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 
 
--------------------------------------- 
Review of Best Practices and Obstacles 
--------------------------------------- 
¶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. 
 
---------------------- 
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. 
 
---------------- 
Looking Forward 
---------------- 
¶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