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. 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, while Transparency International  ranked Burma 1.9 on a corruption scale ranging from 0 (highly corrupt) to  10 (highly clean).
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. 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).
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. 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 these funds were spent by  UNDP, the UN Children’s Fund (UNICEF) and the World Food Program  (WFP), as shown in figure 2. 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.
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.
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. 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. 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,  malnutrition, 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.
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 political 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. 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 project 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. 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 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.
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.
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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.

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.

Appendix II: Comments from the Department of State

Appendix III: Comments from the UN Country Team

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 explain 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.

Appendix IV: Comments from UNAIDS

Appendix V: GAO Contact and Staff Acknowledgments

	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.

Summary:
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.