Cablegate: Interagency Cordination, Best Practices And

VZCZCXYZ0000
PP RUEHWEB

DE RUEHJA #2032/01 3090433
ZNR UUUUU ZZH
P 040433Z NOV 08
FM AMEMBASSY JAKARTA
TO RUEHC/SECSTATE WASHDC PRIORITY 0516
INFO RUEAUSA/DEPT OF HHS WASHINGTON DC

UNCLAS JAKARTA 002032

SIPDIS
SENSITIVE

AIDAC FOR KHILL/GH, RGREENE/GHIDN, SSOLAT/ASIA/EAA
FA FOR DDIJKERMAN, GAC FOR MDYBUL

SENSITIVE BUT UNCLASSIFIED

E.O. 12958: N/A
TAGS: SENV CASC EAID ID
SUBJECT: INTERAGENCY CORDINATION, BEST PRACTICES AND
LESSONS LEARNED THROUGH PEPFAR AND PMI I

REF: STATE 00112759

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Review of Best Practices and Obstacles
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1. The PresidentQs Emergency Plan for AIDS Relief (PEPFAR)
team in Indonesia will submit a Mini-Country Operational
Plan on November 15, 2008, and will discuss interagency
coordination in its Management and Staffing narrative.
Indonesia is a priority USG focus country for tuberculosis,
having the third highest burden in the world after India
and China. USAIDQs partners actively support the National
Tuberculosis Program (NTP). Indonesia is not a
Presidential Malaria Initiative (PMI) focus country,
although USAID supports a small program in malaria-endemic
areas of Eastern Indonesia which focuses on prevention,
rapid diagnosis and prompt treatment for pregnant women and
their children.

2. (SBU) Should the PEPFAR reauthorization bill result in
funding increases for HIV/AIDS, malaria and tuberculosis, a
strong case could be made for increasing support for
tuberculosis, especially such NTP priorities as creating
local capacity to manage multi-drug resistant tuberculosis
(MDR-TB), establishing infection control in hospitals,
training a large pool of public and private sector
physicians in DOTS (Direct Observed Treatment Short Course)
and International Standards for Tuberculosis Care (ISTC),
and strengthening the health system to ensure that an
effective nation-wide drug management and logistics system
is in place. Given the likelihood for approval of Round 8
proposals to the Global Fund to Fight AIDS, Tuberculosis
and Malaria, there will be sharply increased needs for
technical oversight to ensure that these activities are
effectively and transparently rolled out.

3. (SBU) PEPFAR Indonesia was invited to submit a concept
note for a Partnership Compact on September 30, 2008. If
approved, the additional funding will be used to broaden
the scope of the PEPFAR program in Indonesia from one
focused primarily on Most-atQRisk-Populations (MARP) to
include technical assistance targeted at the national level
and for health systems strengthening in Tanah Papua.

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Agency Core Strengths
----------------------
4. Under the leadership of the Ambassador, USG agencies
maintain a core team of highly-skilled and dedicated
national and expatriate staff to effectively manage the
implementation of the PEPFAR program in Indonesia. The
current USG PEPFAR presence is comprised of STATE, USAID,
and DOD(PACOM). These agencies maintain strong in-country
coordination on HIV/AIDS. The HHS/CDC/ Global AIDS Control
Program (GAP) regional office in Bangkok provides support
to several countries in the region. Although Indonesia is
not a direct GAP country, HHS/CDC has full-time staff
working on influenza. A new Peace Corps program has been
considered for Indonesia in 2009, contingent on funding.
Peace Corps has a long history of involvement with
development assistance activities in the health sector.

5. Staffing for Results (SFR) is focused on assuring the
comprehensive integration and support of the Government of
IndonesiaQs 2007-2010 National HIV/AIDS Strategic Plan.
The positions and functions included in the management and
staffing budget line are essential to effective planning,
implementation and monitoring of the Emergency Plan.
STATE, through its ECON section, is engaged with the PEPFAR
process throughout the annual planning cycle. DOD
activities and programs are managed by staff located in
PACOM/Hawaii, while in-country liaison is provided by the
Office of Defense Cooperation. Currently, USAID has one
USPSC, one USDH, one technical FSN and two FSN support
staff. A collaborative interagency process is maintained
through regular communications and field visits.

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Looking Forward
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A. The F process, in conjunction with the PEPFAR
requirements, creates a significant management burden on
posts. This burden has resulted in a significant
deflection of staff time away from managing programs
towards managing inter agency processes. Overtime, this
could dramatically exacerbate vulnerabilities, particularly

in an environment like Indonesia where corruption is still
a major issue. Further attempts to simplify, streamline
and reconsider the administrative burdens imposed by these
processes would be greatly appreciated. The Government of
Indonesia (GOI) is still pleased to work with us on these
and other issues, but they have expressed a desire for a
better partnership. The do not believe that these
processes and US bilateral assistance investments,
including PEPFAR are consonant with the principles of the
Paris Declaration. To a great extent, they see the
processes and investment decisions as being driven by
Washington and not by the development needs and priorities
of Indonesia. The Partnership Compact prospect presents an
opportunity to offset this, assuming that it really does
enable better and more effective shared responsibility and
choice.

B. The GOI and the donors here are strong proponents of the
best practices for aid effectiveness exemplified in the
Paris Declaration of the DAC.

HUME

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