe we fairly described UNAIDS' work
in our draft report.

Background:

Military regimes have ruled Burma for most of the past 45 years. The
current regime took power in 1988. In Burma's last election in 1990,
Burmese citizens voted to oust the regime in favor of the National
League for Democracy. The regime confined the League's leader (Aung San
Suu Kyi) and many of the League's members, and continued to rule Burma
despite international condemnation. As of September 2006, the regime
was holding more than 1,100 political prisoners under conditions that
State has described as "harsh." Amnesty International reported that the
regime has subjected Burmese political prisoners to torture and ill-
treatment that has resulted in the deaths of some prisoners.[Footnote
6] The regime has also condoned the use of forced labor and taken
military action against ethnic groups living in areas within Burma.
According to the U.S. government, Burmese campaigns against ethnic
minorities in conflict regions may have displaced as many as 500,000
persons. Due in part to the country's widespread violations of human
rights, The Fund for Peace ranked Burma among the world's top 20 most
unstable countries,[Footnote 7] while Transparency International ranked
Burma 1.9 on a corruption scale ranging from 0 (highly corrupt) to 10
(highly clean).[Footnote 8]

Burma is also one of the world's most impoverished countries. In 2006,
the UN Development Program (UNDP) ranked Burma 130 out of 177 countries
in its annual human development index based on economic and social
indicators.[Footnote 9] The U.S. government has ranked Burma's per
capita gross domestic product 186 out of 229 countries and territories-
-below those of neighboring Bangladesh and Laos. Both infant and
maternal mortality rates are high in Burma. Humanitarian needs are
particularly acute in the border areas that have been afflicted for
many years by conflict and instability, according to the UN High
Commissioner for Refugees. HIV/AIDS has become a generalized epidemic,
with approximately 1.3 percent of the population suffering from the
virus. According to UN officials, the quality of education in Burma has
been declining from formerly high levels. Low educational attainment is
depriving many Burmese children of a good start in life and
significantly lowering their income opportunities and productivity as
adults, according to the United Nations. The weak education system also
has long-term implications for the country's ability to develop.
According to the most recent World Bank data available to the public,
the regime spent less during 2001 and 2003 on health and education in
terms of percentage of gross domestic product than Bangladesh,
Cambodia, and Laos, which are other low-income nations in the region.
Burma has also emerged as a leading opium and methamphetamine producer
and a source of human trafficking, according to the U.S. government.

The regime's leadership and policies have undergone shifts since it
took power. Beginning in 1989, the regime began signing cease-fire
agreements with some of Burma's ethnic groups. In 2002, it released the
winner of the 1990 election. In 2003, Burma's newly appointed Prime
Minister began offering the United Nations expanded opportunities to
address some of Burma's problems. However, the regime subsequently
renewed military activities against minorities along Burma's border
with Thailand, reconfined the winner of the 1990 election, and, after
purging the Prime Minister from power in October 2004, issued new
restrictions on international organizations in Burma. In November 2005,
the regime announced that it was moving Burma's capital from Rangoon to
Nay Pyi Taw, which is more than 200 miles from the Rangoon headquarters
offices of international organizations working in Burma (see fig. 1).

Figure 1: Burma:

[See PDF for image]

Sources: GAO analysis of UN and U.S. government data; Map resources
(map).

[End of figure]

The regime's actions have prompted the United States to impose a
variety of sanctions. The United States has banned the importation of
Burmese goods, the export of financial services and arms by U.S.
persons to Burma, and new U.S. investment in Burma. It has barred high-
ranking Burmese officials from visiting the United States. The United
States also proposed a UN Security Council resolution that would have
called upon the regime to cease attacks on civilians in ethnic minority
areas and begin a substantive political dialogue that would lead to a
transition to democracy.[Footnote 10] In addition, it has supported UN
resolutions on Burma, such as those passed by the UN General Assembly
in response to the human rights situation in Burma. According to State,
U.S. objectives for Burma include the release of political prisoners,
the start of a credible and inclusive national reconciliation process,
the ending of forced labor and attacks on civilians, and increased
access for UN organizations and nongovernmental organizations.

While several other nations have imposed sanctions on Burma, China has
strengthened its ties with that country. Australia, Canada, and the
European Union have joined the United States in imposing some form of
sanctions against the regime, according to State. In contrast, China
has increased its commercial presence in Burma, emerged as Burma's
largest single source of imports (about 30 percent in 2005), and become
a strong market for Burmese exports. In addition, the current Burmese
Prime Minister visited Beijing in February 2006 and signed agreements
with Chinese officials that will provide Burma with grants and
concessionary loans.

Burma has also become increasingly isolated from the World Bank, the
Asian Development Bank, and the International Monetary Fund. The World
Bank reported that it has not approved any new loans to Burma since
1987 and has no plans to resume its program. Burma is currently in
arrears to the World Bank and has not enacted economic and other
reforms. The Asian Development Bank and the International Monetary Fund
have not made new loans to Burma since the 1980s.

The United Nations and several international organizations have become
an important source of outside assistance to the country. UN entities
informed us that they had spent about $218 million in Burma from 2002
through 2005. In 2005, more than 70 percent of thes

e funds were spent
by UNDP, the UN Children's Fund (UNICEF) and the World Food Program
(WFP), as shown in figure 2.[Footnote 11] Of the remaining agencies,
the UN World Health Organization (WHO) informed us it spent about $4.9
million in Burma during 2005, while UNHCR and the UN Population Fund
(UNFPA) informed us they had each spent about $4.3 million. The UN
Office on Drugs and Crime (UNODC) and the Food and Agriculture
Organization (FAO) reported they had spent about $3 million and about
$2 million, respectively, in Burma during the same year. ILO informed
us it spent about $321,000 in Burma during 2005, while UNAIDS reported
it spent about $691,000.

Figure 2: Reported UN Expenditures in Burma, 2002-2005:

[See PDF for image]

Sources: UN organizations.

Note: Percentages may not total to 100 percent due to rounding.

[End of figure]

The United States has provided financial support for some UN programs
in Burma. For example, it has helped fund programs conducted in Burma
by UNICEF. U.S. law requires that the United States withhold a
proportionate share of its voluntary contributions to most UN
organizations in connection with their programs in Burma. For example,
the United States has withheld a proportionate share of its voluntary
contributions to UNDP because UNDP conducts programs in Burma.[Footnote
12]

UNDP's governing board has also limited the scope of UNDP's mandate to
conduct programs in Burma. UNDP's governing board, which includes the
United States, has directed UNDP to work directly with the Burmese
people at the grass roots level and not through the regime. State has
requested and obtained annual assurances from UNDP that UNDP's Burma
program is focused on the needs of the poor, does not provide any
benefits to the regime, and works only through organizations that are
independent of the regime.[Footnote 13] Other UN entities are not
restricted from working with the Burmese regime by their mandates.

International Organizations Are Undertaking Wide Range of Efforts to
Address Burma's Problems:

The United Nations and other international organizations have
undertaken numerous efforts to address some of Burma's most pressing
problems. These efforts include programs aimed at addressing prison
conditions, forced labor, and conflicts in Burma's ethnic areas.
International organizations are also attempting to provide food
security to vulnerable populations, promote local economic development,
detect and treat HIV/AIDS and other diseases, and strengthen the
educational system.

ICRC and ILO Attempt to Monitor Prison and Labor Conditions:

ICRC and ILO are attempting to address issues involving prison and
forced labor conditions in Burma. ICRC has attempted to monitor prison
conditions in Burma, while ILO has sought to allow victims of forced
labor to file complaints without interference from the regime.

ICRC has sought to improve Burmese prison conditions by meeting with
inmates unaccompanied by Burmese officials. In accordance with its
international mandate of visiting prisoners during situations of
internal violence and their consequences, ICRC began visiting Burmese
prisons in 1999 following 13 years of negotiations with the regime.
According to ICRC officials and documents, ICRC staff conducted about
450 prison visits between 1999 and 2005. ICRC staff informed us that
while they do not allow regime officials to accompany them during
prison visits, they have worked with regime ministries to improve
prison health conditions and to help prisoners contact their families.
According to ICRC, the prison visit program has helped improve
prisoners' physical and psychological well-being.

To address the problem of forced labor in Burma, ILO has recently
succeeded in establishing an independent mechanism to handle complaints
from victims of this practice. ILO is charged with defining
international labor standards, including an internationally recognized
ban on the use of forced labor.[Footnote 14] In 1998, an ILO inquiry
reported that it had found "abundant evidence" of the "pervasive use of
forced labour imposed on the civilian population...by the authorities and
the military" in Burma. Following negotiations with ILO, Burma agreed
in 2002 to allow ILO to station a liaison officer for forced labor
issues in Rangoon. In 2003, Burma agreed in principle to an ILO plan of
action that called for the establishment of a non-Burmese facilitator
for forced labor issues. This facilitator would receive and investigate
complaints of forced labor provided in confidence and would then work
with the regime to resolve the complaints while protecting the rights
of the complainant.

International Organizations Seek to Aid Populations in Conflict Areas:

International organizations are also attempting to help populations in
areas of Burma that have been marked by tension or conflict between
regime forces and ethnic groups, according to officials of
international organizations. These organizations include UNHCR and
ICRC.

UNHCR is currently working in two areas that have been subject to
ethnic tensions. Near Burma's border with Bangladesh, UNHCR is serving
as the lead international agency in engaging the regime on protection
issues affecting a large population of stateless Muslims, including
more than 200,000 former refugees who began returning to Burma from
Bangladesh in 1993. According to UNHCR, it is coordinating the work of
several other international organizations in providing needed support
to this population. UNHCR is also attempting to address the needs of
persons living in three provinces near Burma's southeastern border with
Thailand, where military campaigns have displaced large numbers of
villagers. As a result of these campaigns, many thousands of Karen,
Karenni, and Mon ethnic groups have crossed the border into Thailand. A
senior UNHCR official told us that UNHCR was granted access to these
areas in 2004 as part of a contingency plan for the possible
repatriation of these refugees.

ICRC has also sought to assist and protect populations in conflict
areas. ICRC officials informed us that ICRC teams travel to these areas
to persuade fighting forces to avoid harming civilians and to help
civilians who have already been harmed. The teams, which include
medical personnel and interpreters, have operated from ICRC field
offices. ICRC officials informed us that ICRC policy calls for the
teams to travel freely in these areas without regime supervision. They
stated that they do not notify authorities of each team's activities,
although they must ask for permission to establish field offices.

International Organizations Aim to Address Burmese Development and
Health Needs:

UN and other international organizations have launched a wide range of
assistance programs in Burma to address Burma's many social and health
problems. These problems include food shortages, poverty, threats to
public health, and a deficient and declining educational system.

International organizations have sought to address food shortages in
Burma, including those affecting displaced populations along Burma's
borders as well as other areas where malnutrition is increasingly
prevalent.

* WFP, the emergency food aid arm of the United Nations, has sought to
provide food to vulnerable populations in Burma that suffer from
hunger, m

alnutrition, and poverty and have been adversely affected by
regime policies. WFP delivers food assistance to northwestern Burmese
Muslim populations and to families from mostly ethnic minority groups
who lost their main livelihood under a regime ban on opium cultivation.
WFP implements food assistance programs for students and landless
workers, and provides nutrition support for mothers and young children.
WFP implements its programs with cooperating partners such as other UN
entities or nongovernmental organizations rather than the regime. WFP
has also provided emergency food assistance to families affected by the
2005 tsunami disaster and has responded to other localized food crises,
such as floods and crop failures.

* FAO helps developing countries improve and modernize practices in
agriculture, livestock and fisheries, and forestry by providing
technical cooperation, expertise, and information, and by bringing
knowledge to the field. For example, in northwest Burma, FAO works with
foreign donors to provide support for agricultural resource management
and promotes seed projects to improve food security for refugees
returning from Bangladesh. FAO has also provided technical assistance
to strengthen Burma's emergency preparedness for avian influenza and to
aid tsunami-affected areas.

UNDP is currently operating several major programs at the grass roots
level that seek to address poverty in Burma. These programs include
projects aimed at strengthening the capacity of poor communities to
address their basic needs, in part through the creation of community
development groups. In 2005, UNDP expanded its operations to include a
greater number of poor communities in selected remote townships. It was
able to retain access to several formerly inaccessible townships after
the ouster of the former Prime Minister who had invited UNDP to
establish itself in them. It has also supported the creation of small
banking networks that provide financial services to producers in
selected poor villages, including the one pictured in figure 3. UNDP
has also worked with other UN entities to secure funding from other
international donors to establish a major campaign against the spread
of AIDS and other infectious diseases in Burma.

Figure 3: Participants in a UNDP-Sponsored Small Banking Project near
Bassein:

[See PDF for image]

Source: GAO.

[End of figure]

International organizations have also sought to address threats to
public health in Burma. Several UN entities have provided assistance to
combat HIV/AIDS, malaria, and tuberculosis; to support the country
capacity in both the human and animal sectors for avian and human
influenza pandemic preparedness and response; and to improve
reproductive health and combat the manufacture and use of dangerous
drugs.

* UNAIDS is a joint effort of 10 UN entities that aims to prevent new
HIV infections, provide care for those already infected, and mitigate
the impact of the epidemic. Using available data on HIV/AIDS
prevalence, UN entities aim to promote condom usage; raise awareness on
prevention methods; provide care, treatment, and support for people
living with HIV/AIDS; and take other actions.

* WHO, the UN authority on international health, provides technical
cooperation on health matters to Burma and other member states. WHO's
priorities for Burma include preventing and controlling diseases such
as HIV/AIDS, malaria, and tuberculosis and vaccine-preventable diseases
such as polio, measles, and neonatal tetanus and tuberculosis;
strengthening health systems; improving child, adolescent, and
reproductive health; and strengthening Burma's ability to address avian
and human influenza.

* UNFPA assists countries such as Burma in providing quality
reproductive health and family planning services and formulates
population policies that support sustainable development. UNFPA's
assistance to Burma has focused on reducing maternal mortality and
preventing the spread of HIV/AIDS by improving reproductive health
information and services and by providing reproductive health
commodities.

* UNODC operates several programs in Burma, including efforts to reduce
demand for injecting drugs and the transmission of HIV among and from
users of injecting drugs. Implementation of these programs is
concentrated in areas near certain border areas where the prevalence of
HIV and drug abuse is high. According to UNODC, it has supported almost
2,400 individuals in accessing drug treatment and rehabilitation
services, while about 12,000 youth accessed its youth development
centers and more than 6,500 individuals accessed UNODC health care
services. UNODC has other programs in Burma, including programs to help
define alternative livelihoods for families who lost their main
livelihood under a regime ban on opium cultivation.

UNICEF also conducts a range of activities that include programs aimed
at addressing deficiencies in Burma's educational system and improving
women and children's health. Based on educational data to which it has
access, UNICEF works with Burma's Ministry of Education to promote
comprehensive quality education in Burma. UNICEF has supported projects
in early childhood development, quality basic education, life skills,
and HIV/AIDS prevention education. It has also provided school supplies
to children from poor families and supported local parent-teacher
associations and teachers in improving the learning environment for
children.

Burmese Military Regime Has Blocked or Impeded Activities of Many
International Organizations:

According to officials of international organizations, Burma's regime
has blocked or impeded activities undertaken by many international
organizations following its ouster of the former Prime Minister in
2004. It has blocked international efforts to monitor prison
conditions, and, until recently, forced labor cases. The regime has
also significantly restricted international assistance to populations
living in conflict areas, and, to a lesser degree, impeded food,
development, and health programs. Despite these actions, many of the
international officials we spoke with told us that they are still able
to achieve meaningful results in their efforts to mitigate some of
Burma's many problems.

Regime Has Become More Restrictive Since 2004:

The Burmese military regime became more restrictive regarding
activities of international organizations after it purged the former
Prime Minister in October 2004, according to officials of international
organizations now working in Burma. The regime formalized its
restrictions on the international organizations in 2006 by publishing
guidelines to govern their activities in Burma. The guidelines, if
fully implemented, would further tighten regime controls over these
activities and contain provisions that UN officials consider to be
unacceptable.

International organization officials informed us that the regime had
become more restrictive of their activities since 2004. While the
regime allowed UNDP to proceed with a previously agreed upon expansion
of its programs into certain remote villages, international
organization officials told us that the regime had otherwise increased
restrictions on international access to conflict areas. The regime has
also begun pressuring some international organizations to work more
closely with regime-sponsored poli

tical mobilization groups, such as
the Union Solidarity Development Association. A senior UN official in
Burma told us that since 2004 the regime has made the operating
environment for UN organizations far more difficult than before. He
noted that the regime had distanced itself from international
organizations. Other officials told us that their organizations were
unable to make contact with regime officials for months after October
2004. International organization staff also reported that a lack of
coordination and consistency between regime ministry staff and between
local commanders led to delays in international programs and approvals
of needed agreements.

The effect of the regime's withdrawal has been compounded by its
decision to distance itself physically from the international
organizations. In 2006, the regime moved its officials to the new
capital, Nay Pyi Taw, which is more than 200 miles inland from Rangoon.
As a result, Rangoon-based international organization officials must
now spend several hours traveling by car and airplane to meet with
government officials who were formerly located in Rangoon.

The regime moved to formalize restrictions on the international
organizations in February 2006, when the Burmese Ministry of National
Planning and Economic Development published guidelines governing
international organizations' programs in Burma.[Footnote 15] A senior
official of the Ministry of National Planning and Economic Development
told us that the guidelines are intended to improve the efficiency and
effectiveness of the international organizations' programs by improving
coordination and eliminating duplicative programs. The official also
stated that the guidelines would help address the tendency of some
international humanitarian entities to become involved in what she
referred to as "political matters." The ministry disseminated differing
English and Burmese language versions of the guidelines. A UN-provided
translation of the Burmese language version revealed that it contains
several restrictions not included in the English language version. A
senior ministry official told us that the Burmese language version is
intended to help Burmese local officials better understand the English
language version of the guidelines.

The provisions in the two versions of the guidelines would restrict
several aspects of international organizations' activities in Burma.
For example, the guidelines would require the international
organizations to:

* agree that their international staff may only travel within Burma
with permission from the subject area ministry and with a regime
representative;

* obtain prior approval of all international projects by subject area
ministries and by the Ministry of National Planning and Economic
Development;

* avoid conducting or distributing any surveys not mentioned and
approved in the original project documentation;

* deposit all incoming funds in Burma's national bank for subsequent
withdrawal as "foreign exchange credits";

* agree that their programs will "enhance and safeguard the national
interest," "prevent infringement of the sovereignty of the State," and
"be on the right track...to contributing to the socio-economic
development of the Nation";

* coordinate their work with local and state coordinating committees
that include representatives of the Union Solidarity Development
Association and similar groups; and:

* select their Burmese national staff from government-prepared lists of
individuals.

The extent to which the regime will fully implement these guidelines is
unclear. High-ranking officials of the Ministry of National Planning
and Economic Development and the Ministry of Health told us that the
guidelines are now in effect and are not being negotiated. UN
officials, who have taken the lead in speaking for all international
organizations regarding the guidelines, informed us that they continue
to try to engage the regime in discussions regarding the guidelines.

A senior UN official familiar with the full range of UN programs in
Burma told us that the United Nations has informed regime officials
that the last three of the above restrictions are not acceptable to the
United Nations. According to this official, the United Nations cannot
agree that its programs would support the regime's definitions of the
national interest because UN humanitarian assistance must be
apolitical. For the same reason, he told us, the United Nations could
not work with committees that include the Union Solidarity Development
Association and similar organizations. Other international organization
officials also informed us that they would not agree to allow the
regime to select their Burmese staff members.

Regime Has Blocked ICRC Initiative to Monitor Prison Conditions:

According to ICRC officials, the regime has blocked ICRC monitoring of
prison conditions. The regime has halted ICRC's prison visit program by
insisting that pro-regime staff observe ICRC meetings with prisoners.
ICRC staff told us that the regime appeared to have reassessed its view
of ICRC and other international organizations in 2004. According to
ICRC officials, in September 2005 the Burmese Ministry of Home Affairs
suddenly demanded that representatives of the Union Solidarity
Development Association accompany ICRC staff on all prison visits. ICRC
refused the ministry's demand, given ICRC's policy of protecting the
confidentiality of its discussions with inmates. As a result, the
ministry has denied ICRC access to Burmese prisons since the end of
December 2005.

Burmese Regime Blocked ILO Efforts until Recently:

The regime frustrated ILO efforts to conclude an agreement establishing
an independent complaints process for forced labor victims for 4 years
until signing an agreement with ILO in February 2007. In 2003, Burma
agreed in principle to establish such a process. ILO relations with the
regime deteriorated after October 2004. In the absence of a final
agreement on the establishment of an independent complaints mechanism,
the ILO liaison officer worked with regime officials to informally
address complaints of forced labor. However, he stopped doing so after
the regime began to arrest and prosecute complainants. Three
individuals were sentenced to death for allegedly contacting ILO. In
2005, the Union Solidarity Development Association staged mass anti-ILO
rallies, while the ILO liaison officer reported receiving 21 similarly
worded death threats. Following ILO expressions of concern about the
situation, the regime released the imprisoned complainants, agreed to
not prosecute complainants for the next 6 months, and began negotiating
a new "understanding" with ILO to protect complainant rights. These
negotiations deadlocked in October 2006 after regime officials objected
to language in the draft understanding that would have allowed the
liaison officer to employ a sufficiently large staff with the
diplomatic and travel rights needed to meet with complainants in a
timely and confidential manner. ILO and the regime subsequently agreed
that necessary adjustments to the liaison officer's staff capacity
would be made "after due consultation," and ILO announced on February
26, 2007, that it had reached an agreement with Burma to establish a
complaints mechanism for victims of forced labor. Prior to the signing
of this agreement, ILO had no pr

oject activities under way in Burma
because of the regime's policies.

Regime Has Restricted International Efforts in Certain Conflict Areas:

According to officials of international organizations, the regime has
impeded international efforts to address the needs of populations in
conflict areas by restricting international access to those areas. It
has limited UNHCR efforts along the Thai border, while halting or
impeding efforts in conflict areas by ICRC and other organizations.

A senior UN official familiar with the full range of UN activities in
Burma informed us that the regime's refusal to allow free access to
conflict areas is one of the most important restrictions faced by
international organizations in that country. The official contrasted
the current regime's policies with those of the former Prime Minister,
who expanded opportunities for UNDP to work in previously closed parts
of Burma.

The current regime's policies have particularly affected efforts by
UNHCR to assist displaced persons in the southeast region near the
border with Thailand. UNHCR officials told us that UNHCR operating
conditions in the southeast region near the border had deteriorated
sharply in 2005. Previously, according to UNHCR, the agency had been
developing plans for the anticipated repatriation of thousands of
refugees from the Thai side of the border, with the support of the
Prime Minister in assessing the region's capacity to support returning
refugees.[Footnote 16] These conditions, along with the prospects for a
political settlement between the regime and a Karen organization,
changed after the Prime Minister's removal. The regime's Ministry of
Interior initially ignored UNHCR's efforts to restart discussions
before reassigning UNHCR to a less influential ministry. More
importantly, the resumption of military operations in the area
convinced UNHCR that conditions were no longer conducive to the return
of refugees.

The regime has also resisted UNHCR's subsequent efforts to assist
communities on the Burmese side of the border that have been affected
by the displacement of persons within the area. UNHCR officials told us
that restrictions on UNHCR's access to several areas have impeded the
agency's efforts to improve its fragmented understanding of the
population's needs and its capacity to address them. The regime, which
denies that internally displaced persons are in the region, has not
allowed UNHCR to access certain border areas that it does not control.
While UNHCR has been allowed to implement certain "quick impact"
projects (such as the building of schools and bridges) in some 300
villages, UNHCR considers these projects to be only a first step toward
fulfilling its protection objectives. Because regime officials closely
monitor these projects, UNHCR staff cannot easily meet with villagers
to improve UNHCR's understanding of the problems facing internally
displaced persons. A senior UNHCR official in Burma told us that UNHCR
does not want to jeopardize its already limited access to the region or
to put the local population at risk by holding public meetings on
protection issues.

The regime has halted ICRC's efforts to assist and protect civilians in
conflict areas over the past 2-1/2 years. ICRC staff informed us that
the regime began restricting ICRC's access to conflict areas after
October 2004. ICRC staff also told us that regime authorities had begun
demanding that representatives of the Union Solidarity Development
Association accompany ICRC teams in certain conflict areas. ICRC staff
stated that allowing regime representatives to do so would compromise
the independence of ICRC's role in these areas. ICRC staff estimated
that between 2002 and October 2006, regime actions reduced the scope of
ICRC's assistance and protection effort by 90 percent. The regime then
ordered ICRC to close its five field offices in Burma, including those
that served as bases for ICRC conflict area teams. ICRC stated that the
closures will make it impossible for it to carry out most of its
assistance and protection work for civilians in the conflict areas.
According to State and ICRC officials, the regime has since allowed
ICRC to reopen the field offices but has not allowed ICRC to resume
humanitarian assistance programs out of the offices. The regime now
insists that ICRC follow strict guidelines that do not allow space for
independent movements by teams as in the past, according to a senior
ICRC official in Burma.

Several other international organizations reported similar difficulties
in sensitive regions of Burma. FAO staff reported that local police had
barred them from traveling to villages in Shan State to question people
regarding food supplies. UNICEF staff stated that they had difficulties
accessing parts of the country. WHO also lacks access to populations in
certain areas. A representative of an international nongovernmental
organization told us that the regime began strictly enforcing its ban
on access to conflict areas after 2004.

Regime Has Impeded Other Assistance Programs:

Officials of international organizations informed us that the regime
has also impeded international food, development, and health programs.
They stated that it has done so by restricting their ability to (1)
move food and international personnel freely within Burma and (2)
gather data needed to understand the scope and nature of Burma's
problems.

Regime's Travel Restrictions Have Hindered Programs:

The regime's policies on travel have hindered international
organizations' efforts to ship food to vulnerable populations within
the country. For example, delays in obtaining transport permits for
food commodities from the current regime have hindered WFP efforts to
deliver food to vulnerable populations. A senior WFP official told us
that WFP has not always been able to deliver food on schedule because
regime officials have required 3 to 5 months to approve food shipments
and because regional military commanders have not always been available
to approve food deliveries upon their arrival. As a result, he stated,
WFP had been unable to deliver several months' worth of food to
students and their families in the northern parts of the Rakhine State
during the 2005 school year. In addition, he informed us that WFP had
been unable to deliver 20 percent to 30 percent of its planned food
shipments during 2005. He added that the regime began to provide
authorizations in a timelier manner in 2006.

The regime's time-consuming travel procedures have also impeded the
ability of international staff to move freely within the country to
ensure the timely provision of assistance. According to UN officials,
the Burmese regime typically requires non-Burmese staff of UN entities
and other international organizations to obtain travel permits to visit
project sites. Officials of eight of the nine UN entities that provide
humanitarian, health, and development assistance in Burma told us that
the regime requires at least 3 to 4 weeks' advance notice to authorize
travel. An official of the remaining entity told us that it is required
to provide 2 weeks' notice. These officials said that the additional
time it takes to apply for travel permits impedes the planning and
monitoring of projects through field visits and reduces the scope of
their activities. In August 2006, the acting UN

Resident Coordinator
informed the Minister of National Planning and Economic Development
that with regard to internal travel, "Unnecessary and time-consuming
procedures impede us from providing assistance in a timely manner."

Moreover, the regime's internal travel restrictions contributed to a
major setback to international efforts to fight three diseases in
Burma. The Global Fund to Fight AIDS, Tuberculosis, and
Malaria[Footnote 17] had agreed to provide $98.4 million over 5 years,
beginning in 2005. However, in 2005 the fund terminated its program in
Burma after the regime instituted new travel clearance procedures that
would have impeded international staff travel to project sites. In
announcing its decision to terminate the program, the fund cited the
adverse impact that the new travel restrictions would have had on its
ability to ensure that the program was properly managed.[Footnote 18]

Some UN international staff also reported they have been hindered by
the regime's requirement that they be accompanied by their regime
counterparts when they travel in Burma, although others noted that the
requirement has some benefits. One official said that counterparts had
prevented her from meeting with project beneficiaries in private.
Another stated that his organization has faced the challenge of finding
government counterparts to accompany international staff when they need
to travel. However, four UN officials noted that Burmese technical
experts had facilitated their travel and access and provided input to
their work.

In addition, officials of three UN entities reported difficulties in
obtaining permission for experts located outside Burma to visit sites
in that country. These experts had been sought out to provide technical
expertise on agricultural, HIV/AIDS, and educational projects. One
organization in Thailand also reported delays in obtaining visas as the
primary reason that it did not have active programs in Burma.

Regime Impeded Gathering and Sharing of Needed Health and Development
Data:

International organization officials told us that the regime's informal
restrictions on surveys and data sharing have impeded their efforts to
address Burma's problems. According to UN officials, regime data
concerning health and education in Burma is incomplete and unreliable.
UN officials noted that the regime has not conducted a census since
1983 and expressed concern that the regime's collection of statistics
has deteriorated since 2004. WHO has reported with concern that Burma's
deteriorating statistics on health are not reliable and that Burma
lacks a plan to develop a nationwide health information system.
Officials working for other UN entities in Burma's health sector
expressed similar concerns. UN officials also criticized Burmese
statistics on education. One official told us that the lack of solid
and evidence-based research on education in Burma significantly impedes
efforts to address educational problems. UN officials also expressed
concern that the regime is deliberately providing inaccurate data to
the public.

The United Nations has stated that these data weaknesses have impeded
international organizations' efforts to assess needs, conduct strategic
planning, and implement programs in Burma. According to the United
Nations, international organizations require a comprehensive
understanding of the needs of the population to efficiently direct
their resources. The United Nations has also noted that surveys would
be valuable for identifying issues related to poverty alleviation,
initiating activities that create longer-term benefits, and evaluating
program performance.

However, UN and other international officials told us that the Burmese
regime has impeded their ability to conduct their own surveys and
freely share the data they gather regarding the nature and scope of
Burma's problems. In its strategic framework for assistance to Burma,
the United Nations has called upon the regime to allow a wider range of
data to be collected, analyzed, and shared without alteration.
According to one UN official, the regime has rejected project proposals
that cite the terms "research" or "data collection." UN health
officials also told us that the regime had restricted the scope of
their HIV/AIDS research and the health data that they could share with
the public. A WFP official told us that while his organization has not
encountered any problems carrying out surveys and assessments in the
regions in which it has been operating, it has encountered difficulty
in carrying out national surveys on food needs. Representatives of
several international nongovernmental organizations working in Burma
also expressed concerns about regime restrictions on research and
surveys by their staff. International organization officials also noted
that the guidelines for international organizations contain the
regime's first formal restriction on research.

In commenting on a draft of this report, UNDP said it recently
completed two major research projects without encountering significant
difficulties with the government. According to UNDP, its survey of over
18,000 households represented a unique effort. Similarly, UNDP noted
that its agricultural sector review provides an in-depth analysis of
the inadequate growth of Burma's agriculture in recent decades that has
contributed to declining real incomes and growing poverty in rural
areas.

Despite Restrictions, International Organization Officials Stressed
That Their Organizations Are Still Able to Achieve Meaningful Results:

Several international organization officials stressed that their
organizations are still able to achieve meaningful results in their
efforts to address Burma's development, humanitarian, and health
problems, despite the regime's post-2004 restrictions. For example,
UNDP reported that its banking projects for small businesses in
selected poor villages had over 180,000 active borrowers as of March
2006. UN officials working in the health sector told us that the
Burmese regime had been increasingly cooperative in efforts to address
HIV/AIDS prevalence and recently worked with several UN entities to
develop a multisectoral plan that targets all victims of the disease in
Burma. For example, UN officials told us that UN entities provided home-
based or community-based care and support on HIV/AIDS to over 5,000
people in 2005, a 175 percent increase over service provision in this
area in 2004. UN officials also noted that they launched a measles
campaign after October 2006 after earlier government resistance. In
addition, a WFP official told us that WFP operations have expanded over
the last 3 years in Burma and have gained better access to certain
areas.

Programs that address health and development issues in Burma have
generally been less constrained by the regime's restrictions than the
ILO and ICRC human rights efforts. Officials said that careful planning
is the key to managing useful health and development projects within
regime limits. Several officials also emphasized that restrictions have
had the least effect on their organizations, which tend to work closely
with the regime. For example, an FAO official told us that FAO
generally has good relations with the technical ministries it
cooperates with due to its close work with these ministries in
providing technical assistance and supporting knowledge transfer.

Concluding Observations:

Due to restrictions imposed by the Burmese regime, international
organizations are facing an increasingly uncertain future as they
continue their efforts to address Burma's assistance needs. The recent
actions of the Burmese regime indicate that it is now seeking to exert
a greater degree of control over international activities in Burma than
before. While the regime appears to have accepted international efforts
to relieve Burma's development, health, and educational problems as
necessary, it has also opted to regulate them more closely. The regime
also appears to have become more insistent that international
organizations cooperate with regime-sponsored political mobilization
groups. Such actions can only further narrow the opportunities for
international organizations to address Burma's pressing human rights,
humanitarian, and development problems.

Agency Comments and Our Evaluation:

We requested comments on a draft of this report from the Secretary of
State and cognizant officials at the United Nations and ICRC. We
received written comments from State, the UN Country Team in Burma, and
UNAIDS, which are reprinted in appendixes II, III, and IV, along with
our responses to specific points.

State said that the draft report presents the challenges and
opportunities facing international nongovernmental organizations in
Burma in a thorough, accurate, and balanced fashion. State added that
it "will continue to encourage the Burmese regime, both directly and
through various UN fora, to lift the unnecessary and unreasonable
restrictions it has placed on organizations seeking to provide
humanitarian assistance and to promote respect for human rights."

The UN Country Team said that it agreed with our analysis that UN and
other international agencies are able to achieve meaningful results in
Burma despite a difficult and complex environment. However, it
expressed concern that our draft report did not note that a significant
opening of humanitarian space on the ground has been achieved by the UN
and its partners in the past decade. This statement is in contrast to
information UN officials had provided earlier stating that conditions
had deteriorated since the 2004 change in government. The team did not
dispute our specific findings about restrictions faced. However, it
noted a significant development for one organization--ILO. Following
the completion of our draft report, ILO and Burma signed an agreement
to establish a mechanism for victims of forced labor to file complaints
on February 26, 2007. We have updated our report to reflect this
change.

The UN Country Team also said our report did not adequately reflect the
nature of the UN entities' work and the differences in their mandates.
We believe we fairly describe the entities' work in our first
objective. While our draft report noted that UNDP has a restricted
mandate prohibiting it from working with the government, we added
language stating that other UN entities' mandates do not have similar
restrictions.

UNAIDS commented that it appreciated our recognition of progress
despite difficulties but added that the draft report could contain more
evidence of this progress. We believe we fairly described UNAIDS' work
in our draft report.

State, UN agencies, and ICRC submitted technical comments that we have
incorporated into this report, as appropriate.

As agreed with your offices, unless you publicly announce the contents
of this report earlier, we plan no further distribution until 30 days
from the report date. At that time, we will send copies to interested
congressional committees, the Secretary of State, and other interested
parties. We will also make copies available to others on request. In
addition, this report will be available at no charge on the GAO Web
site at http://www.gao.gov.

If you or your staff have any questions about this report, please
contact me at (202) 512-9601 or at melitot@gao.gov. Contact points for
our Offices of Congressional Relations and Public Affairs may be found
on the last page of this report. Key contributors are listed in
appendix V.

Signed by:

Thomas Melito:
Director, International Affairs and Trade:

[End of section]

Appendix I: Scope and Methodology:

To identify the principal efforts of United Nations (UN) and other
international organizations in addressing Burma's problems, we examined
documents relating to programs conducted in Burma by the 10 UN entities
located in that country. We also traveled to several locations in
Burma, where we met with officials of the Food and Agriculture
Organization, International Labor Organization, Joint United Nations
Program on HIV/AIDS, UN Children's Fund, UN Development Program, UN
High Commissioner for Refugees, UN Office on Drugs and Crime, UN
Population Fund, World Health Organization, World Food Program, and
International Committee of the Red Cross. We also met with several
international nongovernmental organizations (who asked that we not
identify their organizations in this report). In addition, we met with
Burmese staff working for the United Nations who are implementing three
projects in or around Rangoon and two projects in villages a day's
travel by car and small boat outside of Rangoon and Bassein. In
Thailand, we met with officials from the Inter-Agency Project on Human
Trafficking in the Greater Mekong Sub-Region; UN Educational,
Scientific, and Cultural Organization; UN High Commissioner for
Refugees; UN Industrial Development Organization; and UN Office for
Project Services. We conducted telephone interviews and
videoconferences or exchanged e-mail correspondences with officials at
the headquarters of the 10 UN entities and the respective U.S. missions
in Geneva, New York, Rome, and Vienna. We met with additional U.S.
Department of State officials in Washington, D.C., Burma, and Thailand.
We did not assess UN data on UN expenditures in Burma because we only
used these data as background information in our report.

To describe the impact of the Burmese regime's recent actions on the
activities of international organizations in Burma, we reviewed the
Guidelines for UN Agencies, International Organizations, and NGO/INGOs
on Cooperation Programmes in Myanmar set forth by the Burmese Ministry
of National Planning and Economic Development. We traveled to Nay Pyi
Taw, the newly built Burmese capital, to discuss the regime's
restrictions on international organizations with senior officials from
the Ministry of National Planning and Economic Development and the
Ministry of Health. In addition, we met with officials of the U.S.
embassy and of the leading democratic organization in Burma, as well as
with local recipients of UN assistance. We also spoke with a UN
official from the Department of Political Affairs and met with the
Burmese UN mission in New York. In Thailand, we met with
representatives of the British and Dutch embassies to discuss aspects
of their nations' aid to Burma. In Washington, D.C., we met with
officials of the U.S. Departments of State and the Treasury,
individuals from several international nongovernmental organizations,
and individuals at the World Bank and International Monetary Fund.

We conducted our work from May 2006 through February 2007 in accordance
with generally accepted government auditing standards.

[

End of section]

Appendix II: Comments from the Department of State:

United States Department of State:
Assistant Secretary for Resource Management and Chief Financial
Officer:
Washington, D.C. 20520:

Ms. Jacquelyn Williams-Bridgers:
Managing Director:
International Affairs and Trade:
Government Accountability Office 441 G Street, N.W.
Washington, D.C. 20548-0001:

Mar 15 2007:

Dear Ms. Williams-Bridgers:

We appreciate the opportunity to review your draft report,
"International Organizations: Human Rights Programs Blocked in Burma;
Other Assistance Proceeds Despite Constraints," GAO Job Code 320417.

The enclosed Department of State comments are provided for
incorporation with this letter as an appendix to the final report.

If you have any questions concerning this response, please contact
Aaron Cope, Bunna Desk Officer, Bureau of East Asian and Pacific
Affairs at (202) 647-0056.

Sincerely,

Signed by:

Bradford R. Higgins:

cc: GAO - Cheryl Goodman:
EAP - Christopher Hill:
State/OIG - Mark Duda:

Department of State Comments on GAO Draft Report:

International Organizations: Human Rights Programs Blocked in Burma;
Other Assistance Proceeds Despite Constraints GAO-07-457/GAO Code
320417:

Thank you for the opportunity to comment on the draft report
International Organizations: Human Rights Programs Blocked in Burma;
Other Assistance Proceeds Despite Constraints.

We found that the draft report presents the challenges and
opportunities facing international non-governmental organizations in
Burma in a thorough, accurate, and balanced fashion. The State
Department will continue to encourage the Burmese regime, both directly
and through various UN fora, to lift the unnecessary and unreasonable
restrictions it has placed on organizations seeking to provide
humanitarian assistance and to promote respect for human rights.

The State Department expresses its appreciation for the GAO's collegial
approach to producing this report and its openness to input and
clarifications from the State Department.

[End of section]

Appendix III: Comments from the UN Country Team:

UNITED NATIONS:

NATIONS UNIES:

Office Of The Resident Coordinator, Yangon, Union Of Myanmar Office Of
The Humanitarian Coordinator. Yangon, Union Of Myanmar:

Reference:

5 March 2007:

Dear Mr. Melito,

On behalf of the United Nations Country Team (UNCT) in Myanmar, I would
like to thank you for the opportunity to comment on your Office's draft
report titled "Human Rights Programs Blocked in Burma; Other Assistance
Proceeds Despite Constraints." While fully agreeing with the analysis
reflected in the second half of the title (that United Nations and
other international agencies are able to make progress in this country
despite a difficult and complex operating environment), the Country
Team is concerned that the full picture of what is being accomplished,
including on the human rights front, is not necessarily captured in the
draft report.

The comments of the UNCT can be summarized as threefold: 1) the report
does not adequately reflect the differences in UN agencies' mandates
and the nature of their work; 2) the analysis fails to capture the fact
that a significant opening of humanitarian space on the ground has been
achieved by the United Nations and its partners in the past decade; and
3) the report does not include a number of United Nations activities
that contribute to the establishment of a protective environment for
the nation's people, including some that specifically address human
rights. Concerning this last point, there has been a significant
development on the human rights front since the drafting of your
report. Specifically, the International Labour Organisation has
concluded on 26 February 2007 an agreement with the Government of
Myanmar on the establishment of a complaints mechanism for victims of
forced labour.

With regard to the mandate issue, the report does not clarify which
agencies are mandated to work with Government and those which are not.
For example, it seems to single out the United Nations Childrens' Fund
(UNICEF), saying it "assists the Burmese regime." In fact, several
United Nations agencies provide technical support to Myanmar's social
services structures, which are eroding due to lack of budgetary
support, as is noted, and the lack of capacity of the younger
generation of civil servants. These functions of United Nations
agencies are in full compliance with the mandates set out for them by
their Executive Boards, which are made up of United Nations member
states.

Only the United Nations Development Programme (UNDP) has a specific
restriction, placed on it by its Executive Board, to not work with
Government. Similarly, by implementing a Protracted Relief and Recovery
Operation (PRRO) rather than a Country Programme, the World Food
Programme (WFP) also does not work directly with Government. In
addition, some of the descriptions of agencies' work seem to leave out
important parts of their mandates. Though, for example, the United
Nations Office on Drugs and Crime (UNODC) is acknowledged as working in
the HIV/AIDS sector, the organization is also involved in defining
alternative livelihoods for ex-opium farmers, monitoring of the extent
and patterns of opium poppy cultivation, and the socio-economic status
of opium farmers.

Regarding the issue of humanitarian space, a great deal has been
achieved over the last three to four years in terms of geographical
access, programmatic success, and operating space for the UN and non-
governmental organizations (NGOs). In terms of geography, for example,
ten years ago UNODC struggled to start its operations in the Wa
regions. Now UNODC's projects reach about one third of the total Wa
population (120,000 people), and its access opened the door for that of
INGOs and other UN agencies. There are now more than 15 UN agencies and
international NGOs operating in this very poor and needy area.
Similarly, in 2004 the United Nations High Commissioner for Refugees
for the first time was allowed to start work in eastern border areas of
possible refugee return, and its presence is opening the way for its
NGO partners as well. This point about the UN expanding space for
others is an important one, as in some cases the UN "umbrella" helps
NGOs set up operations in a specific area. This said, clearly a number
of INGOs have also been very effective in expanding humanitarian space.

On the programmatic side, the example of HIV/AIDS shows how much can be
achieved through persistent work by international agencies. In the mid-
1990's, the Government did not acknowledge the severity of HIV in the
country. Today, in contrast, international NGOs, the UN and its
partners are providing anti-retroviral treatment to nearly 6,000
patients, double the number from just 2005. More than 300,000 people
benefited from HIV and health education. Since 2000, voluntary HIV
counseling of pregnant women is now permitted in community based
screening programmes involving community midwives, and in health
clinics. This programme is now functional in 90 townships. There are 16
outreach service delivery sites for drug users, as opposed to just one
in 2001. The number of pregnant women accessing prevention of
mother-
to-child transmission services has more than tripled between 2003 and
2005. Condom use in Myanmar is estimated to have expanded from 3
million per year in 1996, to 40 million in 2005, more than a ten-fold
increase.

It is clearly the case that the HIV/AIDS sector, and communicable
diseases more broadly, is an area where successful work can be done,
and this has been recognized by international donors. It is very
important to note that following the withdrawal of the Global Fund for
HIV, TB and Malaria (which you mention on p23), six donors (the EC, UK,
Netherlands, Sweden, Norway and Australia) put together a new fund,
with more flexible structures but a similar amount of money, to fund
HIV, TB and malaria work in Myanmar in recognition both of the needs
and of the fact that possibilities for meaningful progress do exist. In
this regard, in FN 18 the report notes, incorrectly, that the World
Health Organisation (WHO) "is working to establish an alternative multi-
donor trust fund" on HIV, TB and malaria. It is not a WHO Fund but a
donor-created fund. Other examples of positive programmatic
collaboration include the support UNICEF and WHO provide to the
Government to successfully eradicate polio; the development of a
national Avian influenza pandemic plan in collaboration with FAO,
UNICEF and WHO; and the launching of the national measles campaign in
January 2007.

The third concern is the implication that there are no activities at
all by international agencies (other than the initiatives by ICRC and
ILO) that advance human rights in Myanmar. The United Nations agencies
are working to create a protective environment for the people of
Myanmar, both in the broader sense of having more offices on the ground
(UNDID alone expanded its offices from 24 to 66 townships in the past
two years) and working to provide health, education and livelihoods to
the most vulnerable people in the country, but also in the more
specific, human-rights context.

* UNHCR's work in Northern Rakhine State since 1994 has been
predominantly geared towards enhancing the legal status of former
refugees, who also happen to be stateless. Since 2005 the agency's
focus has expanded to cover the entire stateless population of the area
- close to 800,000 persons - and to engage the Myanmar authorities in a
policy dialogue on human rights issues, including non-discrimination
and legal identity.

* WFP has initiated protection workshops for all its field staff and
partners, in which they learned that the serious protections gaps in
Myanmar required concerted efforts by all relevant organizations but
that support through formal and informal education related activities
should be used the principal entry point through which protection
issues could be addressed. This has shaped the orientation of WFP
activities in 2007 - 09, where a heavy focus is placed on food for
education and food for training activities.

* Since 2004, UNICEF has also supported training workshops on child
protection, juvenile justice, social work, anti-trafficking, commercial
sexual exploitation of children, community-based psychosocial care and
support, alternative care for orphans, family reunification of
trafficked children, and child protection in emergencies - for
community-based organizations, NGO's and technical counterparts.
Training programmes for law-enforcement and social welfare officials
including the police, administration, and social welfare officers and
prison staff have focused on international juvenile justice standards,
child rights, child-friendly and women- friendly procedures, and the
promotion of a more protective environment and services for children.

* On human trafficking, the United Nations Inter-Agency Project on
Human Trafficking in the Greater Mekong Sub-Region (UNIAP) has made
significant progress over the last years in raising awareness of
trafficking issues among government officials and supporting the
development of comprehensive anti-trafficking legislation, enacted in
September 2005, that contains strong provisions for the protection of
trafficking victims. Since then, training and awareness raising
activities for both government and non-government service providers
have included a specific focus on these provisions and have led to
improved protection and immunity from prosecution for trafficking
victims returning to the country.

For your convenience, I have appended to this letter the full set of
comments and suggestions made by the UNCT to the early draft you sent
to us. At the time, your office had also asked us to provide examples
of successes and we have done so. These do not seem to have made it
into the report. It would be regrettable were they not to be included
as it would provide a more nuanced, and possibly more accurate,
assessment of "principal efforts by the United Nations and other
international organizations to address Burma's problems".

One of your colleagues mentioned that a UNCT response to the draft
report would be appended to your final report. Were this to be the
case, we have no objection to the inclusion of this response.

Yours sincerely,

Signed by:

Charles Petrie:
UN Humanitarian & Resident Coordinator in Myanmar:
On behalf of the UN Country Team:

cc: Ms. Cheryl Goodman, Assistant Director, GAO:
Mr. Pierre Toureille, GAO:
Mr. Lyric Clark, GAO:  

The following are GAO's comments on the UN Country Team's letter dated
March 5, 2007.

GAO Comments:

1. The UN Country Team (UNCT) noted that the International Labor
Organization and Burma had concluded an agreement establishing a forced
labor complaints mechanism after we had submitted our draft report for
comments. We have updated the text and title of our report to reflect
this recent development.

2. The UNCT commented that our draft report did not adequately reflect
the differences in UN entities' mandates, in that it did not clarify
which entities are mandated to work with the regime and which are not.
We disagree. Our draft report noted that UNDP's governing board has
restricted UNDP from working through the regime. We further clarified
our report by adding a sentence noting that the mandates of other UN
entities do not contain restrictions similar to those of UNDP.

3. The UNCT commented that our draft report did not describe a
significant opening of humanitarian space in Burma. The UNCT's letter
is not consistent with the information and assessments provided to us
by UNCT members and NGO officials during our October 2006 fieldwork in
Burma. At the time, UNCT and NGO officials provided numerous examples
of how Burmese restrictions had impeded their activities (including
UNHCR's recent efforts in the Thai border region) and a senior UN
official in Burma informed us that the "humanitarian space" in Burma
was dwindling. UNCT members reconfirmed much of this information in
February 2007, when we asked them to review excerpts from our working
draft report for accuracy and sensitivity. We then reflected many of
their suggestions in our draft report, which we subsequently submitted
to UN entities for official review and comment. The UNCT comments do
not take issue with our findings concerning the range and nature of the
regime's restrictions (with the exception of the recent agreement
reached between the government and the ILO). Moreover, they do not
exp

lain how those restrictions might have eased following our field
work.

4. The UNCT commented that our draft report did not address human
rights activities by agencies other than ILO and ICRC. In assessing the
effect of the regime's restrictions on international human rights
efforts, we focused on ILO and ICRC because their missions in Burma are
primarily related to human rights. We did not focus on ancillary
efforts by agencies whose primary mission is to address development and
humanitarian concerns.

5. The UNCT letter states that we did not include the examples of
successes in Burma that we requested in February 2007. We reviewed the
information the UN organizations sent to us and believe we fairly
summarized UN achievements in Burma.

[End of section]

Appendix IV: Comments from UNAIDS:

UNAIDS:
Joint United Nations Programme on HIV/AIDS:

Telephone: +41 22 791 3392:

Reference: CRD/BW/MZ/Iw

Mr Thomas Melito:
Director:
International Affairs and Trade:
United States Government Accountability Office:
Washington DC:

USA:

14 March 2007:

Dear Mr Melito,

Thank you very much for the opportunity to comment on the draft report
of the US Government Accountability Office entitled "Human Rights
Blocked in Burma; Other Assistance Proceeds Despite Constraints". We
welcome this review of the ability of the United Nations to assist the
people of Myanmar in need of health care and other assistance. The
people of Myanmar have rights to information about HIV prevention and
risk as well as to medical treatment and socio-economic care and
support. UNAIDS works to help ordinary Myanmar people to obtain these
rights.

In this light, while appreciating the report's recognition of progress
despite the difficulties, the report could reference more evidence of
this progress and gain consequently in robustness. Specifically,
important gains have been made in Myanmar on the area of AIDS, in
particular since 2003. Some specific text has been provided in the
joint letter from the UN Country Team dated 5 March, 2007 (attached).
Further formal references to the following reports would add to the
depth of your report.

1) Fund for HIV/AIDS in Myanmar, Annual Progress Report 2005, UNAIDS,
2007 (available on www.unaids.org).

2) Response to HIV and AIDS in Myanmar: Progress Report 2005, Ministry
of Health, Government of the Union of Myanmar, 2007. (Attached
electronically and available on www.unaids.org).

3) Joint Programme for HIV/AIDS in Myanmar Progress Report 2003-2004
and Fund for HIV/AIDS in Myanmar Annual Progress Report 2005, UN
Expanded Theme Group on AIDS, 2006 (available on www.unaids.org).

We thank you again for the opportunity to comment on this report.

Yours Sincerely,

Signed by:

Michel Sidibe:
Director:
Department of Country and Regional Support:

[End of section]

Appendix V: GAO Contact and Staff Acknowledgments:

GAO Contact:

Thomas Melito, (202) 512-9601 or melitot@gao.gov:

Staff Acknowledgments:

In addition to the person named above, Cheryl Goodman (Assistant
Director), Pierre Toureille, Lyric Clark, Barbara Shields, Debbie
Chung, and Ian Hongola made key contributions to this report. Martin De
Alteriis and Mary Moutsos provided technical assistance.

FOOTNOTES

[1] Since 1989, Burma's military rulers have promoted "Myanmar" as the
name for the country of Burma. In accordance with U.S. government
policy, this report refers to the country as Burma and not as
"Myanmar."

[2] Aung San Suu Kyi was later awarded the Nobel Peace Prize.

[3] The United States helps fund some UN programs in Burma and also
funds Burmese democracy programs and humanitarian aid to Burmese
refugees outside of the country. About $11 million was appropriated for
these activities, as well as additional activities related to Burma,
for fiscal year 2006 in the Foreign Operations, Export Financing, and
Related Programs Appropriations Act, 2006, Pub. L. No. 109-102.

[4] UN entities with offices in Burma are the Food and Agriculture
Organization, International Labor Organization, UN Children's Fund, UN
Development Program, Joint United Nations Program on HIV/AIDS, UN High
Commissioner for Refugees, UN Office on Drugs and Crime, UN Population
Fund, World Health Organization, and World Food Program.

[5] The three UN entities that operate programs in Burma from Thailand
are the UN Educational, Scientific, and Cultural Organization; the
Inter-Agency Project on Human Trafficking in the Greater Mekong Sub-
Region; and the UN Industrial Development Organization.

[6] See Amnesty International, Myanmar's Political Prisoners: A Growing
Legacy of Injustice (June 2005), which can be viewed at [Hyperlink,
http://web.amnesty.org/library/index/engasa160192005].

[7] Foreign Policy and The Fund for Peace, 2006 Failed State Index.

[8] Transparency International, Corruption Perceptions Index 2006.

[9] UNDP's indicators include life expectancy, literacy rates, and per
capita income.

[10] The resolution was vetoed by China and Russia.

[11] UNDP and WFP reported significant increases in their spending in
Burma in 2005. According to UNDP officials, UNDP funding increased to
about $23 million in 2005 as a result of the former Prime Minister's
decision to allow UNDP to expand into certain areas. According to WFP
officials, WFP funding increased approximately $6 million between 2004
and 2005 as it provided assistance to an increased number of families
affected by the regime's 1999 plan to eradicate poppy production over a
15-year period. We did not assess the reliability of UN expenditure
data because we used it for background purposes only.

[12] Section 301 of chapter 3 of the Foreign Assistance Act of 1961, as
amended (Pub. L. 87-195), states that "the President is authorized to
make voluntary contributions on a grant basis to international
organizations and to programs administered by such organizations...."
Section 307 of the act specifies that "none of the funds authorized to
be appropriated by this chapter shall be available for the United
States' proportionate share for programs for Burma...." with the
exception of contributions to UNICEF and the International Atomic
Energy Agency. Under Section 307, State withheld more than $905,000
from its fiscal year 2004 voluntary contributions to UNDP in connection
with programs in Burma.

[13] State has also obtained UNDP assurances that UNDP has consulted
Burmese pro-democracy groups regarding its program in Burma. Congress
included similar conditions in a provision of the Admiral James W.
Nance and Meg Donovan Foreign Relations Authorization Act, Fiscal Years
2000 and 2001, Pub. L. No. 106-113, ? 108, 113 Stat. 1501, 1501A-417
(1999). This provision, which is no longer in effect, specified that of
the funds made available for fiscal years 2000 and 2001 for voluntary
contributions to UNDP, the United States would withhold "an amount
equal to the amount" that UNDP spent in Burma unless State certified
that all UNDP programs met the act's conditions.

[14] The Forced Labour Convention, adopted on June 28, 1930 in Geneva,
Switzerland, prohibits the use of forced labor, as defined in the
convention. The convention may be found at [Hyperlink,
h

ttp://www.unhchr.ch/html/menu3/b/31.htm]. Burma ratified the
convention in 1955.

[15] Burmese Ministry of National Planning and Economic Development,
Guidelines for UN Agencies, International Organizations, NGO/INGOs on
Cooperation Programs in Myanmar (February 2006).

[16] Over 150,000 Burmese refugees live in camps along the border in
Thailand, according to officials of a nongovernmental organization that
works on the Burma-Thailand border. UNHCR and international
organizations, such as the Thailand Burma Border Consortium, assist
these refugees. The consortium's efforts in Thailand are partially
funded by the United States.

[17] For more information on the Global Fund, see GAO, Global Health:
The Global Fund to Fight AIDS, TB and Malaria Is Responding to
Challenges but Needs Better Information and Documentation for
Performance-Based Funding, GAO-05-639 (Washington, D.C.: June 10,
2005).

[18] Donors are working to establish an alternative trust fund that
supports efforts to combat tuberculosis, HIV/AIDS, and malaria in
Burma.

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