Myanmar Artemisinin Monotherapy Replacement Malaria Project (AMTR) Independent Evaluation Working Paper 4 June 2014

Size: px
Start display at page:

Download "Myanmar Artemisinin Monotherapy Replacement Malaria Project (AMTR) Independent Evaluation Working Paper 4 June 2014"

Transcription

1 Myanmar Artemisinin Monotherapy Replacement Malaria Project (AMTR) Independent Evaluation Working Paper 4 June 2014 The potential impact of increased private sector investment in Myanmar on malaria control strategies and the potential future role of the private sector in contributing to malaria control

2 Myanmar Artemisinin Monotherapy Replacement Malaria Project (AMTR) Independent Evaluation Is implemented by In partnership with ACKNOWLEDGEMENTS The evaluation team would like to thank all those who have generously given their time, experiences and expertise in guiding this assessment. In particular, the staff of DFID and PSI in Yangon. The team would also like to specifically thank all individuals listed in this paper who were interviewed as part of the assessment. This material has been funded by UKAid from the UK Department for International Development (DFID). The views expressed do not necessarily reflect those of HM Government. i

3 TABLE OF CONTENTS ACKNOWLEDGEMENTS ABSTRACT... 1 ABBREVIATIONS AND ACRONYMS INTRODUCTION BACKGROUND Methodology INVESTMENT CLIMATE Myanmar s comparative advantage GOVERNMENT REFORMS THE IMPACT OF INCREASED INVESTMENT ON EXISTING MALARIA CONTROL STRATEGIES Migration and malaria transmission Economic activities and malaria transmission Geographical stratification of malaria endemnicity, resistance areas and economic development PRIVATE SECTOR ENGAGEMENT A role for the private sector in contributing to malaria control Why should the private sector support malaria control? Employees, dependents and the broader community? What role can the private sector play? Existing private sector initiatives Other initiatives to engage the private sector SECURING BROADER ENGAGEMENT Voluntary engagement or government regulation? Voluntary engagement Government regulation Potential regulation points A potential model CONCLUSIONS AND RECOMMENDATIONS REFERENCES ANNEX Key informants and stakeholders met during visit ii

4 ABSTRACT Montrose has been contracted by the UK Department for International Development (DFID) to conduct an independent evaluation of the Population Services International (PSI) Artemisinin Monotherapy Replacement (AMTR) project which is seeking to address artemisinin resistance in Myanmar through the replacement of artemisinin monotherapy with quality assured artemisinin combination therapy through private sector distribution channels. As part of this evaluation, Montrose has been asked to produce a series of working papers and case studies on areas of related interest. This working paper explores the potential impact of increased private sector investment in Myanmar on existing malaria control strategies, and in addition, the potential role that the private sector can play in contributing to future malaria control efforts. References to the private sector in this paper refer to the broader corporate private sector as opposed to the narrower definition of the private sector as private suppliers, distributors and providers of malaria treatment. This paper examines how the recent initiation of a democratisation and liberalisation process in Myanmar is accompanied by increasing opportunities for local and foreign investment, and how investment in both existing and new initiatives, particularly large scale industrial and infrastructure projects is catalysing increased economic activity and increased movements of goods, peoples and services both internally and beyond Myanmar s borders. It examines how such an increase in activities in, and movements through, malaria endemic areas may potentially lead to an increase in malaria cases and also contribute to the spread of artemisinin resistance. Section 2 examines the current investment climate in Myanmar, noting both Myanmar s natural comparative advantage and steps taken by the current government under President Thein Sein to stimulate increased economic investment and development by both local and international partners. In summary, Myanmar s economy grew by 7.5% in the fiscal year and it has been estimated that Myanmar s economy may quadruple in size to over $200 billion by the year Section 3 then looks at the potential impact of increased economic activities on existing malaria control strategies. High transmission environments occur in endemic areas where individuals are exposed to infected mosquitos during peak biting hours. High risk categories of employment thus include activities in forested, semi-forested and forest-like environments such as plantations, where individuals either work outside during peak hours, or sleep without the protection of a net. High risk activities include logging and timber extraction, forest clearance and construction activities such as road, pipeline or power plant construction, mining activities, plantation work and agriculture amongst others. Particularly vulnerable groups are migrant and mobile 1 Asian Development Outlook, Myanmar, ADB, 2014 ( 2 McKinsey Global Institute, Myanmar s moment: Unique opportunities, major challenges, June

5 populations (MMP) whose living conditions and economic activities are more likely to meet high risk criteria. MMP are also likely to play a significant role in the spread of artemisinin resistance as they travel between foci of resistance and areas where resistance has not yet been identified. Section 3 examines how a large proportion of existing and proposed development in Myanmar is in high risk activities such as large scale infrastructure projects and resource extraction. It compares geographical areas of malaria endemnicity and identified or suspected artemisinin resistance, to areas of planned development within Myanmar, and postulates that such increased activity in endemic areas is likely to increase the population exposed to malaria and thus the number of malaria cases. As increased volumes of goods, peoples and services move through endemic areas it is also likely that the spread of artemisinin resistance will be facilitated. This paper recognises that in addition to potentially contributing to increases in malaria cases and the spread of resistance, private sector activities can offer a unique opportunity to deliver or facilitate access to malaria prevention, testing and treatment services for workforces and surrounding communities beyond the current reach of the National Malaria Control Programme (NMCP). Section 4 examines a potential role for the private sector in contributing to malaria control and artemisinin containment strategies, articulating arguments to support private sector involvement in three broad categories: economic, obligation and the public health interest. It also looks at arguments for extending service provision beyond the workforce, to workers families and the broader community. Samples of existing private sector initiatives in the area of malaria control are examined and an overview provided of the activities of implementing partners in engaging the private sector in malaria control. Section 5 looks at ways of securing broader engagement of the private sector and discusses the relative merits of voluntary engagement and government regulation, recognising that different companies may respond more favourably to different approaches. It recommends a combined approach, setting out a regulatory framework to both harness and develop goodwill amongst responsive companies, and also to regulate the activities of those companies who would not naturally engage with a voluntary process. It examines existing voluntary initiatives to engage the private sector and discusses potential access points for the introduction of a formal regulatory system, such as through investment legislation currently under revision by the Ministry of National Planning and Economic Development (MNPED). Revisions include a clause under which investment proposals must allocate a certain proportion of profits to corporate social responsibility (CSR) activities, and a potential option could be to request the inclusion of malaria control where activities are proposed in endemic areas. This paper acknowledges that government capacity to implement and enforce regulation will necessarily be constrained by the size and scale of the current reform agenda, however, the intention and 2

6 framework are still required to set clear standards for adherence. Regarding the model of delivery for service provision through the private sector, this paper recommends that further work be conducted on the design of such an initiative, but recognises that any programme needs to provide clear guidance to ensure that interventions adhere to national malaria treatment standards. This is especially important in the case of artemisinin resistance, where successful containment requires appropriate treatment of suspected falciparum cases to ensure elimination of resistant parasites. Any initiative, voluntary or regulatory, will thus need to outline clear standards, norms and standard operating procedures (SOPs) to govern activities, and establish clear mechanisms for quality assurance, by for example using appropriate key performance indicators (KPIs) to measure and judge performance. The design of any model will need to consider which organisation/s would fulfil the following roles in such an initiative: Engagement, advocacy, networking; Training and awareness; Commodity supply; Testing and treatment; and Monitoring and evaluation. Section 6 concludes by recommending further mapping of the most appropriate government regulatory channels, and the most effective model of engaging all stakeholders in supporting the provision of malaria services through the private sector. It also recommends that initial donor funding is mobilised to provide immediate coverage whilst complimentary regulations are scaled up. In time, private sector companies may be expected to shoulder a greater portion of financial responsibility, but in the interim, direct donor support is required to contain artemisinin resistance as quickly and effectively as possible. The first step is to work with the private sector in partnership to encourage them to open the door. 3

7 ABBREVIATIONS AND ACRONYMS 3MDG The Three Millennium Development Goal Fund ACT Artemisinin-based Combination Therapy ADB Asian Development Bank AMT Artemisinin Monotherapy AMTR Artemisinin Monotherapy Replacement ASEAN Association of Southeast Asian Nations AusAID Australian Agency for International Development BCC Behaviour Change Communications BMGF Bill and Melinda Gates Foundation BPHS Basic Package of Health Services CAP-Malaria Control and Prevention of Malaria CSR Corporate Social Responsibility CSO Civil Society Organisation DFID Department for International Development (UK) DICA Directorate of Investment and Company Administration DIHR Danish Institute for Human Rights DoH Department of Health DOTs Directly Observed Treatment DPW Dawei Project Watch EITI Extractive Industries Transparency Initiative ERAR Emergency Response to Artemisinin Resistance in the Greater Mekong Subregion ESIAs Environmental and Social Impact Assessments EU European Union FDI Foreign Direct Investment FESR Framework for Economic and Social Reform FIL Foreign Investment Laws FMI First Myanmar Investment Co Ltd GAD General Administration Department GMS Greater Mekong subregion GPARC Global Plan for Artemisinin Resistance Containment GPs General Practitioners HMIS Health Management Information System IBHR Institute for Business and Human Rights ILO International Labour Organisation INGO International Non-Governmental Organisation IOM International Organisation for Migration IRS Indoor Residual Spraying ISO International Standards Organisation JSC Joint Steering Committee KPIs Key Performance Indicators LLIN Long lasting Insecticidal Net MARC Myanmar Artemisinin Resistance Containment strategy MBCA Myanmar Business Coalition on Aid MC4T Myanmar Coalition for Transparency 4

8 MCRB Myanmar Centre for Responsible Business MHDC Myanmar Health Development Consortium MIC Myanmar Investment Commission MIMU Myanmar Information Management Unit MMA Myanmar Medical Association MMP Migrant and Mobile Populations MMRD Myanmar Marketing Research Development Co MNPED Ministry of National Planning and Economic Development MoD Ministry of Defence MoECAF Ministry of Environment, Conservation and Forestry MoF Ministry of Finance MOGE Myanmar Oil and Gas Enterprise MoH Ministry of Health MoL Ministry of Labour MoT Ministry of Trade MTE Myanmar Timber Enterprise NGO Non-Governmental Organisation NMCP National Malaria Control Programme OECD Organisation for Economic Co-operation and Development P. falciparum Plasmodium Falciparum PPE Personal Protective Equipment PPPs Public Private Partnerships PSI Population Services International PTT Petroleum Authority of Thailand QDSTM Quality Diagnosis and Standard Treatment of Malaria RBM Roll Back Malaria RDT Rapid Diagnostic Test SEZ Special Economic Zone SOPs Standard Operating Procedures SSB Social Security Board UHC Universal Health Coverage UKTI UK Trade and Investment UMFCCI Union of Myanmar Federation of Chambers of Commerce and Industry UN United Nations UNCTD United Nations Conference on Trade and Development UNDP United Nations Development Programme UNOPS United Nations Office for Project Services URC University Research Co USAID United States Agency for International Development VBDC Vector Borne Disease Control VCC Village Community Committee WHO World Health Organisation WVM World Vision Myanmar 5

9 1. INTRODUCTION The Myanmar Artemisinin Resistance Containment (MARC) framework, developed in collaboration with the World Health Organisation (WHO) and in line with the Global Plan of Artemisinin Resistance Containment (GPARC), was endorsed in April 2011 and outlines immediate containment actions to be put in place to contain artemisinin resistance in Myanmar 3. To date, resistance of Plasmodium falciparum (P. falciparum) has been confirmed in three states along the Thai-Myanmar border (Figure 1); containing this resistance is of upmost importance to prevent the further spread of resistance within Myanmar, as well as regionally and globally. The goals of MARC are: 1) To prevent, or at minimum, significantly delay the spread of artemisinin resistant parasites within the country and along its border ; 2) To reduce transmission, morbidity and mortality of P. falciparum malaria, with priority to areas threatened by resistance 4. Key activities include improving case management through community and private sector involvement, by providing subsidised Quality-Assured Artemisinin Combination Therapy (QA-ACT) and diagnosis, as well as banning oral artemisinin-based monotherapies. The NGO, Population Services International (PSI) has received funding from the UK Department for International Development (DFID), the Bill and Melinda Figure 1. Sites where suspected or confirmed artemisinin resistance has been detected as of 2012 (ERAR framework ) 3 Myanmar Artemisinin Resistance Containment Plan, Myanmar Artemisinin Resistance Containment Plan,

10 Gates Foundation (BMGF) and Good Ventures, for the Artemisinin Monotherapy Replacement Malaria Project (AMTR). PSI has worked closely with private sector suppliers and providers throughout Myanmar to rapidly replace artemisinin monotherapy with highly subsidised QA-ACTs 5. An independent research team was tasked with evaluating the AMTR Project in Myanmar, and in addition to this role, producing a series of working papers and case studies on areas of the project that provide valuable learning for project implementation, the internal stakeholders, and indeed the wider malaria community. The following is one in a series of papers, looking at the specific target area of malaria transmission reduction through use of the drug primaquine (PQ). 5 Outlet Survey: Baseline Study The Republic of the Union of Myanmar 2012 Survey Report 7

11 2. BACKGROUND The recent initiation of a democratisation and liberalisation process in Myanmar is accompanied by increasing opportunities for local and foreign investment. Investment in both existing and new initiatives, particularly large scale industrial and infrastructure projects is catalysing increased economic activity and movements of goods, peoples and services both internally and beyond Myanmar s borders. The increased migration of people along economic migration routes can act as a vector for the transmission of disease between endemic and non-endemic areas, and in parallel, the spread of disease resistance. In Myanmar, artemisinin resistance has been detected in the malaria parasite Plasmodium falciparum (P. falciparum) the species of Plasmodium parasite responsible for the highest rates of malaria associated mortality. Artemisinin resistant P. falciparum was first detected in Cambodia but was subsequently found along the Myanmar-Thai border in the division of Tanintharyi and in the neighbouring divisions of Mon and Bago East. A concern is that increased economic migration fuelled by Myanmar s economic development could facilitate the spread of artemisinin resistance to other endemic areas both within Myanmar and beyond. From a public health perspective, the spread of artemisinin resistance presents a serious threat to global control and elimination campaigns. Artemisinin derivatives combined with other antimalarials in artemisinin-based combination therapy (ACT) currently represent the most effective treatment of P. falciparum malaria. Whilst the combination of artemisinin with other active anti-malarials in ACT should ensure the continued efficacy of ACT in treating artemisinin resistant cases, the spread of artemisinin resistance could increase the likelihood of resistance also developing to partner drugs 6. Spread of artemisinin resistance could also lead to the nonefficacy of treatment in cases where artemisinin monotherapy (AMT) is still being used 7, and in cases where patients fail to take a complete dose of ACT 8. In 2012, an estimated 207 million cases of malaria occurred worldwide, with the majority of the estimated 627,000 associated deaths attributed to cases of P. falciparum 9. Should artemisinin resistance spread to areas such as Africa where both higher transmission rates and a higher proportion of P. falciparum cases contribute to an estimated 80% of malaria mortality cases worldwide 10, the impact on global malaria morbidity and mortality rates could be significant. This pattern of exported resistance from South East Asia via India to the Africa region was associated with the previous spread of 6 WHO Emergency Response to Artemisinin Resistance in the Greater Mekong Subregion, Regional Framework for Action In 2007 the World Health Assembly endorsed the progressive withdrawal of AMTs from the market but in countries still allowed the marketing of these products. WHO World Malaria Report The partner drug in ACT has a longer half-life than the artemisinin and is thus most effective when taken over the period of a complete dose. 9 IBID 10 IBID 8

12 chloroquine and sulfadoxinepyrimethamine resistance, and associated increases in morbidity and mortality 11. Containment of artemisinin resistance is thus essential in reducing the incidence of malaria within Myanmar, and also more broadly - regionally and globally. Whilst containment strategies may only serve to halt, rather than prevent the spread of artemisinin resistance, strategies to slow down the spread of resistance buy time for the development of new drugs which may potentially serve to replace artemisinin. To coordinate the global response to artemisinin resistance the following malaria control and elimination strategies have been developed under the auspices of the World Health Organisation (WHO); the Global Plan for Artemisinin Resistance Containment (GPARC), 2011; the Emergency Response to Artemisinin Resistance in the Greater Mekong Subregion (ERAR), 2013; and in Myanmar, the Myanmar Artemisinin Resistance Containment (MARC) Strategy, All of these strategies note the importance of effective engagement with the private sector to ensure effective malaria control and elimination. Not only do private sector sites serve as source and destination points for mobile and migrant populations, but through virtue of their economic activities (timber extraction, mining, construction etc.) may operate in malaria endemic areas. Likewise, many sites of economic development naturally intersect with foci of artemisinin resistance, potentially through their co-location with economic trade routes and forested border areas. Malaria endemic areas which were once remote and uninhabited may be opened up through increased economic activity to human habitation, bringing workers into increased risk of contracting malaria. Furthermore, new or increased economic opportunities naturally encourage the migration of workers and their families, potentially from areas of artemisinin resistance to areas which were formerly resistance free. In addition, many private sector activities operate in remote and inaccessible areas which are beyond the reach of the public health system. This presents a potential threat or opportunity, dependent on the willingness of private sector employers and employees to engage with malaria control and elimination strategies. This paper examines the current investment climate in Myanmar and the potential impact that increased private sector investment will have on existing malaria control and elimination strategies, and efforts to control the spread of artemisinin resistance. This paper then goes on to examine the potential role that the private sector can play in contributing to future malaria control and elimination strategies to support the containment of artemisinin resistance, and makes a number of recommendations for next steps Methodology This working paper was prepared through a combination of desk based research and correspondence, and an in country visit to 11 White N: Malaria: a molecular marker of artemisinin resistance, The Lancet 2014, 383:

13 Myanmar conducted between the 17th and 26th of March Key informant interviews were conducted with a range of relevant stakeholders from the public, private, donor and non-governmental sectors. A list of stakeholders consulted is provided at Annex A. 10

14 3. INVESTMENT CLIMATE Following decades of internally and externally imposed isolation, Myanmar has been described as one of the few remaining, largely untapped markets in the world 12. Whilst experiencing relatively low levels of development and associated low growth rates in relation to many of its South East Asian neighbours in recent decades, Myanmar possesses a number of innate advantages which make it an attractive proposition for increased private sector investment. Until recently, such investment has been constrained by domestic policies and international sanctions, but following the commencement of political, economic, and social reforms, and the subsequent easing and lifting of sanctions, conditions are favourable for significant increases in both foreign investment and domestic growth Myanmar s comparative advantage Myanmar possesses a portfolio of characteristics which make it an attractive candidate for foreign investment and rapid domestic growth. Resource rich, Myanmar holds significant deposits of natural gas, oil, minerals, and precious and semiprecious stones. Myanmar also possesses substantial arable land (the 25th largest endowment globally), which in combination with ample water supplies (ten times the per capita endowment of India and China) provides significant opportunities in agriculture 13.High value cash crops currently grown in Myanmar include coffee, palm oil and rubber, and large forested areas, rich in teak and hard woods, present significant opportunities in timber extraction. Myanmar is uniquely placed geographically, being the largest country in mainland Southeast Asia. Located at the crossroads of Asia and sharing land borders with Bangladesh, India, China, Laos, and Thailand, Myanmar is in direct proximity with an estimated market of approximately 40% of the world s population 14.Myanmar also possesses an extensive coastal border and a number of natural harbours and constructed ports, presenting the potential to occupy a strategic position with regards to global and regional sea trade. A delta of inland water networks and river systems also present further opportunities for internal distribution and trade as well as hydroelectric power. Myanmar possesses a large working age population estimated at 46 million peoples from an estimated total population of 60 million 15. Labour costs are also considered to be relatively low in the region and, hence, Myanmar may be well placed to benefit if it were to successfully establish a competitive manufacturing base. Finally, due to historically low levels of development, opportunities exist in supporting Myanmar s economic development, particularly with regards to large-scale infrastructure projects such as 12 McKinsey Global Institute, Myanmar s moment: Unique opportunities, major challenges, June IBID 14 IBID, quoting UN Department of Economic and Social Affairs, Population Division. 15 IBID 11

15 construction of internal and cross border transport networks (road, rail, and air); oil and gas pipelines; telecommunications networks; residential, commercial, and industrial property developments; and civil works such as dams, power plants, and water treatment centres. Significant investment is also required in education and health, presenting potential opportunities for private sector investment. 12

16 4. GOVERNMENT REFORMS Recognising that political and economic isolation has resulted in a deficit of skills and growth, the current government under President Thein Sein is keen to promote international investment as a means of providing a much needed injection, not only of capital, but also technology, knowledge and skills. In November 2012, the Government enacted revised Foreign Investment Laws (FIL) to encourage greater flows of Foreign Direct Investment (FDI) into Myanmar. Principle provisions allow for 100% ownership by foreign companies (restrictions apply in some sectors), long term land lease, tax incentives for investments in infrastructure developments, guarantees against nationalisation, and repatriation of profits at market rates. With regards to joint ventures, foreign investors are no longer required to provide a minimum of 35% capital, although a cap on maximum ownership of 80% remains the same 16.. Complimentary reforms include unification of the exchange rate, reform of the banking sector and foreign exchange mechanisms, liberalising the company registration process and establishment of a new anti-corruption committee to increase government transparency and accountability 17. These reforms accompany the broader process of democratisation and liberalisation of the economy which it is hoped will make Myanmar an attractive prospect for increased inward investment (Figure 2). Under the Myanmar Framework for Economic and Social Reform (FESR), 2013, the government outlines key priorities of sustained industrial and infrastructure development. A Special Economic Zone (SEZ) Law was passed in early 2014 providing beneficial conditions such as tax breaks and exemptions for investors in the construction of these strategic sites of low cost production and export 18. Three SEZ have been established: in Dawei in the southern state of Tanintharyi (with the support of Thai investors); in Kyaukphyu in western Rakhine state (with Chinese investment); and in Thilawa south of Yangon on the Irrawaddy Delta (with Japanese investment). A further 19 industrial zones operate across the country and an additional seven local industrial zones are planned in Nai Pyi Taw; Mandalay; Hpa-an, Myawaddy and Phayathonzo in Kayin State; Ponnagyun in Rakhine State and Namoum in Shan state 19. Historically, the presence of western sanctions largely limited Myanmar s trade and investment partners to regional neighbours such as China, India, Malaysia, South Korea, Singapore and Thailand; representatives of which partnered with government or locally owned private business to extract and export Myanmar s resources. Myanmar s leading exports consist of natural gas, timber, vegetables, fish, pulses and beans, rice, textiles, and precious stones and between the years 2006 and 2010 more than three quarters of exports totaling 21.1 billion, were 16 Infrastructure in Myanmar, KPMG, IBID 18 Myanmar Investment Guide, industrial Zones and Special Economic Zones, DICA (Directorate of Investment and Company Administration) 19 IBID 13

17 Millions of USD Potential Impact of Private Sector Investment in Myanmar on Malaria Control Strategies purchased by Thailand, India and China alone 20. A similar picture reflected inward investment where, for example, in the fiscal year 2007/2008, almost all FDI in the oil and gas sector (Amounting to $137 million), came from India 21 (Table 1). Figure 2: Levels of FDI into Myanmar annual average This graph shows an increase in levels of FDI flows into Myanmar over the years 2005 to 2012; an increase which displays a strong correlation with the on-going reform and liberalisation process: (Source: UNCTAD, Country Fact Sheet, Myanmar, 2013) With notable exceptions such as Total, (who signed a production sharing agreement with MOGE in 1992), Western companies represent a relatively recent presence in Myanmar; however opportunities for further investment remain high (a number of recently tendered oil blocks have been awarded to Western companies). Official statistics report that Myanmar attracted over $4 billion in foreign investments in the fiscal year , an amount which is expected to rise in coming years. Integration into the Association of Southeast Asian Nations (ASEAN) economic community in 2015 will lead to increased inward and outward flows of capital and goods between Myanmar and other members of the ASEAN community, and following the lifting of sanctions, it is anticipated that Myanmar s exports will find a broader international market and hence provide a boost to local production and the economy. With increased FDI and increased domestic activity, it has been estimated that Myanmar s economy may quadruple in size to over $200 billion by the year and indeed the Asian Development Bank (ADB) estimates that Myanmar s economy grew by 7.5% in the fiscal year Doing Business in Burma, UKTI, Country Report of the ASEAN Assessment on the Social Impact of the Global Financial Crisis: Myanmar, ASEAN, McKinsey Global Institute, Myanmar s moment: Unique opportunities, major challenges, June Asian Development Outlook, Myanmar, ADB, 2014 ( 14

18 A series of maps displaying existing and planned infrastructure developments including road-links, power-grids, oil and gas fields and pipelines, SEZ, hydropower plants and coal deposits, providing a clear picture of the extent of active development in Myanmar today can be viewed on the Myanmar Information Management Institute (MIMU) website 24. Table 1: Cumulative foreign investment in Myanmar realised and approved - by country of origin, as of 31 October 2013 Existing enterprises (realised) Millions USD % Permitted enterprises (approved) Millions USD China Hong Kong, China Korea Thailand UK Singapore Malaysia France Vietnam Other Total % Table 1 shows a clear predominance of Eastern investment (Source: MNPED figures taken from OECD, Investment Policy Reviews, Myanmar, 2014). 24 Maps courtesy of the Myanmar Information Management Unit located at 15

19 5. THE IMPACT OF INCREASED INVESTMENT ON EXISTING MALARIA CONTROL STRATEGIES Recent evidence suggests declining rates of malaria transmission in some parts of the country 25 reflecting the impact of efforts by the Ministry of Health (MoH) and partners under the National Malaria Control Programme (NMCP). However, increased private sector investment and associated rising levels of production and development may have a negative impact on existing malaria control and elimination strategies, particularly with regards to the containment of artemisinin resistance. Increased levels of economic activity in areas of identified resistance may both increase incidence of infection within those areas, and through increased movements of peoples through resistant areas, facilitate the spread of artemisinin resistance Migration and malaria transmission Changing patterns of economic development lead to changing patterns of migration, as communities and individuals choose, or are forced, to seek economic opportunities or make way for economic developments. In turn, economic growth and infrastructure development lead to further movements of people, goods and services as new trade and transport links, (such as road and rail links between Myanmar, India, China and Thailand), are developed and utilised. There is a general lack of reliable data in Myanmar, particularly concerning populations and population movements 26 ; however, key migratory foci are construction and production sites and the economic corridors linking them internally and externally. Whilst migration in itself is not a definitive risk category and not all migrant and mobile populations (MMP) will be affected by malaria, MMP are considered (after forest/fringe dwellers) to be the major risk group for malaria transmission due to the vulnerable nature of their living and working conditions 27. MMP are also likely to play a significant role in the spread of artemisinin resistance as they travel between foci of resistance and areas where resistance has not yet been identified. The volume of internal economic migrants within Myanmar is very large and estimated to involve millions of people 28. As increased investment and development occurs it is likely that numbers of internal economic migrants will also increase as further communities are displaced and greater numbers move in search of increased and shifting economic opportunities. In addition, an estimated 25 Carrera et al.: Malaria burden and artemisinin resistance in the mobile and migrant population on the Thai-Myanmar border, : an observational study. PLOS Medicine, 2013, 10:e Historically this has been a politically sensitive issue, particularly in areas of ethnic conflict 27 Malaria on the Move: Mapping of Population Migration and Malaria in the South Eastern Region of Myanmar, IOM, IBID. Population statistics are limited in Myanmar with the last census and labour force surveys conducted in 1983 and 1990 respectively, ILO, 16

20 diaspora of between three and five million people (more than 10 percent of Myanmar s current workforce) are currently working abroad, the majority in Thailand 29. Having previously left the country for economic or political reasons, recent political reforms and economic developments may now encourage a substantial proportion of migrants to return. There are also reports that following the political reform process in Myanmar, refugee communities are being forced to return to Myanmar from refugee camps over the Thai border by Thai authorities. In total it is estimated that 80% of border communities of refugees (totaling 2.3 million) will re-enter Myanmar 30. There are also significant numbers of Myanmar migrants on the Thai-Cambodia border another area of detected artemisinin resistance who may return to Myanmar for economic opportunities. Such a significant increase in migration flows throughout Myanmar is likely to have a negative impact on both malaria transmission and the containment of artemisinin resistance Economic activities and malaria transmission High transmission environments occur in endemic areas where individuals are exposed to infected mosquitos during peak biting hours. This applies to both areas of identified resistance where individuals may be infected with resistant strains, and also to endemic areas where evidence of resistance has not yet been identified, and where incoming individuals infected with resistant strains may introduce resistance to the local parasite pool. Box 1: Potential high risk activities in Myanmar Logging/Timber extraction Forest Clearance Transport construction - road, rail, bridge, tunnel Hydro-power/water plant/dam construction Gas/oil pipeline construction Mining/extraction Agriculture livestock and cultivation Plantation work - oil-palm, rubber tapping Brickmaking Fisheries High risk categories of employment thus include activities in forested, semi-forested and forest-like environments such as plantations, where individuals either work outside during peak hours, or sleep without the protection of a net (Box 1). Again, particularly vulnerable groups are migrant and mobile populations (MMP) whose living conditions and economic activities are more likely to meet high risk criteria. As levels of investment and production rise, it is likely that engagement in 29 McKinsey Global Institute, Myanmar s moment: Unique opportunities, major challenges, June Discussion with IOM, March

21 associated high risk activities will also increase (Table 2). Whereas existing enterprises reflect investments which have already been realised, permitted enterprises represent investment applications which have been approved but not yet realised. As can be seen, many such approved investments, including in the dominating sectors of oil, gas and power, are in sectors where activities, once commenced, may increase the risk of malaria transmission in project development areas. For example, plans of the China Power Investment Corporation to invest $20 billion to develop a series of dams on the Upper Irrawaddy river in the north, and approval of plans for a consortium of Chinese, Thai and local investors to develop another series of six dams on the Salween river in the east 31, will all involve construction in malaria endemic areas. Whilst industrial and commercial sites may represent a low malaria risk once a site has been cleared and developed (removing the habitat of the mosquito), such sites often represent a high risk during the development phase when a large workforce may be exposed during clearing and construction activities. This explains why peak numbers of malaria cases are often recorded around periods of development and construction and then decrease following site completion and the commencement of use. In interview discussions with the oil and gas company Total E&P for example, they described how malaria prevalence in the area surrounding construction of the Yuzana gas pipeline 32 peaked at approximately 8000 cases per year in the year of peak construction activities when large numbers of construction workers were moved into previously uninhabited areas. As a point of comparison, confirmed malaria cases surrounding the pipeline in 2013 numbered Total, in consortia with partners MOGE, Chevron and PTT (Petroleum Authority Thailand), run a malaria programme along the pipeline area, delivering prevention, testing and treatment services to surrounding populations as well as employees; figures do not therefore represent cases of affected workers only. However, it is possible that construction activities raise malaria incidence not only amongst workers, but also in existing communities. 31 OECD Investment Policy Reviews, Myanmar, Carrying gas from the off-shore Yuzana oil-field, 63km overland through the southern state of Tanintharyi to neighbouring Thailand 33 Discussion with Total E&P in March 2014 and Total presentation on CSR and Malaria 18

22 This may be particularly the case where migrant workers are being brought in from areas of high prevalence, to areas of moderate or low endemnicity, raising parasite levels within the community. It is also very common for communities to develop around temporary or semipermanent work-sites, thus introducing human populations into endemic areas which were previously uninhabited, and ere malaria incidence may rise accordingly. APACHE Portland cement similarly described how they experienced peak malaria case-loads around the commencement of the construction phase of their cement factory in the Meiktila District of central Myanmar in High Tech Concrete Technology Co, also discussed how peak malaria transmission periods coincided with construction phases in the development of Baluchaung 3 Hydropower Project in Loikaw, Kayah Table 2 below displays cumulative foreign investment in Myanmar by economic sector, a number of which are associated with high risk activities: Existing enterprises (realised) Millions USD % Permitted enterprises (approved) Millions USD Oil and Gas Power Mining Hotel & Tourism Manufacturing Real estate Industrial estate Agriculture Transport and Communications Livestock and fisheries Construction 38 0 Other services Total Source: MNPED figures from 31 October 2013, taken from OECD, Investment Policy Reviews, Myanmar, % 34 Discussion with APACHE Portland Cement Co, March

23 State. Construction employees started to live on site during December 2008 and by January 2009 cases of malaria began to be recorded. During 2009 malaria positivity rates across the entire project workforce peaked, and following completion in 2013, declined sharply. Whilst incidence may in part have been reduced by the malaria control activities undertaken by each of these companies, the statistics Activities such as rubber-tapping involve collecting rubber at night or early in the morning before dawn, exposing workers who are not equipped with appropriate PPE (Personal Protective Equipment) to increased risk of being bitten by infected mosquitos. Other workers such as forestry workers or bamboo cutters may typically sleep outdoors or in environments which make the hanging of nets difficult, such as around communal fires. As levels of private sector investment increase, and stimulate increased levels of development and production in endemic areas, it is likely that the population exposed to malaria will also rise, and that the spread of artemisinin resistance will be facilitated. nevertheless demonstrate how the commencement of construction activities in endemic areas, may be associated with a spike in malaria case-loads. Other economic activities such as timber extraction, palm oil cultivation, and rubber tapping pose a continuous risk in endemic areas, although may also be affected by seasonal patterns of transmission. malaria transmission. It is estimated that 60% of malaria cases in Myanmar are forest-related, although breeding environments for different vectors also exist in coastal and plains regions 35. With such extensive endemnicity, economic development in much of the country will likely involve activities in endemic areas (Figure 3). Figure 3: Area stratification for malaria risk and transmission, MARC/WHO, Geographical stratification of malaria endemnicity, resistance areas and economic development Due to its tropical climate and abundance of suitable breeding environments, malaria is endemic within Myanmar; with the majority of the country, especially in the eastern and western border regions, presenting a moderate to high risk of 35 Strategic Framework for Artemisinin Resistance Containment in Myanmar (MARC) , Myanmar MoH and WHO, April

24 With regards to artemisinin resistance, strong evidence of resistance was originally detected in three States in the south-east of Myanmar; Tanintharyi on the Myanmar-Thai border, the neighbouring State of Mon and Shwegyin township in Bago East. The MARC strategy stratifies areas within Myanmar into 3 tiers (Table 3 and Figure 4) dependent on their inherent presence, or risk, of artemisinin resistance. Tier classification has a determining effect on funding and activity levels. In early 2014 a re-classification of Tier areas occurred to reflect the suspected spread of resistance and to scale up containment activities in previous Tier 2 areas. All 31 Tier 2 Townships have subsequently been re-classified as Tier 1 36 (Figure 5). Table 3: MARC zonation based on the three-tier classification of GPARC Tier Area No. of townships Justification 1 Tanintharyi: All 10 townships Mon: All 10 townships Bago East: Shwegyin township 21 Strong evidence of suspected resistance; Widespread ecological and social risk factors; Intensive population movement 2 Kayin State: All 7 townships Kayah State: All 7 townships Bago East: Remaining 13 townships Kachin: 4 townships 3 Rest of country 31 Unclear evidence of suspected resistance; Near suspected resistance areas in Myanmar, Thailand and China Figure 4: The original Tier 1 areas in the south-east of Myanmar (purple shaded areas are Tier 1) 36 Status report on artemisinin resistance, January 2014, WHO Global Malaria Programme 21

25 Figure 5: Tier map of the Greater Mekong subregion (January 2014) Concentrated mapping of the intersection of economic activities within the Tier 1 area of Tanintharyi has been conducted on behalf of the 3MDG Fund by MMRD 37. Sectors mapped include rubber and palm oil cultivation, mining, oil and gas, Dawei SEZ (deep sea port construction) and fisheries. Estimated numbers of workers employed in high risk industries totalled 87,520, although these estimates are acknowledged as conservative (they do not include numbers of agriculture workers, labourers employed by sub-contractors, or accurate numbers of workers engaged in informal sectors or hidden economies). There can be a difficulty in obtaining accurate data where workers are contracted on an informal or even clandestine basis. This can occur where activities are illegal (such as with some timber extraction) or where a company 37 Private Sector Mapping for Potential Engagement in the Malaria Response in Tanintharyi Region, Myanmar Marketing Research Development Co, 2013 does not wish external observers to identify poor labour practices or the precise size of its tax base. In addition, many workers are informally engaged on a day rate basis either directly or through a sub-contractor, and as such may not be recognised by the principle employer. True numbers at risk will also increase when workers families and satellite communities are taken into consideration. The International Organisation for Migration (IOM), in conjunction with the Ministry of Health (MoH) 38 and WHO, has also conducted a detailed study in Tier 1 areas, mapping population movements in the 21 south-eastern townships categorized as Tier 1. From a total estimated population of 1.12 million across the 21 townships, 13% were mapped as migrant and mobile populations (MMP), 38 Relevant State/Regional Vector-borne Disease Control (VBDC) Teams and the Department of Medical Research Lower Myanmar (DMR-LM) 22

26 originating from 15 out of 17 States/Regions across Myanmar. A total of 55% of those MMP were classed as working in high risk environments and thus at increased risk of contracting malaria and potentially artemisinin resistant falciparum malaria. Significantly, 40% of mapped migrant clusters planned to migrate again within the next 1-2 years, potentially carrying artemisinin resistance into other areas of Myanmar or beyond. Regarding the country as a geographical whole, the series of maps provided in Annex B clearly show the large areas currently, or soon to be, under development. Comparing the intersection of development activities with areas of malaria endemnicity and identified resistance, it is possible to see how such increased economic activity and migration of peoples in affected areas may lead to increased transmission, and the spread of resistance. To provide one such example, construction of a Deep Sea Port, power plant and linking highway and gas and oil pipelines has been underway in the SEZ of Dawei. This large scale project has involved internal displacement of local populations and the engagement of significant numbers of migrant workers. Reports at the time of writing are that construction has been temporarily halted whilst the government focuses construction activities at Thilawa Deep Sea Port to the South of Yangon. If this is the case, then presumably significant numbers of migrant workers will be relocating to economic opportunities elsewhere, potentially carrying resistance with them. 23

27 6. PRIVATE SECTOR ENGAGEMENT Whilst private sector activities in endemic and resistant areas may lead to increased malaria incidence and facilitate the spread of resistance, increased investment may also have positive consequences on existing malaria control and elimination strategies where the private sector are engaged in effective support A role for the private sector in contributing to malaria control Private sector activities can offer a unique opportunity to deliver or facilitate access to malaria prevention, testing and treatment services for workforces and surrounding communities. The current end point of the public health commodity supply chain is the township level, and for service delivery; the village. Beyond these points the NMCP has no, or very limited reach, leaving many worksites and surrounding communities, with little or no service access 39. In some endemic areas this gap is filled by formal or informal private provision, but other areas have very limited access to health services, including malaria testing and treatment. Where the private sector operates in such areas, perhaps attracted by the presence of natural resources; and can be engaged to support the delivery of services; they can do much to bridge the existing gap. Such services or access can be particularly significant in areas such as Tanintharyi where long standing conflicts have placed many communities, particularly in remote or hard to reach areas, beyond the range of public health service delivery. With regards to containing the spread of artemisinin resistance, these communities may play a particularly significant role where they inhabit foci of resistance, especially where they form part of migrant or mobile populations (MMP). Finding successful modalities for engaging these often hard to reach communities such as working through the private sector is thus essential in containing the spread of artemisinin resistance Why should the private sector support malaria control? There are a number of arguments supporting the involvement of private sector companies in malaria control. These can be classed into three broad categories: economic, obligation and the public health interest. Economic: Malaria has a negative effect on productivity if workers are unable to work, or unable to work at full capacity. A high incidence of malaria, and in some cases mortality, can therefore have an adverse impact on operations. A recent study estimated that a company working in an endemic area and employing around 500, mostly migrant workers, could save around 2000 working days per year through implementing a comprehensive malaria control programme 40. Where a company meets the costs of healthcare for its employees, a company could also reduce costs by incorporating preventive 39 There are currently almost 6000 public health service points across Myanmar, but these cover only a third of Myanmar territories. 40 Containing Artemisinin Resistance: Options for Corporate Sector Engagement, Alex Ergo, Broad Branch Associates 24

28 measures such as awareness and education sessions, and the provision of preventive commodities such as LLIN and repellent. Linked to the public good argument, a positive approach to worker and community health can also bring economic benefits where the profile of the company is raised in the eyes of consumers, potential business partners, investors and corporate relations, and the broader international community. In addition, workers in some sectors are now assessing the provision of employee benefits when selecting economic opportunities. The general manager of Dagon International s 10,000 acre oil palm plantation in southern Tanintharyi noted that they would not be able to attract and retain workers if they did not provide health and education benefits to workers and their dependents 41. Obligation: Where company activities in endemic areas potentially result in increased numbers of malaria cases, or contribute to the spread of artemisinin resistance, there should be an obligation for that company to support control and containment activities within and around their operations. Malaria and the spread of artemisinin resistance are public health issues, and where company activities have a potentially adverse effect on public health, they should be required to take adequate steps to prevent and mitigate negative consequences. This principle is outlined in international standards such as the OECD Guidelines for Multinational Enterprises which state that companies should take adequate steps to ensure occupational health and safety in their operations, including providing adequate education and training to employees in environmental health and safety matters 42 ; the UN Guiding Principles on Business and Human Rights, which state that business enterprises should avoid causing or contributing to adverse human rights impacts through their own activities, and address such impacts when they occur 43 ; and ISO which outlines International Standard Guidelines to business on demonstrating social responsibility to workers, their natural environments and their communities. The public health interest: Companies may wish to utilise their unique position of access, to support control and containment activities in favour of public health (locally, nationally and globally). This could form part of a broader CSR (Corporate Social Responsibility) / social investment initiative under which a company wishes to give something back to the community, and as mentioned above, can link in to wider economic arguments. A successful CSR strategy can support key business objectives by facilitating a company s social licence to operate, both locally and amongst the international community. This holds particular resonance in Myanmar which has spent a number of years under the lens of international human rights organisations, and where an effective CSR strategy can assist both local businesses wishing to 41 Discussion with Dagon International in March The Guidelines provide voluntary principles and standards for responsible business conduct consistent with applicable laws. 43 Again the Guidelines provide a voluntary code of practice for States and businesses 25

29 access international markets and partners, and multinational corporations looking to invest ethically within Myanmar Employees, dependents and the broader community? Where a private sector company is willing to support a malaria control programme for employees, they should also consider whether to extend provision to workers dependents and the broader community. There may also be issues of classification regarding the inclusion of workers engaged on a daily basis, sub-contracted or employed through a subsidiary or subcontractor. In addition to the public health argument, there are a number of reasons to support the broader provision of services, related to obligation, efficacy and economy. Firstly, where company activities may potentially increase numbers of malaria cases or facilitate the spread of resistance within a community, there exists an obligation to prevent or mitigate those same consequences. This applies to both pre-existing communities and satellite communities that have developed around, and in response to, a worksite. Secondly, a malaria control intervention targeting only workers, will be undermined where malaria, and potentially resistance, persist within the broader community. In such circumstances, workers will be at a continuous risk of infection from the surrounding parasite pool, which will also have an economic impact on operations. Thirdly, and as mentioned above, some employees are now assessing the provision of dependent benefits when selecting economic opportunities. Dependent on the sector, this may be a significant factor affecting a company s ability to attract and retain staff What role can the private sector play? Existing private sector initiatives A number of companies already engage to deliver, or facilitate access to, malaria services amongst their workforce and surrounding communities, either unilaterally, through the NMCP or other development partners. An overview of such activities discussed in the course of this research is provided below. This is not intended to represent a definitive list, but rather a sample of such activities currently undertaken by private sector companies within Myanmar. Total E&P run a comprehensive malaria control programme for their employees, dependents and sub-contractors as part of a broader package of healthcare services. The programme provides education and awareness training, distribution of LLIN, RDT testing and treatment. Access to all services and commodities is provided free of charge, although in some inpatient/complex cases the patient may have to make some contribution. They also work with 33 villages along the pipeline area between Myanmar and Thailand, covering an estimated 38,000 people. At village level they work with VCCs (Village Community Committees), and at national level they work with the MoH, following malaria standards and treatment guidelines and reporting malaria statistics to the national HMIS. They supply clinics with medicines and support the local hospital, they also conduct six-monthly impregnation of bed nets, and larval 26

30 control activities throughout the year. Total also support other programmes run by NGOs in the area such as PSI; providing transport, gathering the community and supporting LLIN distribution. Total noted that they conduct their CSR programme (of which the malaria control programme is a part) on a voluntary basis, as they believe such activities benefit all parties involved workers, communities and the company. Total have a broader corporate policy on CSR, governing their global CSR activities. Dagon International employs approximately 100 permanent staff and 500 seasonal labourers on their 10,000 acre oil palm plantation in Tanintharyi. They run an on-site dispensary, providing testing and treatment to all workers and their dependents. Treatment at the clinic is free but the cost of commodities is deducted from workers salaries. They also conduct some outreach activities around the plantation, training supervisors from each station one per ten acres - to act as malaria volunteers. PSI provides transport allowances to the supervisors to facilitate their attendance at awareness and education meetings. The company works with both PSI and URC in Kowthaung and Ka Mouk Gyi, who visit every 1-2 months and provide training, LLIN, RDTs and antimalarials (purchased by the company). Dagon support the distribution of LLIN amongst their workforce. Dagon do not offer in-patient services, but noted that other palm oil companies in the region, notably South Dagon (Golden Flower) and Yuzana, do. Dagon International noted that they provide care to their workers so that their workers can work, and also to attract and retain staff. Their primary motivations are economic. Myanmar Agri-Tech Ltd (MAGT), a subsidiary of the FMI Group and Serge Pun Associates, operate a 100, 000 acre plantation in the Delta area growing coffee and silver oak. They operate two clinics for workers, dependents and communities surrounding their operation sites. The company pays all healthcare expenses for consultations and medication. They are not currently working with the NMCP or development partners, but in the past participated in a malaria research project conducted by the Ministry of Defence (MoD) on the use of ACT and primaquine as a preventive measure. MAGT noted that at the time of setting up their clinics in 2006, they had not heard of CSR, but established the clinics as they wished to support workers health. They then expanded support to include local communities as they noted the high incidence of malaria associated morbidity and mortality in many villages. FMI determine what proportion of company budget and profits is spent on CSR and are now formulating a corporate CSR policy to govern all subsidiaries. MAGT have recently entered into a joint venture with a European company who also have a strong policy on CSR. Both High Tech Concrete Technology co (HTCT), and APACHE Portland are part of the Shwe Taung Group, which employs 3304 permanent staff, all of whom are insured under a private health insurance 27

31 scheme. The Group also employs approximately a third of this number of transitional workers, who are provided with occupational PPE and medical care. The hydropower plant which HTCT constructed in Kayah State is now operational and they have 151 maintenance staff in place. The company have a clinic on site and operate a malaria control programme with the support of the Kayah State Malaria Prevention and Control Department (under the NMCP), providing awareness, surveillance, LLIN, IRS and testing and treatment in line with national guidelines. Commodities are purchased by the company and procured from PSI. They are considering extending this service to the local community. Interestingly, we were informed that the malaria control programme at HTCT comes under the human resources budget as opposed to the CSR budget, indicating it is considered as an operational cost as opposed to a CSR activity. APACHE built a clinic for workers at their Meiktila cement factory and appointed a GP to run it who received training from the NMCP and PSI. They also run a clinic in a nearby village serving workers, dependents and the community. Every employee is provided with a LLIN and preventive training. The Shwe Taung group have a corporate policy on CSR and staff welfare. Currently each company is responsible for designing their own programme, but is required to spend 1% of profits on CSR. This attitude is based upon the traditional model of employment in Myanmar whereby employers have a responsibility towards staff welfare; however Shwe Taung is also engaged in more recent initiatives such as the UN Global Compact Other initiatives to engage the private sector A number of other initiatives are seeking to engage the private sector workforce in malaria control strategies in endemic areas, either through engagement with private sector companies or through direct targeting of workers, particularly MMP. The 3MDG Fund is responsible for funding initiatives in the priority artemisinin resistance containment zones, and the Global Fund for areas outside MARC priority areas. Bilateral donor funding is also supporting some initiatives. PSI: As well as working to replace AMT with subsidised, quality assured ACT through private sector supply chains and providers, PSI are undertaking targeted BCC campaigns to provide direct information to consumers on appropriate testing and treatment guidelines 45. They also work through the Sun Franchise clinics of approved private GPs and auxiliary healthworkers, providing training and access to subsidised, quality assured commodities through approved supply chains and thus enabling practitioners to provide malaria testing and treatment in line with national guidelines. A total of approximately 3,600 franchise members have diagnosed and 44 The UN Global Compact is a voluntary framework which promotes ten universally accepted principles in the areas of human rights, labour, the environment and anti-corruption. It provides a framework for CSR, but no specific obligations and it is up to each firm to decide what they will do. Company commitments will however be published, which provides an opportunity to hold firms accountable. 45 The AMTR project is funded by DFID and BMGF 28

32 treated more than 520,000 malaria cases since PSI is currently drafting a model of working with private sector plantations which they hope to pilot with a coffee plantation in the Delta region. MMA: The Myanmar Medical Association (MMA) implements the QDSTM (Quality Diagnosis and Standard Treatment of Malaria) Project with funding from the Global Fund and support from UNDP and WHO. The project seeks to provide training and support to private practitioners to improve the quality of malaria diagnosis and treatment. QDSTM field teams work with 400 GPs, 16 fixed and mobile clinics, and 420 village medical coordinators/volunteers in 107 townships in endemic areas. They provide training and case management following NMCP guidelines and have developed specific guidelines for volunteers. They provide free commodities through UNOPS funding in MARC Tier 1 areas, and LLIN through MARC. They sometimes work with private sector companies in areas where fixed and mobile clinics are operating. URC: URC is implementing the CAP-Malaria project with USAID funding in four townships in Kayin state and 4 townships in Tanintharyi 46. The project aims to contain resistance through vector control, and improving the quality of diagnosis and treatment. The project works with a number of private companies such as Yuzana who run an 180,000 acre plantation and fishery in Tanintharyi and employ between 40-60,000 mobile and migrant workers at any one time. Project activities include health education programmes, training malaria volunteers and health clinic staff, supplying RDT and ACT and distributing LLIN. They are also working with companies around the construction of the deep sea port in Dawei where they are piloting a net lending scheme to migrant workers, as successfully used in Cambodia. Malaria Consortium: Whereas the Malaria Consortium is not currently engaging private sector employers, they are implementing a Positive deviance project, training volunteers amongst fishermen and rubber tappers in Tanintharyi to identify positive examples of knowledge, attitudes and behaviour around malaria prevention and control, and share the with the broader community. IOM: With the support of funding from 3MDG, the Global Fund and MARC, IOM is working in Mon, Kayin, the Delta area and Rakhine to target MMP at key transit sites such as bus stations and temples, villages and worksites, including rubber plantations, forestry camps, goldmines and other hard to reach settings. They work with the NMCP, employers and workers, to provide diagnosis and treatment in line with national guidelines; BCC; personal protection such as bednets and repellent; monitoring DOTs 47 and drug resistance; and referral of severe cases. This work is in conjunction with their mapping of MMP which enables them to better target their provision of services. IOM are also in 46 URC is implementing CAP-Malaria in Myanmar, Cambodia and Thailand in partnership with Save the Children and the Kenan Institute Asia 47 Directly Observed Treatment used to ensure compliance with a treatment schedule and particularly important in the containment of artemisinin resistance where it is essential that a full course of treatment is taken to prevent the development and spread of further resistance 29

33 discussions with the government on cross border malaria management an issue which will be increasingly significant as greater numbers of migrants move back and forth over the border to engage in economic opportunities. World Vision: World Vision International Myanmar (WVM) has been implementing a community based malaria project since 2007 with funding from the Three Diseases Fund ( ) and the Global Fund ( ). Current coverage extends to a population of around 200,000 across 194 villages in Tanintharyi Division, and Kayah and Chin States. Target populations include forest workers, oil plantation and rubber plantation workers, fishermen, and migrant workers amongst other at risk groups. Project activities include health education, delivery of Long Lasting Insecticide Nets (LLINs), treatment of community owned bednets, diagnosis using RDTs, treatment in accordance with National treatment guidelines and referral services. Activities are implemented through 250 community malaria volunteers trained by WVM in partnership with the Department of Health. 30

34 7. SECURING BROADER ENGAGEMENT Whilst a number of companies are clearly engaged in existing activities, other companies reported that they were interested in supporting malaria control activities but needed guidance and support to help them design and implement in line with recommended standards. A number of other companies declined interview and from anecdotal evidence it is clear that not all companies are engaged, or will actively seek to engage in, malaria control programmes 48. What is required if the potential opportunity presented by the private sector is to be successfully harnessed and realised, is a targeted intervention to coordinate comprehensive private sector interest and engagement in malaria control and elimination strategies. Such a programme needs to engage private sector companies in supporting malaria control and provide clear guidance to ensure that interventions adhere to national malaria treatment standards. This is especially important in the case of artemisinin resistance, where successful containment requires appropriate treatment of suspected falciparum cases to ensure elimination of resistant parasites. Incomplete dosing, prescription of AMT and the provision of sub-standard commodities can all result in the proliferation rather than containment of resistance. Adherence to national standards and treatment guidelines is thus essential to ensure that appropriate doses of correct treatments are given and that adherence to the treatment schedule is observed. Such an initiative or initiatives need to be promptly operationalised if the threat of artemisinin resistance is to be contained Voluntary engagement or government regulation? Voluntary engagement As noted at section 4.1.1, a number of international voluntary codes of practice provide general standards and guidelines on socially responsible business practice in Myanmar. These include the OECD Guidelines for Multinational Enterprises, the UN Guiding Principles on Business and Human Rights, ISO 26000, the UN Global Compact and the EITI 49. The UMFCCI CSR Unit and the Myanmar Centre for Responsible Business (MCRB) 50 are also working to support companies on best practice in social responsibility. The voluntary nature of such initiatives does mean however that membership and compliance is at the discretion of individual businesses. The concept of CSR is relatively new to Myanmar, although gaining traction in some areas, building on the 48 Please note that only a sample of companies operating in Myanmar were contacted for interview and hence, the fact that a particular company was not interviewed does not mean that they were contacted and declined. 49 The Extractive Industries Transparency Initiative is a global coalition of governments, companies and civil society working together to improve openness and accountable management of revenues from natural resources President Thein Sein wishes Myanmar to join the EITI this year. 50 The MCRB is a join initiative of the Institute for Business and Human Rights (IBHR) and the Danish Institute for Human Rights (DIHR). Its aim is to facilitate dialogue, partnerships and process around business and human rights related issues. 31

35 traditional Buddhist practice of donations and perceived as a viable strategy for regaining international confidence and credibility. Current CSR activities are conducted at the discretion of individual businesses, and again, whereas some companies will embrace such initiatives, others will not. There is anecdotal evidence that the nationality of company ownership may play some part in company policy, with some respondents stating that Myanmar owned corporations, are more likely to care for their work-force than outside investors Whilst some foreign owned companies may be covered by domestic legislation within their home countries, it was anecdotally reported that other South East Asian investors, whose practices are not governed by domestic regulation are the least likely to provide social and health care programming for their workforce or local communities. Considering the high proportion of FDI from such countries (see Table 1 above), this is potentially a significant issue 51. Company size was also considered to be significant in determining their capacity to deliver coverage, particularly to the broader community. The Myanmar Health Development Consortium (MHDC) and Myanmar Business Coalition on Aid (MBCA) have proposed a voluntary accreditation scheme to engage the private sector in malaria control. A forum on Corporate sectors and non-state actors response to the threat of artemisinin resistance in Myanmar was organised in Yangon in November 2013 with the support of the UMFCCI CSR Unit; and brought together representatives from the private and public sectors, donors, NGOs and other implementing partners, scientific and research communities 52. This apparently represented the first time that private sector actors had collectively sat round the table with representatives of the MoH and NMCP, formation of PPPs in this area. The proposed scheme was based upon a model of engagement pioneered in Thailand in response to HIV/Aids, under which companies are awarded different levels of accreditation dependent on their commitment, which has to be renewed every two years. The MBCA have been active in engaging the private sector in HIV/Aids programmes for a number of years and wish to build on this success. The forum concluded with 17 companies and NGOs agreeing to adopt the Corporate commitment to combat artemisinin resistance in Myanmar, although at the time of writing detail on what the scheme would actually comprise has not been provided. Key considerations will be whether the signatories are required to adhere to any minimum standards of service provision to gain or retain their accreditation, how such a scheme would be monitored to ensure compliance, and by whom. As described above, it is essential that malaria control provisions be carried out in adherence with standard treatment guidelines to ensure 51 Please note that these are soft generalisations and do not apply to all companies of any particular nationality. 52 The forum received financial support from RBM (Roll Back Malaria), the 3MDG Fund, Shwe Taung Development Co, Ltd, The Global Fund, SUMITOMO Chemical and MSP Caterpillar. 32

36 the containment of artemisinin resistance, and any such scheme should thus seek to establish mechanisms for quality assuring the contributions made by its members, for example by: Ensuring interventions proposed are appropriate and in line with National policy and best practice; Monitoring implementation through SOPs stressing both the quality and coverage of services provided; and Using appropriate KPIs to measure and judge performance. Another key consideration with any voluntary initiative is the incentive for private sector companies to engage. As described above in section 4.1.1, a number of arguments support private sector engagement and may prove persuasive. There is also evidence through levels of participation in other voluntary initiatives, such as the UN Global Compact and the EITI, that there is an appetite amongst companies; particularly where they are eager to gain perceived benefits from association with such best practice schemes and the status they confer. Despite such incentives however, a voluntary scheme can only capture a certain strata of businesses to whom such an initiative appeals for economic or broader reasons. A voluntary scheme would contain no provisions for ensuring that private sector actors in endemic areas support malaria control programmes amongst their workforce or broader communities, and currently, no mechanism for ensuring any existing programmes comply with minimum standards. Additionally, there are a number of reasons why companies may not want to engage in such voluntary initiatives, such as the potentially prohibitive nature of necessary costs (whether time, money or other resources), or in some cases because a company may not want to admit external observers or representatives of the public sector 53. In their presentation at the November forum, the MMRD made a recommendation that a JSC (Joint Steering Committee) be convened to take forward the voluntary initiative, headed by the General Administration Department (GAD) and the Department of Health (DoH) 54, with the regional heads of the major private sector companies in attendance. At the time of writing, the NMCP confirmed that whilst they are conducting state and regional co-ordination meetings in Mon, Kayin, Bago, Kayah, and Kachin; private sector participation within these meetings is weak. Businesses that attended the initial forum are invited to attend but the majority do not come, and principal participation is from CSOs and community groups. The NMCP has requested a list of companies participating in the voluntary accreditation scheme, detailing where they are working and what activities they are undertaking to enable them to coordinate service provision There may be issues with the use of under-age or forced labour, poor working conditions and practices, or a reluctance to map precise numbers of workers for tax purposes. 54 The Department within the Ministry of Health responsible for the NMCP 55 Discussion with NMCP, March,

37 Government regulation Whilst voluntary accreditation has a role to play in galvanising potential interest and good will amongst the business community; the majority of respondents engaged in the course of this research (including a number of private companies), felt that a voluntary scheme alone would not be sufficient to engage all necessary companies effectively. Many organisations within Myanmar still look to government for the prescription of behaviour, and complimentary regulation is required to ensure that minimum standards are set and observed for corporate interests operating in endemic areas. The environmental, health and social practices of some companies are governed by existing legislation within their home jurisdictions. European investors for example, are expected to conform to EU and home country regulations such as respective national Companies Acts, Corporate Governance Codes and the soon to be ratified EU Directive on Disclosure. Likewise, US companies when they start to invest will be expected to comply with and report against the US regulatory framework. In addition, Indian companies of a certain scale are mandated to spend 2% of net profits on CSR under the recently enacted Indian Companies Act Where such companies are involved in joint ventures, such regulation may also raise the bar with regards to corporate standards on social responsibility more broadly. Whilst such regulation is of course positive, it may not provide specific stipulations or guidance on coverage for malaria control activities in endemic areas. In addition, the Ministry of Labour (MoL) operates a social security scheme that covers approximately 670,000 workers 56 (around 1% of the population) in Myanmar. The scheme was originally established under the Social Security Act 1954 to cover formal sector workers in industrial, predominantly urban areas, but is currently being extended under the new Social Security Law 2012, to incorporate a broader range of sectors. Both employers and employees in designated sectors must make compulsory contributions to the scheme (1.5% and 2.5% of wages respectively), which entitles workers to access free medical care in designated facilities. The scheme is administered by the Social Security Board (SSB) under the supervision of the MoL and operates 93 clinics, 41 government enterprise clinics, and three workers hospitals in Yangon, Mandalay, and Htantabin 57. Provisions under the new law also allow insured workers to access treatment in approved private facilities. Coverage under the 2012 law extends to production industries, construction projects, works carried out with foreign or domestic investment including joint ventures, and mining, oil and gas sectors, amongst others; however some categories, such as seasonal farming and fisheries workers, daily-wage earners and part time workers are excluded 58. The scheme also states that education sessions on 56 Figure at January 2014, Social Protection, Myanmar, ILO, 57 Social Protection, Myanmar, ILO IBID 58 The Social Security Law 2012, Social_Security_Bill-ocr-en.pdf 34

38 occupational safety, health, and infectious diseases including malaria, will be provided in insured enterprises, but the extent of such activities is not known. Whilst the existence of the SSB is undoubtedly positive, concerns exist over the quality, accessibility and coverage of care provided. Few companies engaged in this research had any knowledge of the SSB, and only one company acknowledged coverage. The one company covered under the scheme said they provided alternative private medical insurance for employees as the quality of care under the SSB was very poor. There were also concerns around accessing designated facilities, particularly in remote and hard to reach areas, and the lack of coverage for informal workers. In addition, whilst companies and individuals not automatically covered under the scheme are able to apply for voluntary registration, the absence of compulsory coverage for workers in excluded categories, workers dependents and the broader community, will likely leave large gaps if such a scheme is to be relied upon to provide comprehensive malaria control and containment. The current government has also initiated a dialogue around Universal Health Coverage (UHC) and the provision of a Basic Package of Health Services (BPHS) in Myanmar; partially predicated on the anticipation of increased government revenues generated through increased levels of economic investment 59. However, such developments are likely to take some years to come to fruition and the issue of artemisinin resistance is one which requires immediate action. Currently, there is no specific regulation to govern the provision of malaria control and artemisinin containment by private companies in endemic areas. What is needed is domestic regulation within Myanmar to stipulate that all private sector entities meet their obligations to workers and surrounding communities when operating in endemic areas. The difficulty is in identifying key leverage points where such regulation can be enforced. The Myanmar government structure is diffuse, with a significant number of central ministries and regional administrative bodies exercising jurisdiction over different business spheres. To give an example; in the timber industry, permission to extract is governed by the Ministry of Environment, Conservation and Forestry (MoECAF), but the state owned Myanmar Timber Enterprise (MTE), which is the sole concession holder for all forestry concerns in Myanmar, sits beneath MoECAF and holds responsibility for registration of all timber extraction companies. Similar structures exist in other sectors such as agriculture, mining, oil and gas etc. MoECAF is currently drafting new guidelines on ESIAs which all businesses will be expected to present for planned and on-going operations. 59 The government s main source of revenue in recent years has been the export of natural gas to Thailand, and another major source has been taxes on domestic and international trade. The Myanmar economy: Tough Choices, Global Economy and Development: Working Paper 51, September 2012, Lex Rieffel, Brookings Institute. 35

39 In addition, any business wishing to commence operations within Myanmar has to apply for a general licence to operate. Foreign owned companies wishing to benefit from incentives under the FIL must apply through the MIC (Myanmar Investment Commission), which formally sat under the Ministry of National Planning and Economic Development (MNPED), but has now been established as an independent body (although key positions are still held by government officials). Other foreign owned companies not wishing to apply for preferential treatment under the FIL, must apply for a licence through DICA (Directorate of Investment and Companies Administration) which also sits under the MNPED. These provisions include companies wishing to apply to form joint ventures. Locally owned enterprises must also apply for licences from the MIC under the Myanmar Citizens Investment Law. Furthermore, companies must also gain approval to operate from State/Regional administrations, before they can approach the MIC; however, there can often be a disconnect between regional and central government processes. Companies which have already been granted a licence to operate must apply to re-new their licences under the MIC every five years. Whilst the diffuse nature of the system is positive in presenting a significant number of potential access points, this can also make consensus and co-ordination difficult Potential regulation points The most practical entry point for regulating private sector engagement in malaria control may be through the MIC and DICA, who could exercise scrutiny over the business proposals of companies wishing to operate in endemic areas. There is currently no written policy to govern corporate CSR activities, but there is an unwritten understanding within the MIC that companies should direct at least 1% of profits to CSR. This applies to all FDI including Joint Ventures. A similar attitude is adopted by the MIC with regards to renewals of existing business licences. MNPED are currently revising investment laws with plans to unify foreign and domestic investment regulations; a CSR clause is to be introduced but will not make specific stipulations with regards to particular activities or sectors (i.e., health, education). This is a positive development as it will reduce the arbitrary nature of the current process. What is still needed, however, is an additional stipulation governing malaria control activities for companies wishing to operate in endemic areas this could potentially be incorporated as a clause within the ESIA of companies wishing to operate in endemic areas. MNPED have suggested that the regulation point for malaria specific provision could sit at the State/Regional administrative level which has to approve licence applications before they are referred to the MIC. A suggestion of this paper is that MOECAF and the Malaria Prevention and 36

40 Control Department in each area could be engaged to support this process. Once a company s licence application has been approved, an organisation should then be tasked with supporting and monitoring private sector activities in the area of malaria control. Complimentary guidance should be drafted and provided to businesses wishing to operate in endemic areas, stipulating standards, guidelines and standard operating procedures (SOPs) for the provision of malaria control activities to the workforce and affected communities (such as the provision of LLIN and PPE). Key Performance Indicators (KPIs) should be created to measure the performance of activities, and designed to feed into both NMCP and corporate reporting structures. Companies should also be required to incorporate stipulations on due diligence with regards to malaria control for workers in their contracts with sub-contractors, including where day-labourers are used. The MIC and DICA should have powers to refuse to grant or renew licences where necessary provisions have not been made. Regarding additional penalties where provisions are not adhered to, Minister Kan Zaw of MNPED stated that Myanmar is in a period of promoting incentives not disincentives 60. A system of complimentary incentives would provide positive support to such an initiative, and could potentially be provided through the status of voluntary accreditation, and if possible through certain financial incentives, such as tax off-setting or some other incentive, where a company is implementing a significant CSR health programme, including malaria control activities where necessary 61. Whilst the NMCP holds responsibility for the setting of national malaria guidelines, it has no power to enforce compliance 62. The MoH could however support the regulatory framework, through the formation of national policy and guidelines, and through co-ordination of the initiative across government; in addition there could be a role for the NMCP in the review and approval of company proposals, if they have the capacity to do so A potential model This paper recommends that a combination of regulation and voluntary accreditation be utilised to engage the private sector on supporting malaria control activities in endemic areas. Regarding the model of delivery for service provision through the private sector, further work is needed on the precise design of such an initiative, but it is recommended that initial donor funding is mobilised to provide immediate coverage whilst complimentary regulations are 60 Discussion with Dr Kan Zaw, Minister of MNPED, March Please note that these suggestions are the thoughts of the paper and are not intended to represent the suggestions of MNPED. 62 Discussion with NMCP, March Again, these are suggestions of the paper and are not intended to represent suggestions of the NMCP. 37

41 scaled up. In time, private sector companies may be expected to shoulder a greater portion of financial responsibility, but in the interim, direct donor support is required to contain artemisinin resistance as quickly and effectively as possible. The first step is to work with the private sector in partnership to encourage them to open the door. It was understood during the course of this review that the NMCP does not currently have the capacity or resources to work directly in private sector settings. Although health resourcing is expected to rise as government revenues increase (a positive consequence of increased private sector development), it is understood that resources may still be inadequate to bridge the gap between existing service delivery points and private sector operations. In this case, it will be necessary to engage implementing partners to deliver commodities and services to private sector sites. The design of any model will need to consider which organisation/s will fulfil the following roles: Engagement; Training and awareness; Commodity supply; Testing and treatment; and Monitoring and evaluation. Key elements of a model could be represented as seen in Figure 6. Figure 6: Model of delivery for service provision through the private sector 38

ARTEMISININ RESISTANCE IN THE GREATER MEKONG SUBREGION

ARTEMISININ RESISTANCE IN THE GREATER MEKONG SUBREGION 1 ARTEMISININ RESISTANCE IN THE GREATER MEKONG SUBREGION Key messages The situation in the Greater Mekong Subregion is critical. We are at a tipping point. If resistance to artemisinin emerges elsewhere,

More information

Malaria Consortium Myanmar

Malaria Consortium Myanmar Malaria Consortium Myanmar Malaria Consortium has become one of the world s leading specialist non-profit organisations dedicated to improving the lives of the poor and marginalised in Asia and Africa.

More information

REGIONAL ARTEMISININ MALARIA INITIATIVE (RAI)

REGIONAL ARTEMISININ MALARIA INITIATIVE (RAI) REGIONAL ARTEMISININ MALARIA INITIATIVE (RAI) IMPLEMENTATION, ACHIEVEMENT AND LESSONS LEARNT REGIONAL TRAINING WORKSHOP ON ANTIMICROBIAL RESISTANCE (AMR) 15-18 NOVEMBER 2016 BANGKOK, THAILAND Background

More information

Containing artemisinin resistance of Plasmodium falciparum in Myanmar: achievements, challenges and the way forward

Containing artemisinin resistance of Plasmodium falciparum in Myanmar: achievements, challenges and the way forward Policy and practice Containing artemisinin resistance of Plasmodium falciparum in Myanmar: achievements, challenges and the way forward Access this article online Website: www.searo.who.int/ publications/journals/seajph

More information

Malaria Consortium Asia provides technical assistance to countries in developing winning proposals for resource mobilisation in the GMS,

Malaria Consortium Asia provides technical assistance to countries in developing winning proposals for resource mobilisation in the GMS, Asia Who We Are The principal aim of Malaria Consortium is the prevention and treatment of disease, particularly but not exclusively malaria, among the poorest and most at risk. Malaria Consortium staff

More information

DELAYING ARTEMISININ RESISTANCE: FRAMING POLICY RESPONSE FOR AN EMERGING PUBLIC HEALTH CONCERN

DELAYING ARTEMISININ RESISTANCE: FRAMING POLICY RESPONSE FOR AN EMERGING PUBLIC HEALTH CONCERN DELAYING ARTEMISININ RESISTANCE: FRAMING POLICY RESPONSE FOR AN EMERGING PUBLIC HEALTH CONCERN Introduction Every year more than 200 million cases of Malaria occur and nearly 600,000 deaths are estimated

More information

The global challenge of antimalarial drug resistance

The global challenge of antimalarial drug resistance The global challenge of antimalarial drug resistance MMV Stakeholders Meeting New Delhi, India 8 November 2012 Robert D. Newman, MD, MPH Director, Global Malaria Programme newmanr@who.int AR Situation

More information

in the Greater Mekong Sub-region

in the Greater Mekong Sub-region in the Greater Mekong Sub-region 05 07 August 2013 Towards Multi-sectoral Actions to Combat Malaria Drug Resistance in the Greater Mekong Sub-region Dr. Leonard Ortega Regional Adviser, Malaria WHO South

More information

Status report on artemisinin resistance

Status report on artemisinin resistance Status report on artemisinin resistance Key messages 1. artemisinin resistance and delayed parasite clearance The term artemisinin resistance 1 is used to describe delayed parasite clearance observed after

More information

Artemisinin resistance: global situation, update and next steps. WHO Webinar

Artemisinin resistance: global situation, update and next steps. WHO Webinar Artemisinin resistance: global situation, update and next steps WHO Webinar Definitions Terminology: multidrug-resistant, extensively drug-resistant and pandrug-resistance (Magiorakos et al., 2011); Antimalarial

More information

PROGRAM BRIEF: PSI/MYANMAR. Improving Malaria Case Management in the Private Sector: Artemisinin Monotherapy Replacement (AMTR) Project. psi.

PROGRAM BRIEF: PSI/MYANMAR. Improving Malaria Case Management in the Private Sector: Artemisinin Monotherapy Replacement (AMTR) Project. psi. PROGRAM BRIEF: PSI/MYANMAR Improving Malaria Case Management in the Private Sector: Artemisinin Monotherapy Replacement (AMTR) Project psi.org 1 Artemisinin Monotherapy Replacement Project 2012-2015 AMTR

More information

"Made In China 2025 & Internet Plus: The 4th Industrial Revolution" Opportunities for Foreign Invested Enterprises in China

Made In China 2025 & Internet Plus: The 4th Industrial Revolution Opportunities for Foreign Invested Enterprises in China China Insights - Made in China 2025 and Internet Plus - Opportunities for foreign companies in China "Made In China 2025 & Internet Plus: The 4th Industrial Revolution" Opportunities for Foreign Invested

More information

CHAPTER TWENTY COOPERATION. The objective of this Chapter is to facilitate the establishment of close cooperation aimed, inter alia, at:

CHAPTER TWENTY COOPERATION. The objective of this Chapter is to facilitate the establishment of close cooperation aimed, inter alia, at: CHAPTER TWENTY COOPERATION ARTICLE 20.1: OBJECTIVE The objective of this Chapter is to facilitate the establishment of close cooperation aimed, inter alia, at: strengthening the capacities of the Parties

More information

First Myanmar Investment Public Co., Ltd.

First Myanmar Investment Public Co., Ltd. First Myanmar Investment Public Co., Ltd. Summary: First Myanmar Investment Public Co., Ltd. (FMI), a company incorporated in November 1992 in Myanmar, became the first company to be listed on the Yangon

More information

Science, technology and engineering for innovation and capacity-building in education and research UNCTAD Wednesday, 28 November 2007

Science, technology and engineering for innovation and capacity-building in education and research UNCTAD Wednesday, 28 November 2007 Science, technology and engineering for innovation and capacity-building in education and research UNCTAD Wednesday, 28 November 2007 I am honored to have this opportunity to present to you the first issues

More information

in Developing Countries in FY2008

in Developing Countries in FY2008 Study on Economic Partnership Projects in Developing Countries in FY2008 Study on Research and Development Center for Space Technology of Vietnam Academy of Science and Technology in Hoa Lac in Socialist

More information

DHA piperaquine as an eradication tool in Myanmar

DHA piperaquine as an eradication tool in Myanmar DHA piperaquine as an eradication tool in Myanmar Myaing Myaing Nyunt MD PhD Celebrating 15 years of MMV Siam Reap, Cambodia 25 February 2015 Evidence and action for malaria elimination in Myanmar Evidence:

More information

CCM-Thailand Round 9 malaria proposal to the GFATM. Snapshot information to interested partners

CCM-Thailand Round 9 malaria proposal to the GFATM. Snapshot information to interested partners ANNEX 3 CCM-Thailand Round 9 malaria proposal to the GFATM Snapshot information to interested partners Draft October 1 st, 2008 I. Context Huge strides have been made in the last 10 years to reduce the

More information

Guyana Shield Meeting on the Implementation of the Framework for Artemisinin Resistance Prevention, Containment, and Elimination in South America

Guyana Shield Meeting on the Implementation of the Framework for Artemisinin Resistance Prevention, Containment, and Elimination in South America Guyana Shield Meeting on the Implementation of the Framework for Artemisinin Resistance Prevention, Containment, and Elimination in South America Paramaribo, Suriname 12-14 July 2016 Background Artemisinin-based

More information

Colombia on the Frontier of Biomedicine. Zagaya

Colombia on the Frontier of Biomedicine. Zagaya Colombia on the Frontier of Biomedicine An Intersectorial Meeting for Research, Innovation and Health February 27 & 28, 2012 Hotel Intercontinental, Cali, Colombia Kay Monroe, Executive Director Zagaya

More information

High Level Seminar on the Creative Economy and Copyright as Pathways to Sustainable Development. UN-ESCAP/ WIPO, Bangkok December 6, 2017

High Level Seminar on the Creative Economy and Copyright as Pathways to Sustainable Development. UN-ESCAP/ WIPO, Bangkok December 6, 2017 High Level Seminar on the Creative Economy and Copyright as Pathways to Sustainable Development UN-ESCAP/ WIPO, Bangkok December 6, 2017 Edna dos Santos-Duisenberg creative.edna@gmail.com Policy Advisor

More information

ASEAN: A Growth Centre in the Global Economy

ASEAN: A Growth Centre in the Global Economy Bank Negara Malaysia Governor Dr. Zeti Akhtar Aziz Speech at the ASEAN SME Conference 2015 It is my pleasure to be here this afternoon to speak at this inaugural ASEAN SME Conference. This conference takes

More information

Trans-Pacific Partnership Agreement: The Empowerment of Small and Medium-Sized Enterprise in Malaysia

Trans-Pacific Partnership Agreement: The Empowerment of Small and Medium-Sized Enterprise in Malaysia International Journal of Business and Management Invention ISSN (Online): 2319 8028, ISSN (Print): 2319 801X Volume 5 Issue 11 November. 2016 PP 31-35 Trans-Pacific Partnership Agreement: The Empowerment

More information

Learning Lessons Abroad on Funding Research and Innovation. 29 April 2016

Learning Lessons Abroad on Funding Research and Innovation. 29 April 2016 Learning Lessons Abroad on Funding Research and Innovation 29 April 2016 In South Africa universities contribute 2.1% of gross domestic product more than textiles and forestry and they employ 300,000 people

More information

Affordable Medicines Facility-malaria (AMFm): Innovative Financing for Better Access

Affordable Medicines Facility-malaria (AMFm): Innovative Financing for Better Access Affordable Medicines Facility-malaria (AMFm): Innovative Financing for Better Access Medicines For Malaria Venture Stakeholders Meeting, Dar-es-Salaam, 3 June 2011 Olusoji Adeyi, MD, DrPH, MBA Director

More information

A Science & Innovation Audit for the West Midlands

A Science & Innovation Audit for the West Midlands A Science & Innovation Audit for the West Midlands June 2017 Summary Report Key Findings and Moving Forward 1. Key findings and moving forward 1.1 As the single largest functional economic area in England

More information

Supporting Regional Project Development for Association of Southeast Asian Nations Connectivity

Supporting Regional Project Development for Association of Southeast Asian Nations Connectivity Major Change in Technical Assistance Project Number: 46309-001 TA Number: 8240 November 2013 Supporting Regional Project Development for Association of Southeast Asian Nations Connectivity ABBREVIATIONS

More information

Interim Report on the Heiligendamm Process at the G8 Summit in Hokkaido Toyako 7 to 9 July 2008

Interim Report on the Heiligendamm Process at the G8 Summit in Hokkaido Toyako 7 to 9 July 2008 Interim Report on the Heiligendamm Process at the G8 Summit in Hokkaido Toyako 7 to 9 July 2008 Prepared by the Steering Committee of the Heiligendamm Process consisting of the personal representatives

More information

Your Excellency, President of the Socialist Republic of Vietnam Tran Dai Quang. Minister and Chairman of the President s Office Dao Viet Trung

Your Excellency, President of the Socialist Republic of Vietnam Tran Dai Quang. Minister and Chairman of the President s Office Dao Viet Trung Embargoed till after delivery Please check against delivery OPENING REMARKS BY MR S ISWARAN MINISTER FOR TRADE AND INDUSTRY (INDUSTRY) AT THE SINGAPORE-VIETNAM BUSINESS FORUM GRAND BALLROOM, THE RITZ-CARLTON

More information

Investing in Myanmar CO-OPERATIVE BANK LTD SINCE 1992

Investing in Myanmar CO-OPERATIVE BANK LTD SINCE 1992 Investing in Myanmar CO-OPERATIVE BANK LTD SINCE 1992 About CB Securities Wholly Owned Subsidiary of CB Bank, third largest bank in Myanmar by Assets Established in 2015 for development of modern capital

More information

Information Technology Policy

Information Technology Policy Vision Information Technology Policy "To place Nepal on the global map of information technology within the next five years." Background The world's least developed countries including Nepal have availed

More information

OECD-ASEAN Business Statement

OECD-ASEAN Business Statement OECD-ASEAN Business Statement Business priorities and recommendations to promote digital transformation for an enhanced and inclusive business environment in Southeast Asia August 2017 I. Preamble Southeast

More information

SECTOR ASSESSMENT (SUMMARY): FINANCE (SMALL AND MEDIUM-SIZED ENTERPRISE FINANCE AND LEASING) 1. Sector Performance, Problems, and Opportunities

SECTOR ASSESSMENT (SUMMARY): FINANCE (SMALL AND MEDIUM-SIZED ENTERPRISE FINANCE AND LEASING) 1. Sector Performance, Problems, and Opportunities Second Small and Medium-Sized Enterprise Development Project (RRP BAN 36200) SECTOR ASSESSMENT (SUMMARY): FINANCE (SMALL AND MEDIUM-SIZED ENTERPRISE FINANCE AND LEASING) Sector Road Map 1. Sector Performance,

More information

Eastern Seaboard Development Program

Eastern Seaboard Development Program IV JICA/OECF Joint Evaluation Thailand Eastern Seaboard Development Program Project Sites Laemchabang 1. Background and Objectives of Evaluation Survey Through the Japan International Cooperation Agency

More information

ASEAN Open Innovation Forum 14 October 2017 Nay Pyi Taw

ASEAN Open Innovation Forum 14 October 2017 Nay Pyi Taw ASEAN Open Innovation Forum 14 October 2017 Nay Pyi Taw Demand Articulation and potential Demonstration Projects Formulation Country s viewpoints on developmental challenges faced by: Khamnhong SICHANTHAVONG

More information

COUNTRY REPORT: TURKEY

COUNTRY REPORT: TURKEY COUNTRY REPORT: TURKEY (a) Why Economic Census? - Under what circumstances the Economic Census is conducted in your country. Why the economic census is necessary? - What are the goals, scope and coverage

More information

ASEAN Regulatory Harmonisation and Approval Process

ASEAN Regulatory Harmonisation and Approval Process ASEAN Regulatory Harmonisation and Approval Process Selvaraja Seerangam National Pharmaceutical Control Bureau Ministry of Health Malaysia Open Forum on Key Issues on TB Drug Development- 18-19 August

More information

Draft executive summaries to target groups on industrial energy efficiency and material substitution in carbonintensive

Draft executive summaries to target groups on industrial energy efficiency and material substitution in carbonintensive Technology Executive Committee 29 August 2017 Fifteenth meeting Bonn, Germany, 12 15 September 2017 Draft executive summaries to target groups on industrial energy efficiency and material substitution

More information

RECOMMENDATIONS LDAC CONFERENCE ON EXTERNAL DIMENSION OF THE CFP LAS PALMAS DE GRAN CANARIA, September 2015

RECOMMENDATIONS LDAC CONFERENCE ON EXTERNAL DIMENSION OF THE CFP LAS PALMAS DE GRAN CANARIA, September 2015 RECOMMENDATIONS LDAC CONFERENCE ON EXTERNAL DIMENSION OF THE CFP LAS PALMAS DE GRAN CANARIA, 16-17 September 2015 GENERAL STATEMENTS 1. We recognise the progress made with the latest reforms to the exterior

More information

Status report on artemisinin resistance

Status report on artemisinin resistance Status report on artemisinin resistance Key messages 1. artemisinin resistance and delayed parasite clearance The term partial artemisinin resistance 1 is used to describe delayed parasite clearance observed

More information

The 26 th APEC Economic Leaders Meeting

The 26 th APEC Economic Leaders Meeting The 26 th APEC Economic Leaders Meeting PORT MORESBY, PAPUA NEW GUINEA 18 November 2018 The Chair s Era Kone Statement Harnessing Inclusive Opportunities, Embracing the Digital Future 1. The Statement

More information

AN OVERVIEW OF THE STATE OF MARINE SPATIAL PLANNING IN THE MEDITERRANEAN COUNTRIES MALTA REPORT

AN OVERVIEW OF THE STATE OF MARINE SPATIAL PLANNING IN THE MEDITERRANEAN COUNTRIES MALTA REPORT AN OVERVIEW OF THE STATE OF MARINE SPATIAL PLANNING IN THE MEDITERRANEAN COUNTRIES MALTA REPORT Malta Environment & Planning Authority May 2007 AN OVERVIEW OF THE STATE OF MARINE SPATIAL PLANNING IN THE

More information

ARTEMISININ RESISTANCE

ARTEMISININ RESISTANCE EMERGENCY RESPONSE TO ARTEMISININ RESISTANCE IN THE GREATER MEKONG SUBREGION REGIONAL Framework for action 2013-2015 ISBN 978 92 4 150532 1 REGIONAL framework for action 2013-2015 Emergency response to

More information

THE 4 th ZAMBIA ALTERNATIVE MINING INDABA

THE 4 th ZAMBIA ALTERNATIVE MINING INDABA THE 4 th ZAMBIA ALTERNATIVE MINING INDABA Our Natural Resources, Our future, Putting Local Communities First Ndola, Copperbelt 23 rd - 26 th June 2015 Declaration We, Civil Society Organisations, Faith

More information

Executive Summary. Introduction:

Executive Summary. Introduction: Recommendations for British Columbia s 2013 Budget AME BC s Pre-Budget Submission to the Select Standing Committee on Finance and Government Services - October 18, 2012 Introduction: Executive Summary

More information

Antitrust & Competition

Antitrust & Competition Antitrust & Competition Mayer Brown s multi-disciplinary Antitrust & Competition team offers a seamless, coordinated service throughout the Asia Pacific region, and has the benefit of extensive regional

More information

EXECUTIVE SUMMARY: ASIAN SMES AND GLOBALIZATION

EXECUTIVE SUMMARY: ASIAN SMES AND GLOBALIZATION EXECUTIVE SUMMARY: ASIAN SMES AND GLOBALIZATION 1. AIM OF THE STUDIES Large enterprises (LEs) and small and medium enterprises (SMEs) are the two important wheels of development in developing countries.

More information

GROWTH-STRATEGY FOR THE ENGINEERING INDUSTRY TO ACHIEVE RAPID INDUSTRIALIZATION AND ECONOMIC GROWTH

GROWTH-STRATEGY FOR THE ENGINEERING INDUSTRY TO ACHIEVE RAPID INDUSTRIALIZATION AND ECONOMIC GROWTH GROWTH-STRATEGY FOR THE ENGINEERING INDUSTRY TO ACHIEVE RAPID INDUSTRIALIZATION AND ECONOMIC GROWTH Javed Akhtar Paracha* ABSTRACT The paper focuses on the importance of the engineering sector in economic

More information

Feature. Accelerate Business Development Contributing to Further Enhance Ophthalmic Treatment in Asia. 2020, our goal is to become #1 in

Feature. Accelerate Business Development Contributing to Further Enhance Ophthalmic Treatment in Asia. 2020, our goal is to become #1 in Feature Accelerate Business Development Contributing to Further Enhance Ophthalmic Treatment in Asia Based on our long-term strategic vision toward 2020, our goal is to become #1 in Asia in terms of our

More information

ORCADE. Organisation pour le Renforcement des Capacités de Développement Tel: BP 675 Ouagadougou 09 Burkina Faso

ORCADE. Organisation pour le Renforcement des Capacités de Développement Tel: BP 675 Ouagadougou 09 Burkina Faso ORCADE Organisation pour le Renforcement des Capacités de Développement Tel: 25 36 20 89 09 BP 675 Ouagadougou 09 Burkina Faso SEMINAR FOR INFORMATION AND KNOWLEDGE SHARING AMONG STAKEHOLDERS IN THE MINING

More information

The Sustainable Tourism Programme of the 10-Year Framework of Programmes on Sustainable Consumption and Production

The Sustainable Tourism Programme of the 10-Year Framework of Programmes on Sustainable Consumption and Production The Sustainable Tourism Programme of the 10-Year Framework of Programmes on Sustainable Consumption and Production Generating collective impact Scaling up and replicating Programmatic implementation Helena

More information

Nasir, Dao PKM Abdul Partner PwC Legal (Vietnam) Co., Ltd

Nasir, Dao PKM Abdul Partner PwC Legal (Vietnam) Co., Ltd Nasir, Dao PKM Abdul Partner PwC Legal (Vietnam) Co., Ltd Get in touch Tel. (direct): +84 (8) 3824 0109 nasir.pkm@pwc.com Professional profile Nasir is a partner and the Legal Services Leader in Vietnam.

More information

Software Production in Kyrgyzstan: Potential Source of Economic Growth

Software Production in Kyrgyzstan: Potential Source of Economic Growth 400 INTERNATIONAL CONFERENCE ON EURASIAN ECONOMIES 2011 Software Production in Kyrgyzstan: Potential Source of Economic Growth Rahat Sabyrbekov (American University of Central Asia, Kyrgyzstan) Abstract

More information

Copernicus Evolution: Fostering Growth in the EO Downstream Services Sector

Copernicus Evolution: Fostering Growth in the EO Downstream Services Sector Copernicus Evolution: Fostering Growth in the EO Downstream Services Sector Summary: Copernicus is a European programme designed to meet the needs of the public sector for spacederived, geospatial information

More information

Australia and Japan: a View from Asia Kevin Sneader October 13th 2014

Australia and Japan: a View from Asia Kevin Sneader October 13th 2014 Australia and Japan: a View from Asia Kevin Sneader October 13th 2014 The world s economic centre of gravity has come back to Asia Locations weighted in 3D space by GDP 1980 2000 2010 1950 1940 1820 1500

More information

Media Release October 5 th, 2010

Media Release October 5 th, 2010 Media Release October 5 th, 2010 PSAC STUDIES REVEAL OIL & GAS SERVICES SECTOR IS A $65 BILLION INDUSTRY (Calgary, AB) --- The Petroleum Services Association of Canada ( PSAC ) announced today the results

More information

Cambodia: From Control to Elimination

Cambodia: From Control to Elimination Cambodia: From Control to Elimination Ministry of Health National Centre for Parasitology, Entomology and Malaria Control (CNM) Dr. Kheng Sim Presentation at APMEN Meeting, 8 May 212 History of Malaria

More information

THE INTERNATIONAL COMPETITIVENESS OF ECONOMIES IN TRANSITION THE UNTAPPED POTENTIAL: A CHALLENGE FOR BUSINESS AND GOVERNMENT BELARUS

THE INTERNATIONAL COMPETITIVENESS OF ECONOMIES IN TRANSITION THE UNTAPPED POTENTIAL: A CHALLENGE FOR BUSINESS AND GOVERNMENT BELARUS THE INTERNATIONAL COMPETITIVENESS OF ECONOMIES IN TRANSITION THE UNTAPPED POTENTIAL: A CHALLENGE FOR BUSINESS AND GOVERNMENT BELARUS NATIONAL COMPETITIVENESS ISSUES, CONSTRAINTS AND STRATEGIC IMPLICATIONS

More information

Getting the evidence: Using research in policy making

Getting the evidence: Using research in policy making Getting the evidence: Using research in policy making REPORT BY THE COMPTROLLER AND AUDITOR GENERAL HC 586-I Session 2002-2003: 16 April 2003 LONDON: The Stationery Office 14.00 Two volumes not to be sold

More information

Medical Technology Association of NZ. Proposed European Union/New Zealand Free Trade Agreement. Submission to Ministry of Foreign Affairs & Trade

Medical Technology Association of NZ. Proposed European Union/New Zealand Free Trade Agreement. Submission to Ministry of Foreign Affairs & Trade Medical Technology Association of NZ Proposed European Union/New Zealand Free Trade Agreement Submission to Ministry of Foreign Affairs & Trade February 2016 1 Introduction The Medical Technology Association

More information

An Innovative Public Private Approach for a Technology Facilitation Mechanism (TFM)

An Innovative Public Private Approach for a Technology Facilitation Mechanism (TFM) Summary An Innovative Public Private Approach for a Technology Facilitation Mechanism (TFM) July 31, 2012 In response to paragraph 265 276 of the Rio+20 Outcome Document, this paper outlines an innovative

More information

IN-DEPTH ASSESSMENT OF THE SITUATION (CONTRACT NO ENTR/2010/16, LOT 2) Task 6: Research, Development and Innovation in the Footwear Sector

IN-DEPTH ASSESSMENT OF THE SITUATION (CONTRACT NO ENTR/2010/16, LOT 2) Task 6: Research, Development and Innovation in the Footwear Sector IN-DEPTH ASSESSMENT OF THE SITUATION OF THE EUROPEAN FOOTWEAR SECTOR AND PROSPECTS FOR ITS FUTURE DEVELOPMENT (CONTRACT NO ENTR/2010/16, LOT 2) Task 6: Research, Development and Innovation in the Footwear

More information

EXECUTIVE BOARD MEETING METHODOLOGY FOR DEVELOPING STRATEGIC NARRATIVES

EXECUTIVE BOARD MEETING METHODOLOGY FOR DEVELOPING STRATEGIC NARRATIVES EXECUTIVE BOARD MEETING METHODOLOGY FOR DEVELOPING STRATEGIC NARRATIVES EXECUTIVE BOARD MEETING METHODOLOGY FOR DEVELOPING STRATEGIC NARRATIVES 1.Context and introduction 1.1. Context Unitaid has adopted

More information

IIRSA INDICATIVE TERRITORIAL PLANNING METHODOLOGY REVISION OF THE IIRSA PROJECT PORTFOLIO GTE ANDEAN HUB

IIRSA INDICATIVE TERRITORIAL PLANNING METHODOLOGY REVISION OF THE IIRSA PROJECT PORTFOLIO GTE ANDEAN HUB IIRSA INDICATIVE TERRITORIAL PLANNING METHODOLOGY REVISION OF THE IIRSA PROJECT PORTFOLIO GTE ANDEAN HUB Santa Cruz, 22 August, 2007 Objetives of the IIRSA Project Portfolio To allow the countries (which

More information

G20 Initiative #eskills4girls

G20 Initiative #eskills4girls Annex to G20 Leaders Declaration G20 Initiative #eskills4girls Transforming the future of women and girls in the digital economy A gender inclusive digital economy 1. During their meeting in Hangzhou in

More information

ASEAN Vision A Concert of Southeast Asian Nations

ASEAN Vision A Concert of Southeast Asian Nations ASEAN Vision 2020 We, the Heads of State/Government of the Association of Southeast Asian Nations, gather today in Kuala Lumpur to reaffirm our commitment to the aims and purposes of the Association as

More information

JOB DESCRIPTION. Department: Technical Length of contract: 3 years renewable. Reporting to: Chief of Party Direct reports: Numbers to be confirmed

JOB DESCRIPTION. Department: Technical Length of contract: 3 years renewable. Reporting to: Chief of Party Direct reports: Numbers to be confirmed JOB DESCRIPTION Job title: Technical Director and Malaria Specialist Location: Luanda Angola Department: Technical Length of contract: 3 years renewable Role type: Global Grade: 10 Travel involved: Frequent

More information

Innovation Management Processes in SMEs: The New Zealand. Experience

Innovation Management Processes in SMEs: The New Zealand. Experience Innovation Management Processes in SMEs: The New Zealand Experience Professor Delwyn N. Clark Waikato Management School, University of Waikato, Hamilton, New Zealand Email: dnclark@mngt.waikato.ac.nz Stream:

More information

CanNor Building a Strong North Together Strategic Framework CanNor.gc.ca

CanNor Building a Strong North Together Strategic Framework CanNor.gc.ca CanNor Building a Strong North Together Strategic Framework 2013-2018 CanNor.gc.ca Table of Contents Introduction...2 CanNor Building a Strong North Together...3 Our Stakeholders...4 The Northern Economy...7

More information

Shell Project Delivery Best Practices Dick L. Wynberg, GM NOV Projects Integrated Gas Shell Global Solutions International B.V

Shell Project Delivery Best Practices Dick L. Wynberg, GM NOV Projects Integrated Gas Shell Global Solutions International B.V Shell Project Delivery Best Practices Dick L. Wynberg, GM NOV Projects Integrated Gas Shell Global Solutions International B.V SEPTEMBER 26, 2017, ST. PETERSBURG, HOTEL ASTORIA Definitions and cautionary

More information

Session 8: Maritime Safety and Security. Raymond Gilpin, Ph.D. Academic Dean. Impact through Insight

Session 8: Maritime Safety and Security. Raymond Gilpin, Ph.D. Academic Dean. Impact through Insight Session 8: Maritime Safety and Security Raymond Gilpin, Ph.D. Academic Dean Impact through Insight Africa s Maritime Environment Abundant natural resources: Significant fishing grounds Growing interest

More information

UN Countries in the Flyway Partner Ramsar

UN Countries in the Flyway Partner Ramsar AIM OF THE REGIONAL INITIATIVE 1. How is it implementing the Ramsar approach? Describe briefly the operational means of your initiative to promote the objectives of the Convention and how your initiative

More information

An Introduction to China s Science and Technology Policy

An Introduction to China s Science and Technology Policy An Introduction to China s Science and Technology Policy SHANG Yong, Ph.D. Vice Minister Ministry of Science and Technology, China and Senior Fellow Belfer Center for Science and International Affairs

More information

RIO Country Report 2015: India

RIO Country Report 2015: India From the complete publication: RIO Country Report 2015: India Chapter: 6. Conclusions Venni Krishna 2016 This publication is a Science for Policy Report by the Joint Research Centre, the European Commission

More information

Technology and Competitiveness in Vietnam

Technology and Competitiveness in Vietnam Technology and Competitiveness in Vietnam General Statistics Office, Hanoi, Vietnam July 3 rd, 2014 Prof. Carol Newman, Trinity College Dublin Prof. Finn Tarp, University of Copenhagen and UNU-WIDER 1

More information

THE REPUBLIC OF THE UNION OF MYANMAR

THE REPUBLIC OF THE UNION OF MYANMAR THE REPUBLIC OF THE UNION OF MYANMAR The 2014 Myanmar Population and Housing Census The Union Report: Religion Census Report Volume 2-C Department of Population Ministry of Labour, Immigration and Population

More information

TRANSFORMATION INTO A KNOWLEDGE-BASED ECONOMY: THE MALAYSIAN EXPERIENCE

TRANSFORMATION INTO A KNOWLEDGE-BASED ECONOMY: THE MALAYSIAN EXPERIENCE TRANSFORMATION INTO A KNOWLEDGE-BASED ECONOMY: THE MALAYSIAN EXPERIENCE by Honourable Dato Sri Dr. Jamaludin Mohd Jarjis Minister of Science, Technology and Innovation of Malaysia Going Global: The Challenges

More information

Highlights of the Main Results

Highlights of the Main Results THE REPUBLIC OF THE UNION OF MYANMAR The 2014 Myanmar Population and Housing Census Highlights of the Main Results Census Report Volume 2 A Department of Population Ministry of Immigration and Population

More information

EXPLORATION DEVELOPMENT OPERATION CLOSURE

EXPLORATION DEVELOPMENT OPERATION CLOSURE i ABOUT THE INFOGRAPHIC THE MINERAL DEVELOPMENT CYCLE This is an interactive infographic that highlights key findings regarding risks and opportunities for building public confidence through the mineral

More information

The Policy Content and Process in an SDG Context: Objectives, Instruments, Capabilities and Stages

The Policy Content and Process in an SDG Context: Objectives, Instruments, Capabilities and Stages The Policy Content and Process in an SDG Context: Objectives, Instruments, Capabilities and Stages Ludovico Alcorta UNU-MERIT alcorta@merit.unu.edu www.merit.unu.edu Agenda Formulating STI policy STI policy/instrument

More information

Developing the Arts in Ireland. Arts Council Strategic Overview

Developing the Arts in Ireland. Arts Council Strategic Overview Developing the Arts in Ireland Arts Council Strategic Overview 2011 2013 1 Mission Statement The mission of the Arts Council is to develop the arts by supporting artists of all disciplines to make work

More information

Chapter 11 Cooperation, Promotion and Enhancement of Trade Relations

Chapter 11 Cooperation, Promotion and Enhancement of Trade Relations Chapter 11 Cooperation, Promotion and Enhancement of Trade Relations Article 118: General Objective 1. The objective of this Chapter is to establish a framework and mechanisms for present and future development

More information

They all say it is about the economy. It is more than ratio s, percentages, and growth; it is about the Lives of people

They all say it is about the economy. It is more than ratio s, percentages, and growth; it is about the Lives of people They all say it is about the economy It is more than ratio s, percentages, and growth; it is about the Lives of people Let me share my version of that vision based on the belief that Curaçao Connects Communities

More information

USTR NEWS UNITED STATES TRADE REPRESENTATIVE. Washington, D.C UNITED STATES MEXICO TRADE FACT SHEET

USTR NEWS UNITED STATES TRADE REPRESENTATIVE.   Washington, D.C UNITED STATES MEXICO TRADE FACT SHEET USTR NEWS UNITED STATES TRADE REPRESENTATIVE www.ustr.gov Washington, D.C. 20508 202-395-3230 FOR IMMEDIATE RELEASE August 27, 2018 Contact: USTR Public & Media Affairs media@ustr.eop.gov UNITED STATES

More information

Contents Census Overview 1

Contents Census Overview 1 Contents Page no: Introduction 3 Chapter 1: Demographic Characteristics 5 Chapter 2: Social Characteristics 21 Chapter 3: Migration and Urbanization 27 Chapter 4: Education 37 Chapter 5: Economic Characteristics

More information

OECD-INADEM Workshop on

OECD-INADEM Workshop on OECD-INADEM Workshop on BUILDING BUSINESS LINKAGES THAT BOOST SME PRODUCTIVITY OUTLINE AGENDA 20-21 February 2018 Mexico City 2 About the OECD The Organisation for Economic Co-operation and Development

More information

- The experience and relevance of EU SMEs support in Asia-

- The experience and relevance of EU SMEs support in Asia- EU-Japan Centre for Industrial Cooperation 日欧産業協力センター EU policy and instruments for innovation and SMEs internationalization - The experience and relevance of EU SMEs support in Asia- Dr. Silviu Jora,

More information

Raw Materials: Study on Innovative Technologies and Possible Pilot Plants

Raw Materials: Study on Innovative Technologies and Possible Pilot Plants Raw Materials: Study on Innovative Technologies and Possible Pilot Plants Ton Bastein, TNO Brussels 26 th November, 2013 Contents Project goals Development and logic of the study Development of criteria

More information

TERMS OF REFERENCE. Preparation of a Policymakers Handbook on E-Commerce and Digital Trade for LDCs, small states and Sub-Saharan Africa

TERMS OF REFERENCE. Preparation of a Policymakers Handbook on E-Commerce and Digital Trade for LDCs, small states and Sub-Saharan Africa TERMS OF REFERENCE Reference: Post Title: NBCWG0923 Preparation of a Policymakers Handbook on E-Commerce and Digital Trade for LDCs, small states and Sub-Saharan Africa Project Location: home-based with

More information

POLICY BRIEF AUSTRIAN INNOVATION UNION STATUS REPORT ON THE. adv iso ry s erv ic e in busi n e ss & i nno vation

POLICY BRIEF AUSTRIAN INNOVATION UNION STATUS REPORT ON THE. adv iso ry s erv ic e in busi n e ss & i nno vation POLICY BRIEF ON THE AUSTRIAN INNOVATION UNION STATUS REPORT 2014 23.01.2015 mag. roman str auss adv iso ry s erv ic e in busi n e ss & i nno vation wagne rg asse 15 3400 k losterne u bu r g aust ria CONTENTS

More information

Environmental technology diffusion in developing countries

Environmental technology diffusion in developing countries 03/05/2013 Environmental technology diffusion in developing countries The roles of different actors in the transition to a sustainable society Saskia Manshoven Study commissioned by the European Commission,

More information

In-Country Shared Value Creation The Case of Ghana

In-Country Shared Value Creation The Case of Ghana In-Country Shared Value Creation The Case of Ghana 6 th Plenary Session, OECD Policy Dialogue on Natural Resource-Based Development Paris, 22 23 June 2016 Isabelle RAMDOO African Minerals Development Centre

More information

CAPETANO OIL LIMITED (+233) (+233)

CAPETANO OIL LIMITED (+233) (+233) 1 CAPETANO OIL LIMITED (+233) 202 027 485 (+233) 209 985 175 www.capetano.com info@capetano.com C90/24 Osu Badu Street, Airport Residential Area, Accra Ghana. 2017 Capetano Oil Limited. All rights reserved.

More information

DIRECTION OF SCIENCE, TECHNOLOGY AND INNOVATION POLICY IN THAILAND

DIRECTION OF SCIENCE, TECHNOLOGY AND INNOVATION POLICY IN THAILAND DIRECTION OF SCIENCE, TECHNOLOGY AND INNOVATION POLICY IN THAILAND By Mr. Pichet Durongkaveroj Secretary General, National Science Technology and Innovation Policy Office, Thailand 99 I SCIENCE, TECHNOLOGY

More information

OECD Science, Technology and Industry Outlook 2008: Highlights

OECD Science, Technology and Industry Outlook 2008: Highlights OECD Science, Technology and Industry Outlook 2008: Highlights Global dynamics in science, technology and innovation Investment in science, technology and innovation has benefited from strong economic

More information

Programme. Social Economy. in Västra Götaland Adopted on 19 June 2012 by the regional board, Region Västra Götaland

Programme. Social Economy. in Västra Götaland Adopted on 19 June 2012 by the regional board, Region Västra Götaland Programme Social Economy in Västra Götaland 2012-2015 Adopted on 19 June 2012 by the regional board, Region Västra Götaland List of contents 1. Introduction... 3 2. Policy and implementation... 4 2.1 Prioritised

More information

International Workshop on Economic Census

International Workshop on Economic Census International Workshop on Economic Census United Nations Statistics Division (UNSD) National Bureau of Statistics of China (NBS) 26 29 July 2005, Beijing Country Profile on Economic Census Thailand Ms.Luckana

More information

The Internationalization of R&D in India: Opportunities and Challenges. Rajeev Anantaram National Interest Project March 2009

The Internationalization of R&D in India: Opportunities and Challenges. Rajeev Anantaram National Interest Project March 2009 The Internationalization of R&D in India: Opportunities and Challenges Rajeev Anantaram National Interest Project March 2009 Context of the Paper Part of the Private Sector Advisory Group constituted by

More information

STI OUTLOOK 2002 COUNTRY RESPONSE TO POLICY QUESTIONNAIRE CZECH REPUBLIC. 1. General framework and trends in science, technology and industry policy

STI OUTLOOK 2002 COUNTRY RESPONSE TO POLICY QUESTIONNAIRE CZECH REPUBLIC. 1. General framework and trends in science, technology and industry policy STI OUTLOOK 2002 COUNTRY RESPONSE TO POLICY QUESTIONNAIRE CZECH REPUBLIC 1. General framework and trends in science, technology and industry policy 1.1 Overview and assessment of policies for science,

More information

models for malaria elimination in the Greater Mekong Sub Region Lisa White, MAEMOD, Mahidol Oxford Tropical Medicine

models for malaria elimination in the Greater Mekong Sub Region Lisa White, MAEMOD, Mahidol Oxford Tropical Medicine Spatially explicit transmission dynamic models for malaria elimination in the Greater Mekong Sub Region Lisa White, MAEMOD, Mahidol Oxford Tropical Medicine Research Unit What is a model? A simplified

More information