Fund Board Aide Memoire
Three Diseases Fund Second Annual Review Meeting
14 October 2009

The Three Diseases Fund Second Annual Review was held on 14th October 2009 at the Sedona Hotel Yangon. Some 160 participants attended representing The Fund Board, Fund Manager, Ministry of Health, donors, UN agencies, INGOs and local NGOs and CBOs. The day comprised plenary sessions and open discussion. The findings of the independent Mid Term Evaluation were presented and discussed in plenary. The Day closed with a Market Place exhibition by 31 implementing partners.

This Fund Board Aide Memoire documents major themes which emerged from the day.

The Fund Board will develop an action plan in response to the recommendations of the Mid Term Evaluation and other issues raised in the Annual Review.

Policy
Collaboration: The opening remarks and a number of presentations and interventions noted how the collaboration, trust and partnership have developed last year among all actors involved in the 3DF. Partnership building was already a key theme of the 2008 ARM, but further progress was clear.

The Ministry of Health noted that the 3DF had become an "innovative partnership with all the key partners". The outcome of better partnership was reflected through practical examples from the presentations such as: TB referrals, consistent quality standards between different partners, joint work on M&E. The importance of the Technical Strategic Groups (TSG) was reaffirmed.

The National Malaria Control Programme summarized the importance of partnership in tackling the epidemic: Together we can make it.

Although progresses had been made, the need for better synergy was highlighted both between programmes (such as 3DF and LIFT) and diseases (within 3DF such as TB and HIV). There was a strong call for practical action to take this forward.

The problem solving attitude of partners was highly commended. Important changes have been made in response to constructive feedback, such as agreements on indirect costs and multi-year contracts. Sustained progress is needed and the Fund Board welcomed direct feedback from all. CBOs emphasized the importance of the link to the community and responding to their needs.

A strong plea from the forum was made to address the other health needs of communities beyond the three diseases. The limitations of vertical programmes were raised repeatedly particularly versus the basic health needs of hard to reach communities. The donors informed the forum of a forthcoming Scoping Study to explore the various options for future health support. Inputs will be very much welcome for this exercise. The donors said they would also welcome an opportunity to meet with the Minister of Health to discuss the health Millennium Development Goals.

Programmes
Evidence was presented from all three diseases on the limitations in coverage of services. The forum acknowledged the need to scale up the response to address gaps. The limitations of funding, both from government and donors, were acknowledged. The question of equity of support was raised, acknowledging the limitations of the competitive grants-based approach in this regard.

The importance of practical coordination at the township level was highlighted to enhance working with communities, cooperation between partners and coordinating with the TMO. A more comprehensive approach is needed.

The record on access for the 3DF for visas and travel authorization for the 3DF has been good and acknowledged by the 3DF. In 2008 there had been no requests turned down by the Ministry of Health. Requests were made from the forum for Ministry of Health to include other 3DF implementing partners in the same efficient visa and travel authorization system.

Several interventions and presentations demonstrated the improved focus on results. The forum reaffirmed the importance of robust strategic information such as the prevalence surveys or research, reporting of shared indicators, analysis and the use of the data decision making. The Fund Board encouraged the TSGs to suggest prioritized studies or surveys to the 3DF to address strategic information gaps.

Community Based Organisations underlined their important role in linking to the communities and having a much greater understanding of needs. Further capacity development was vital to strengthen this role.

Management
The need to learn the lessons from the Fund Flow mechanism was acknowledged in order improve the efficiency of supporting activities at township level.

Conclusion
The findings of the Mid Term Evaluation were presented. The complexity of working in this setting, and the constraints that all parties were under, were acknowledged. However the main conclusion of the Mid Term Evaluation is that the 3DF has been successful. The forum reaffirmed the conclusion with the acknowledgement that a significant beginning has been made but there is much more to do.

The Fund Board Aide Memoire can be downloaded from the link below: