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III. Regional Programs

U.S. Government Assistance to and Cooperative Activities with Eurasia

Bureau of European and Eurasian Affairs

January 2004

NUMBERS OF PARTICIPANTS IN U.S.-BASED TRAINING AND EXCHANGE PROGRAMS

In FY 2003, over 9,700 citizens of the Eurasian countries traveled to the United States on USG-funded training and exchange programs implemented by USAID and the U.S. Departments of Agriculture, Commerce and State.

Since 1993, the U.S. Government has brought more than 110,000 people from the Eurasian countries to the United States on training and exchange programs in fields ranging from management to social-service provision to NGO development. These programs have proven to be the USG's most effective tool in reaching out to the next generation of Eurasian leaders to give them first-hand experience with the day-to-day functioning of a market-based, democratic system.

Country	Economic Restructuring	Democratic Transition	Social Stabilization	Cross-Sectoral	Total START	Fee-For-Services	GRAND TOTAL
Armenia	28	3	1	5	37	76	113
Azerbaijan	5	9		8	22	48	70
Belarus						1	1
Georgia		5		2	7	29	36
Moldova						22	22
Kazakhstan	17	3	10		30	47	77
Kyrgyz Republic	4	2	9		15	5	20
Russia				16	16	156	172
Tajikistan	3	5	9		17	16	33
Turkmenistan	2		2		4		4
Ukraine						183	183
Uzbekistan	5	21	13		39	14	53
GRAND TOTAL	64	48	44	31	187	597	784

U.S. DEPARTMENT OF STATE, BUREAU OF EDUCATIONAL AND CULTURAL AFFAIRS (ECA)
NUMBERS OF U.S. AND EURASIAN TRAINING AND EXCHANGE PROGRAM PARTICIPANTS, FY 2003 (FSA FUNDING AND ECA BUREAU BASE FUNDING)

Click here for chart.

U.S. DEPARTMENT OF AGRICULTURE (USDA)
COCHRAN FELLOWSHIP PROGRAM PARTICIPANTS, FY 2003

Country	FSA Funding	USDA Funding	Total
Armenia	10	4	14
Azerbaijan	2	0	2
Belarus	0	0	0
Georgia	11	0	11
Kazakhstan	3	3	6
Kyrgyz Republic	22	0	22
Moldova	17	0	17
Russia	7	22	29
Tajikistan	7	0	7
Turkmenistan	6	0	6
Ukraine	16	4	20
Uzbekistan	7	0	7
Total	108	33	141

Country	Completed Program	Began Program
Kazakhstan	1	2
Kyrgyz Republic	0	2
Russia	11	8
Ukraine	7	5
Uzbekistan	3	3
Total	22	20

Country	Participants Trained
Armenia	9
Azerbaijan	12
Belarus	3
Georgia	13
Kazakhstan	51
Kyrgyz Republic	8
Moldova	5
Russia	157
Tajikistan	7
Turkmenistan	0
Ukraine	43
Uzbekistan	13
Total	321

U.S. DEPARTMENT OF JUSTICE, OFFICE OF OVERSEAS PROSECUTORIAL
DEVELOPMENT, ASSISTANCE AND TRAINING (DOJ/OPDAT)
TRAINING PROGRAM PARTICIPANTS, FY 2003

Country	Participants in U.S.-Based Programs	Participants in Third-Country Programs	Total Participants
Azerbaijan		8
Georgia	6	35
Kyrgyzstan		6	6
Kazakhstan		8	8
Moldova		7	7
Russia	12	21	33
Tajikistan		6	6
Ukraine		22	22
Uzbekistan	3	20	23
Total	21

AMERICAN UNIVERSITY
TRANSNATIONAL CRIME AND CORRUPTION CENTERS (TraCCC)
EXCHANGE/TRAINING PROGRAM PARTICIPANTS, FY 2003
(FUNDED BY DOJ/OPDAT)

Country	Participants in U.S.-Based Programs	Participants in Third-Country Programs	Total Participants
Georgia		13	13
Russia	11	10	21
Ukraine	6	8	14
Total	17	31	48

U.S. AGENCY FOR INTERNATIONAL DEVELOPMENT (USAID)
BUREAU FOR EUROPE AND EURASIA (E&E) - REGIONAL PROGRAMS

The vast majority of USAID-funded assistance activities are conducted bilaterally, however, some activities are conducted across two or more Eurasian countries, thereby promoting regional cooperation and stability in Eurasia, a region critical to U.S. national interests and the Global War on Terrorism. In FY 2003, USAID continued to support the transition of the Eurasian countries' formerly authoritarian, centrally planned societies towards participatory democracies with strong market-based economies. Central goals of USAID's regional programs include the promotion of policy reform, institutional development, and broad-based citizen participation.

USAID regional assistance focuses on cross-border cooperation and regional integration in areas such as information technology, health, financial development, infrastructure development, micro-enterprise development, environment, energy, anti-corruption, and rule of law. USAID's cross-border activities in Eurasia include conflict mitigation programs designed to contribute to a better climate for reform, social-sector initiatives designed to broaden the benefits of reform, and anti-corruption initiatives. Some examples of USAID regional programs are provided below.

ENTERPRISE FUNDS

The U.S. Government (USG)-funded Enterprise Funds seek to promote private-sector development, including the small business sector, joint ventures and the agricultural sector. The Funds provide loans, grants and equity investments, and support feasibility studies, technical assistance, training, insurance, guarantees and other mechanisms. The Funds have provided venture capital and long-term financing in countries whose financial markets are still evolving and the business environment remains fragile, with local banks and foreign investors reluctant to commit funds to small and medium-sized enterprises (SMEs). The programs offered by the Funds range from venture capital to lending for micro-enterprises. The Funds have also assisted enterprises by providing limited technical assistance and training. Private boards of directors set policy and oversee the management of the Funds. Some boards have performed extremely well, while others have had mixed results. The following table shows the financial status of the Enterprise Funds and European Bank for Reconstruction and Development (EBRD) Small Business Funds operating in the Eurasian region as of the end of FY 2003:

Fund	Funds Authorized	Funds Obligated	Funds Expended
Enterprise Funds
- The U.S.-Russia Investment Fund (TUSRIF)	$440m	$317m	$303m
- Western NIS Enterprise Fund (WNISEF)	$150m	$142m	$114m
- Central Asian - American Enterprise Fund (CAAEF)	$150m	$106m	$106m
Subtotal	$740m	$565m	$523m
EBRD Small Business Funds
- Russia Small Business Fund	$35m	$35m	$29.4m
- Lower Volga Regional Venture Fund	$20m	$20m	$14.3m
Subtotal	$55m	$55m	$43.7m
Total	$795m	$620m	$566.7m

The U.S.-Russia Investment Fund (TUSRIF)

The U.S.-Russia Investment Fund (TUSRIF) was created in April 1995 as the result of the consolidation of the Russian-American Enterprise Fund (RAEF) and the Fund for Large Enterprises in Russia (FLER). The planned capitalization for TUSRIF is $440.0 million. TUSRIF has offices in New York, Moscow, Yekaterinburg (Urals), Khabarovsk, Yuzhno-Sakhalin, Vladivostok (Russian Far East), Rostov-on-Don (Southeast Russia), and St. Petersburg (Northwest Russia). In 1999, TUSRIF established a private management company, Delta Capital Management, to raise funding from private sources and from international financial institutions (IFIs). TUSRIF provides financial services to small and medium-sized Russian firms through five subsidiaries: a wholly owned bank and four financial services. Additional information on TUSRIF is available at the Fund's website: http://www.usrussiafund.ru

Western NIS Enterprise Fund (WNISEF)

WNISEF was established in 1994 to accelerate private sector development in the three Western NIS countries, Ukraine, Moldova, and Belarus, by providing technical assistance and capital to SMEs. Of the $150.0 million originally authorized, $141.7 million has been obligated. In the interests of conserving resources, WNISEF closed its representative office in Minsk in September 2003 but continues to monitor the economic environment in Belarus through the Kiev office.

WNISEF currently has outstanding commitments to 14 companies, totaling approximately $52 million. These companies employ approximately 11,000 people. The financial results of the individual portfolio companies, as audited by international accounting firms, are impressive, with the majority achieving consistent double-digit growth year-on-year, in terms of sales revenues and profitability. During the period October 2002 to March 2003, WNISEF demonstrated that investing in Ukraine and Moldova created value for WNISEF and for the economies in which it operates. Examples include the following:

• The successful sale to an international company of Vitana-Intravest, the market leader in Moldova's brewery and soft-drink sector. The Fund's investment of $4.7 million for 85% of this joint stock company returned a 2.2 times cash-on-cash return for an internal rate of return of 20%.
• The Fund entered into a management buyout contract for Ecoprod (agricultural distribution company).
• Two of the Fund's portfolio companies in Ukraine are planning to undergo leveraged recapitalization, which will provide WNISEF with partial returns of the capital invested in each company.

The Ukraine-based International Center for Policy Studies recently analyzed the economic impact of WNISEF's portfolio investments. This study provides a comprehensive economic assessment of the quantitative effects (direct, indirect and induced) on economic development in Ukraine and Moldova produced by 12 select WNISEF portfolio companies from 1997-2002. The study showed that for each dollar invested by WNISEF, approximately eight dollars of additional incremental value was created in the marketplace.

WNISEF's Small Business Lending Program has evolved from a direct-lending operation into two financial consortia with the International Finance Corporation (IFC), EBRD and the DOEN Foundation. In Ukraine, the Micro Finance Bank has disbursed 12,344 loans totaling $67.1 million, with a delinquency rate of only 1.2%. In Moldova, Microenterprise Credit of Moldova has disbursed 2,987 loans totaling $12.4 million, with a 0% delinquency rate. WNISEF plans to increase its equity interest in AgroIndBank of Moldova from its current 9.9% to 17 to 20%. With this transaction, WNISEF together with EBRD and the Management Group intends to consolidate a majority ownership interest in the bank in order to facilitate an exit as soon as 2004.

WNISEF has entered a franchise arrangement with Delta Capital (see TUSRIF section above) to develop a home mortgage lending institution. WNISEF is actively engaged with USAID and the Mortgage Bankers' Association in this venture.

Central Asian - American Enterprise Fund (CAAEF)

The Central Asian-American Enterprise Fund (CAAEF) was created in 1994 to promote the creation of small and medium-sized businesses in Central Asia. The CAAEF has a total authorized capitalization of $150.0 million, of which $111.0 million has been obligated to date. Business conditions in most of Central Asia are extremely difficult especially for equity investments, which make up the majority of the Fund's portfolio. FY 2001 was a particularly difficult year for the CAAEF. By the end of year, especially after September 11, 2001, investor interest and business conditions in Central Asia deteriorated dramatically. The Fund is in the process of winding down its loan programs and will exit its equity investments as soon as is feasible.

Lower Volga Regional Venture Fund (LVRVF)

The LVRVF is one of twelve EBRD Russian regional venture funds. The LVRVF is part of an initiative agreed upon by the G-7 governments and the European Union at the Tokyo Summit in July 1993 to support SME development in Russia. The LVRVF opened for business in May 1995 with a $30.0 million capital commitment from the EBRD, a $3.0 million commitment from the fund manager, and a pledge of $20.0 million from USAID to cover technical assistance and operating costs during the ten-year life of the fund. The LVRVF has adapted an early-stage venture capital investment strategy that actively participates in corporate governance and invests in above-average-growth companies in the Volgograd, Samara and Saratov regions. As of September 30, 2003, the LVRVF's cumulative investment were $24.9 million in eleven investments, with $14.3 million of the USAID grant utilized for operating expenses and technical assistance to firms. Six investment opportunities are in the project pipeline-the Fund's management expects to be fully invested by the end of 2004.

EBRD Russia Small Business Fund

At the Tokyo G-7 Summit in 1993, the G-7 and Russian Governments asked the EBRD to establish and manage a Russia Small Business Fund (RSBF) through contributions from the EBRD, G-7 members and Switzerland. The RSBF provides loans to small and micro-enterprises through selected Russian commercial banks to provide small businesses with finance and strengthen the capacity of the Russian banking sector to lend to small businesses. The RSBF makes available loans of up to $150,000 with maturities of up to three years. In some cases, a loan amount can go up to $500,000 to finance production equipment or the acquisition of real estate. Such financing has not been previously available to small firms from local banks. The USG pledged $30.0 million to the RSBF at the Tokyo Summit, which primarily financed technical assistance to the banks implementing the program. In 1998, the U.S. Government agreed to contribute an additional $5.0 million in loan capital, with at least 50 percent of these funds to go to the Regional Initiative (RI) sites of Samara, Novgorod, and the Russian Far East.

As of June 30, 2003, USAID's $35.0 million had leveraged a total of $902.7 million in RSBF disbursements for 91,175 loans to Russian enterprises through partner banks. The outstanding portfolio amounts to $208 million in 35,408 loans; KMB Bank continues to be responsible for the major portion (75% of the portfolio in volume and 69% in terms of number of loans). Repayment rates on both micro- and small loans remain excellent. Loans in arrears over 30 days account for only 1.0% of the RSBF's total outstanding portfolio.

EURASIAN-AMERICAN PARTNERSHIP FOR ENVIRONMENTALLY SUSTAINABLE ECONOMIES (ECOLINKS)

EcoLinks actively promotes environmental technology transfer, market-based partnerships and environmental best practices that address critical environmental problems in municipalities and industries in Europe and Eurasia. Since the program's inception in 1999, EcoLinks activities have leveraged more than $20 million in trade and investment in Eurasia. EcoLinks coordinates business partnership building efforts using its trade network and grants. Challenge Grants were available for project pre-feasibility studies until 2002; smaller Quick-Response Awards are currently used to bring potential partners together to initiate business cooperation.

EcoLinks has trade offices and provides grants to build environmental business partnerships in Armenia, Georgia, Kazakhstan, Moldova, Ukraine and the Russian Far East. The most active countries for EcoLinks grants are Ukraine and Kazakhstan. In 2003, EcoLinks facilitated the participation of Kazakhstani water infrastructure and mining delegations in U.S. environmental trade events. In FY 2003, EcoLinks awarded eight Quick-Response Awards to Eurasian firms totaling $33,831 and one follow-on Challenge Grant in Ukraine totaling approximately $9,500. In FY 2003, EcoLinks facilitated more than $10 million in environmental trade and investment in Eurasia, including purchases of more than $6 million in U.S. goods and services.

In FY 2004, EcoLinks will lead a U.S. private-sector environmental technology delegation and environmental project seminar in Kazakhstan and Uzbekistan in May. To promote additional environmental technology business activities in Eurasia, EcoLinks will also lead a delegation of U.S. firms and Ukrainian mining companies to a regional mine clean-up event in June.

FARMER-TO-FARMER (FTF) PROGRAM

The John Ogonowski Farmer-to-Farmer Program is congressionally mandated and funded through the Farm Bill, with P.L. 480 funds transferred to USAID for program implementation. The Eurasian component of the Program operates in all 12 countries of Eurasia and was set to end in FY 2003. Following an external evaluation of the Farmer-to-Farmer Program that recommended continuing the current FTF activities in Eurasia, the Program's four cooperative agreements have been extended to the end of FY 2007. Beginning in FY 2004, the program will increasingly focus on volunteer technical assistance in specific agricultural commodity sectors.

FTF provides short-term agricultural technical assistance through U.S. volunteers to facilitate the transition to a free-market economy. The FTF Program focuses on agribusiness development, including production, credit, processing, marketing, development of associations and cooperatives and agricultural/business training. FTF is implemented by a consortium of private voluntary organizations (PVOs) and cooperative development organizations, including Agricultural Cooperative Development International/Volunteers in Overseas Cooperative Assistance (ACDI/VOCA), the Citizens' Network for Foreign Affairs (CNFA), Land O'Lakes, Winrock International and Mercy Corps International. In many Eurasian countries, FTF works with other USAID and U.S. Department of Agriculture grantees and the Peace Corps. The FTF Program seeks to increase sustainability of private agribusiness through improved technologies and business management practices, help farmers' associations and cooperatives improve service delivery and advocacy efforts, strengthen rural finance systems to provide credit and other services to agricultural enterprises, develop and disseminate best practices for volunteer technical assistance, and improve environmental and natural resource management.

In FY 2003, FTF volunteers assisted 355 organizations representing 25,245 beneficiaries in the Eurasian countries, including 10,802 individual producers, processors and rural credit specialists who received formal training under the FTF Program. Surveys of participating organizations showed that 94% of them increased both their annual production and profits. FTF volunteers also helped farmers and farm groups form 26 new organizations in the region this year, as well as helping 80 existing organizations increase their memberships. Participating organizations surveyed indicated that 97% successfully intervened with government or business on behalf of their members. FTF volunteer assistance to the rural financial sector increased credit opportunities for farmers and agribusinesses: 88% of financial institutions surveyed reported an increase in the number of agricultural-related loans and 91% improved overall banking services provided to the agricultural sector. The FTF Program also focuses on assisting women entrepreneurs and women farm-owners and managers. FTF volunteers have provided training and advice in management and accounting skills, technical and handicraft skills for rural women, and training in the provision of social services for rural women. Of the 25,245 Eurasian beneficiaries of FTF volunteer assistance in FY 2003, 40% were women. The following tables show the number of Eurasian participants trained and the number of FTF volunteers fielded in FY 2003, by country:

Armenia Azerbaijan Georgia	Russia	Belarus Moldova Ukraine	Kazakhstan Kyrgyz Rep. Tajikistan Turkmenistan Uzbekistan	TOTAL
358	3,386	2,679	4,379	10,802

Country	Total Fielded FY 2003	Total Fielded FY 2000-03
Armenia	26	103
Georgia	25	114
Azerbaijan	25	113
Caucasus Subtotal	76	330
Kazakhstan	34	128
Kyrgyz Republic	20	114
Tajikistan	28	74
Turkmenistan	28	104
Uzbekistan	41	134
Central Asia Subtotal	151	554
Ukraine	42	164
Moldova	32	118
Belarus	13	36
West Eurasia Subtotal	87	318
Russia	125	569
TOTAL	439	1,771

U.S.-ISRAEL COOPERATIVE DEVELOPMENT RESEARCH PROGRAM (CDR)

The USAID-funded Cooperative Development Research (CDR) Program was established in 1985 to support joint applied research projects involving Israeli scientists and their counterparts in developing countries. In 1992, a special initiative extended the program to Kazakhstan, the Kyrgyz Republic, Turkmenistan, Uzbekistan, and Georgia. The Eurasian component of the CDR program focuses primarily on research in arid-lands agriculture - an area of Israeli expertise and particular need in Central Asia - and includes projects in water management and environmental protection as well as agronomy and livestock management.

Since 1993, the Eurasian component of the CDR Program has awarded approximately 90 research grants of up to $150,000 each, a figure that does not include the considerable matching funds provided by Israeli research institutions. Program funding for each annual review cycle has been $1.5 million. Projects are chosen from proposals jointly authored by Israeli and recipient-county scientists, and selections made by USAID on the advice of peer review panels composed of U.S. scientists. Technical accomplishments achieved in FY 2003 included the following:

Georgia: Demonstration of the potential of continuing land reforms to enhance agricultural production; initiation of field tests of candidate biocontrol formulations containing different types of insecticidal fungi to control common and damaging agricultural pests.

Kazakhstan: Establishment of a collection of native apricot landraces for identification of lines with resistance to plum pox virus; measurement of groundwater dynamics on a major river delta to provide guidance for water resource management and contamination abatement; identification of plant species capable of phytoremediating soil contaminated with heavy metals and radionuclides.

Kyrgyz Republic: Development and implementation of an automated irrigation scheduling system that distributes appropriate irrigation amounts directly to farmers on a daily basis, and an improved understanding of contaminant flow and retention in Lake Issyk-Kul.

Turkmenistan: Delineation of the hydrogeological research area for a geophysical survey and completion of the first phase of seismic data collection toward the ultimate goal of improving groundwater exploration and management; moved promising candidate varieties of saltgrass into field testing for suitability for reclaiming land in the Aral Sea Basin; obtained initial results demonstrating the feasibility of ecologically extracting valuable minerals from naturally occurring brines; developed policy recommendations from a study showing that liberalization of government agricultural policies on trade and land tenure would improve the agricultural economy.

Uzbekistan: Generation of initial attenuated strains of Babesia spp. to be developed into a vaccine against bovine babesiosis; construction of a pilot plant to test improved techniques to control dust pollution from the cottonseed oil industry.

In addition, results of earlier CDR-funded grants are being taken to the next stage of implementation. For example, an Israeli-Uzbek project developed and tested a vaccine against the strain of Theileria annulata found in Central Asia, and this vaccine is now being promoted for commercialization and wide scale distribution, with a potential regional market totaling over ten million cattle. The CDR Program has also provided valuable links to otherwise isolated scientific communities in Central Asia and Georgia. It has funded research equipment, international travel, periodicals, publications, and access to electronic mail. The training of students from the region, both in their home countries and in Israel, is a key part of nearly every CDR grant. Central Asian scientists are using the training and equipment to continue their own research after their CDR-funded grants have ended. Due to budgetary constraints, there is no further funding for the Eurasian component of the CDR Program; new grants will continue to be awarded using previously received funding, but no new proposals will be accepted.

SUPPORT FOR THE GLOBAL FUND TO FIGHT AIDS, TUBERCULOSIS AND MALARIA

The Global Fund to Fight AIDS, Tuberculosis and Malaria was established in January 2002 as a multilateral financial instrument to complement existing donor programs addressing these three diseases worldwide. The purpose of the Global Fund is to attract, manage and disburse additional resources through public/private partnerships. Several countries in the region have already applied for funding, and have been awarded first-year grants to begin implementation of comprehensive responses. In 2003, USAID provided technical assistance for Uzbekistan's application to the Global Fund. The grant application was approved for $24.5 million over five years. USAID also provided $52,000 to support a regional workshop for all first- and second-round recipients of Global Fund monies in Kiev, Ukraine. During the workshop, preliminary assessments of the recipients' future technical needs were prepared and country implementation plans were drafted.

TUBERCULOSIS (TB) CONTROL PROGRAMS

In 1998, USAID established its first TB control pilot project in the Eurasia region in Almaty, Kazakhstan. By 2003, USAID investments had expanded to include TB control activities in 14 countries across Europe and Eurasia, in an effort to help host governments control TB through implementation of the World Health Organization's (WHO) Directly Observed Therapy, Short-Course (DOTS) strategy. A recent evaluation assessed the impact of USAID'S five-year investment in assistance to TB programs in seven countries, including Russia, Kazakhstan, Uzbekistan and Ukraine. The evaluation results indicated that the implementation of DOTS had expanded and performance had improved, political support for TB control based on the DOTS strategy had increased, and progress had been made in managing multi-drug-resistant TB. Other results of USAID's TB activities include the following: (1) standardizing TB treatment regimens and increasing the use of sputum smear microscopy in the diagnosis of TB; (2) establishing a high-level working group for TB in Russia to decrease opposition to the DOTS approach; (3) approaching or surpassing the WHO target of 85% treatment success rates in pilot sites of Orel Oblast (Russia) and Uzbekistan; and (4) reducing TB-related mortality by 37% since activities began in 1998 in Kazakhstan. USAID and the Centers for Disease Control and Prevention (CDC) estimate that more than 20,000 TB deaths were prevented in Kazakhstan between 1998 and 2003.

COMBATING IODINE DEFICIENCY DISORDER

Iodine deficiency disorder (IDD) is the world's leading cause of preventable mental retardation. Populations with even modest IDD show reductions in children's IQs of 10 to 15%. Largely through the efforts of UNICEF, Kiwanis and USAID, 70% of the world's population now has access to iodized salt, but in the Eurasian region, only approximately 28% of households use iodized salt. Since FY 2000, USAID has invested $3.9 million in IDD programs in Europe and Eurasia, and the investment is showing results. For example, a 2003 national household survey conducted in Georgia showed 67.5% of households using adequately iodized salt, up from a mere 8.1% in 1999. The result shows that universal salt iodization (i.e., 90% of households) is possible in Europe and Eurasia, and Georgia is well on its way to reaching this goal.

COMPARATIVE REPORT ON REPRODUCTIVE, MATERNAL AND CHILD HEALTH IN EASTERN EUROPE AND EURASIA

Through the CDC and ORC/Macro International, USAID funded the preparation of a comparative report on data from 16 health surveys conducted in 12 countries in Eastern Europe and Eurasia. The report, which was completed in 2003, covered Armenia, Azerbaijan, Georgia, Kazakhstan, the Kyrgyz Republic, Moldova, Russia, Turkmenistan, Ukraine and Uzbekistan. The surveys asked a series of questions of women of reproductive age, producing vital information on fertility rates, abortion rates, contraceptive prevalence, knowledge of HIV/AIDS, percentages of babies breastfed, anemia rates, infant mortality rates, sexual knowledge and behavior of young adults, and the extent of domestic violence. The data included evidence that in areas with greater prevalence of the use of modern contraceptive methods, abortion was less common. The report provides essential information for policy-makers and will influence future programming in family planning, reproductive/maternal health, and child survival.

NEONATAL RESUSCIATATION TRAINING

By the end of FY 2003, nearly 20,000 medical personnel had received training in neonatal resuscitation techniques, based on the guidelines of the American Academy of Pediatrics. This number includes 3,400 obstetrical and neonatal health care personnel that received training in FY 2003 at the 17 neonatal resuscitation training centers (NRTCs) located in six Eurasian countries supported by USAID's Health Partnerships Program: Armenia, Azerbaijan, Georgia, Russia, Ukraine and Uzbekistan.

During FY 2003, data collection was initiated for the second round of a study designed to analyze birth outcomes among NRTCs. The first round of the study found that infants born at institutions with more than 25% of maternity/neonatal service personnel trained in neonatal resuscitation, compared with institutions having smaller percentages trained, had better outcomes related to such factors as Apgar scores, central nervous system complications, and incidence of asphyxia and respiratory distress syndrome. Analysis of data will be completed in FY 2004 to determine if infant outcomes during the second round follow the same pattern as during the first round.

WOMEN'S WELLNESS CENTERS

USAID supports the cross-border work of nearly 30 Women's Wellness Centers (WWCs) in Armenia, Belarus, Georgia, Kazakhstan, Moldova, Russia, Ukraine and Uzbekistan. Each WWC provides a client-centered approach to health-care services that addresses women's needs throughout their lives and offers a comprehensive range of ambulatory clinical and educational services, including early detection, screening, disease prevention and health-promotion services. During FY 2003, approximately 550,000 patient visits were recorded in these centers. A workshop on clinical practice guidelines (CPGs) was held in Odesa, Ukraine, for WWC directors and focused on development, adaptation and use of CPGs to improve the quality of care. Participants received copies of American International Health Alliance's (AIHA) CPG Process Manual.

SUPPORT FOR NATIONAL INFECTION CONTROL PROGRAMS

As part of a region-wide initiative, AIHA has cooperated with Ministries of Health in Georgia, Kazakhstan, Russia, and Ukraine to assist in the development of national infection control programs. As of the end of FY 2003, a total of 4,363 medical professionals had received continuing education in modern infection control practices. Production of the second edition of an Infection Control Manual was completed in FY 2003. The manual, which was produced in both English and Russian, contains information on infection control programs, surveillance, common microorganisms and antibiotic resistance. The manual was distributed at the Third International Russian Applied Research Conference held in St. Petersburg in September 2003, and will also be sent to USAID missions, Ministries of Health, AIHA partners, regional health authorities, infection control training centers, and sanitary epidemiology station (SES) offices.

During FY 2003, an evaluation survey of Eurasian laboratories using the WHO's WHONET database software (which was developed for the management of microbiology laboratory data and the analysis of antimicrobial susceptibility test results) found that 13 of 18 labs established by AIHA since 1997 were still functioning. The 13 WHONET labs reported routinely conducting surveillance of antibiotic resistance at their home institutions and for outside groups, and maintaining current WHONET databases. Half of these laboratories had produced recommendations on antibiotic use based on the results of surveillance, and a smaller number of labs had been able to influence policy decisions. AIHA also designed and conducted a survey to assess hospital-based infection control capacity and surveillance within the Eurasian countries.

HUMANITARIAN PROGRAMS

U.S. DEPARTMENT OF AGRICULTURE (USDA) - FOOD ASSISTANCE PROGRAMS

In FY 2003, USDA provided approximately $64.47 million in humanitarian aid to the Eurasian countries, including $42.50 million in targeted direct-feeding and food-aid monetization programs implemented by private voluntary organizations (PVOs). An overview of these programs is provided below:

Country	Allocation	Metric Tons	Implementing Organizations
Azerbaijan	$6.09 million	approx. 13,300	Relief International International Relief and Development Vishnevskaya-Rostropovich Foundation
Georgia	$11.89 million	approx. 50,000	Government of Georgia
Kyrgyz Rep.	$3.32 million	approx. 1,390	Mercy Corp
Moldova	$15.05 million	approx. 23,520	International Partnership for Human Development
Russia	$9.98 million	approx. 37,000	Russian Farm Community Project
Tajikistan	$8.06 million	approx. 14,000	Cooperative for Assistance and Relief Everywhere, Inc. Counterpart International Mercy Corps Save the Children
Uzbekistan	$10.08 million	approx. 56,700	Government of Uzbekistan

U.S. DEPARTMENT OF AGRICULTURE (USDA) - EXPORT CREDIT GUARANTEE PROGRAMS

In FY 2003, USDA allocated $99 million in export guarantee programs to the Eurasian countries. These programs include the GSM-102 Program, GSM-103 Program, Supplier Credit Guarantee Program (SCGP), and the Facility Guarantee Program (FGP). These programs encourage U.S. agricultural exports to buyers in countries where credit is necessary to maintain or increase U.S. sales, but where financing may not be available without such credit guarantees. Two programs underwrite credit extended by the private banking sector in the United States to approved foreign banks using dollar-denominated, irrevocable letters of credit to pay for food and agricultural products sold to foreign buyers. The GSM-102 Program covers credit terms up to three years. The GSM-103 Program covers longer credit terms up to ten years. The SCGP helps U.S. exporters offer competitive, open-account financing to foreign buyers. Under this program, USDA reduces the financial risk to exporters by guaranteeing a large portion of the payments due from importers on short-term credit extended by the exporters or U.S. financial institutions. The FGP is designed to expand sales of U.S. agricultural products to emerging markets where the demand for such products maybe constrained due to inadequate storage, processing, or handling capabilities. The program provides payment guarantees to facilitate the financing of manufactured goods and services exported from the Untied States to improve or establish agriculture-related facilities in emerging markets.

A country-by-country overview of these programs is provided below.

Country	Program	Allocation	Registered Exports
Armenia	SGCP	$5 million	---
Azerbaijan	GSM-102 SCGP	$7 million $7 million	--- ---
Kazakhstan	GSM-102 SCGP	$10 million $15 million	$3.5 million $1.8 million
Russia	GSM-102  SCGP	$27 million $13 million	$25.70 million  $6 million
Ukraine	SCGP	$15 million	$10.2 million

U.S. DEPARTMENT OF STATE - COORDINATOR'S OFFICE HUMANITARIAN ASSISTANCE

In FY 2003, the Humanitarian Programs Division of the Office of the Coordinator of U.S. Assistance to Europe and Eurasia provided over $232 million in U.S. Defense Department excess and privately donated commodities to the Eurasian countries at a cost to the U.S. Government of just over $21 million. The leveraged commodities were provided to those segments of the population who are most in need of humanitarian relief. For more detailed descriptions of this assistance, please see the country assessments in Part II of this report.

Country	Air Shipments	Ground Shipments	Cargo Value (millions)	Transp. Cost (millions)	Total Assistance
Armenia	5	76	$14.42	$1.52	$15.94
Azerbaijan	6	104	$21.90	$1.56	$23.46
Belarus	2	68	$14.92	$0.69	$15.61
Georgia	10	67	$15.63	$2.66	$18.29
Kazakhstan	0	85	$9.77	$0.84	$10.61
Kyrgyz Republic	6	95	$15.64	$1.64	$17.28
Moldova	1	73	$12.32	$1.16	$13.48
Russia	0	59	$6.63	$2.26	$8.89
Tajikistan	4	125	$46.98	$4.01	$50.99
Turkmenistan	0	26	$2.17	$0.51	$2.68
Ukraine	1	301	$30.09	$2.76	$32.85
Uzbekistan	7	102	$41.99	$1.43	$43.42
TOTAL	42	1,181	$232.48	$21.04	$253.52

NUCLEAR SAFETY PROGRAMS

U.S. DEPARTMENT OF ENERGY (DOE) - NATIONAL NUCLEAR SECURITY ADMINISTRATION -
INTERNATIONAL EMERGENCY MANAGEMENT AND COOPERATION (IEMC)

IEMC assists several Eurasian countries with the development and integration of emergency programs, including communications systems, networks and training; development and implementation of procedures and policy for response; training of advisory personnel, responders and decision-makers; readiness assurance; and development and implementation of exercise programs. IEMC provides technical assistance and training assistance tailored to specific needs and requests. These core elements are integrated into a partner country's national "command center" during an emergency, facilitating a national program to respond effectively to accidents. Effective responders can mitigate consequences; notify, instruct, and protect affected populations; protect the environment; and protect workers. IEMC collaborations yield safer nuclear emergency response systems in case of emergency, with data exchange between national agencies command centers for rapid, reliable bilateral/multilateral communication and information exchange. IEMC's Emergency Procedures Assistance Program is helping the Eurasian countries formulate emergency operating procedures, thereby providing for consistent procedures and, more importantly, a measure of assurance that personnel can properly handle emergency or potential emergency situations. IEMC also provides information and assistance in developing emergency operations centers. This involves establishing global partnerships to help design, equip, and set up the emergency centers to ensure effective communication and response in mitigating nuclear accidents/incidents.

IEMC projects have been undertaken in Armenia, Georgia, Russia and Ukraine. IEMC also collaborates with Eurasian countries through international organizations such as the International Atomic Energy Agency (IAEA), North Atlantic Treaty Organization (NATO), European Union (EU) and Nuclear Energy Agency (NEA) to ensure a consistent approach to nuclear safety throughout the region.

Armenia: IEMC conducted information and project exchanges with Armenia on emergency management cooperation and information sharing. In conjunction with the IAEA, Nuclear Regulatory Commission (NRC), and the U.S. Department of State, IEMC is providing assistance to Armenia in a pilot program to enhance the public health and safety aspects of radioactive source control programs. IEMC is also holding preliminary discussions regarding assistance to develop an enhanced crisis center with a connection to the headquarters of the Armenian Atomic Energy Agency. In addition, IEMC provided equipment to Armenia for personnel dosimetry, emergency response, and radiation detection and surveying.

Georgia: IEMC provided technical expertise and equipment, including an advanced radiological computer survey (ARCS) unit and other handheld detection equipment, to the IAEA to assist Georgia in its search for orphan radiological sources.

Russia: IEMC helped establish and is continuing to work with the Situation and Crisis Center (SCC) at the headquarters of the Ministry of Atomic Energy (MinAtom). Opened in October 1999, the SCC provides a capability similar to the DOE Emergency Operations Center, which helps ensure early warning and notification of nuclear/radiological concerns. The SCC also facilitates direct information exchange through video and data links. IEMC has worked with MinAtom to establish an emergency management planning, preparedness, and training program. Another collaborative exercise is scheduled for FY 2004. Other activities planned for FY 2004 include connecting three Russian facilities to the Russian Ministry for Atomic Energy's (MinAtom) Situation and Crisis Center, boosting the network to a total of 10 sites. IEMC also plans to connect the Russian Ministry of Civil Defense, Emergencies, and Elimination of Consequences of Natural Disasters (EMERCOM) and Russia's Nuclear Safety Institute to the MinAtom network.

Ukraine: IEMC is helping to establish an emergency-preparedness training program and an offsite emergency and training center. IEMC is working with the Ukrainians to develop satellite emergency communication among their nuclear power plants, the headquarters of EnergoAtom (Ukraine's national nuclear utility company), and the offsite emergency and training center. IEMC-provided voice, data and video connections will enable effective communication in the event of a nuclear emergency.

U.S. NUCLEAR REGULATORY COMMISSION (NRC) NUCLEAR SAFETY REGULATION PROGRAM

The NRC, a small, independent federal agency, began providing nuclear safety and regulatory assistance to the former Soviet Union in 1988, two years after the accident at the Chornobyl Nuclear Power Plant. Following the break-up of the Soviet Union, the NRC's nuclear safety assistance activities expanded to include European and Eurasian countries where Soviet-designed nuclear power plants were in operation (Armenia, Bulgaria, Czech Republic, Hungary, Kazakhstan, Lithuania, Russia, Slovak Republic and Ukraine). Since FY 1992, NRC has received approximately $45.25 million in FREEDOM Support Act (FSA) funds to support nuclear safety assistance activities in the Eurasian countries.

Armenia: Since 1994, the NRC has provided to the Armenian Nuclear Regulatory Authority (ANRA) training in fire protection, radiation embrittlement of metals, radioactive waste and spent-fuel management, seismic issues, and decommissioning of nuclear power plants. The NRC has also supported ANRA in developing its safety analysis review capability. In FY 2003, the NRC helped ANRA complete a computer model that simulates the impact of earthquakes on the Metsamor Nuclear Power Plant. The NRC also helped ANRA complete and submit for parliamentary consideration proposed revisions to Armenia's basic nuclear law to strengthen safety and security requirements for radioactive sources.

Kazakhstan: Since 1994, the NRC has provided training for Kazakhstani Atomic Energy Committee (KAEC) personnel in fire protection, radioactive waste and spent fuel management, emergency planning and emergency response, and inspection of research reactors. Specific accomplishments achieved during FY 2003 include development of a Kazakhstani national-level plan for responding to radiological emergencies and development of a specific regulation covering processing and disposal of low and intermediate-level nuclear waste and sodium processing associated with BN-350 fast breeder reactor decommissioning efforts.

Russia: Since 1992, the NRC has provided assistance to the Russian Federal Nuclear and Radiation Safety Authority (GosAtomNadzor or GAN) in developing a legislative basis for nuclear regulation and legal enforcement, an emergency response capability, an analytical simulator and regulatory training programs and a training center. During FY 2003, the NRC conducted workshops on the NRC's current spent fuel storage requirements and on processes and procedures for conducting licensing reviews for modernizing the operation of nuclear power plants. The NRC also completed a probabilistic risk assessment for the Kalinin nuclear power plant.

Ukraine: Since 1992, the NRC has provided assistance to the State Nuclear Regulatory Committee of Ukraine (SNRCU) in licensing nuclear power plants and developing emergency response capabilities, a legislative basis for nuclear regulation and legal enforcement, and an analytical simulator and training center. During FY 2003, the NCR worked with the SNRCU to complete 22 of 36 regulatory reviews needed to support licensing of three pilot nuclear power plants and developed 10 of 40 inspection procedures needed to support licensing of two nuclear power plants currently under construction. The NRC also completed a computer model that simulates neutron irradiation of VVER-1000 and VVER-440 reactor pressure vessels and completed construction of SNRCU's new emergency response center.

U.S. GOVERNMENT SUPPORT FOR THE CHORNOBYL SHELTER FUND

The construction of a new safe containment structure over Ukraine's damaged Chernobyl Unit 4 is expected to be completed by 2008. The new structure will stabilize and replace the existing deteriorating "sarcophagus," which was constructed in haste under extremely hazardous conditions and which was never intended to serve as a permanent entombment structure. The Chernobyl Shelter Fund is managed by the European Bank for Reconstruction and Development (EBRD), which in 1997 assembled a group of 26 contributing nations, including the United States, that pledged to fund the new shelter. Implementation of the project is contracted to a project management consortium led by Bechtel.

As of late 2003, a number of key milestones had been achieved in term of tenders, regulatory review and approval, and construction of support facilities. This stage was reached after a lengthy period of finalization of the conceptual design for the shelter. The tendering process has been completed for the installation of an integrated monitoring system, and two pre-qualification bids have been received for the stabilization component of the project, which has been reviewed and approved by the Nuclear Regulatory Committee of Ukraine. The new safe containment structure, the largest and most significant component, is proceeding on schedule. Tender documents are being reviewed by the nuclear regulators, and a competitive bidding process, with up to five proposals, is anticipated. A tender for site-clearing leading to the construction of the new containment is also due to be released shortly.

The finalization of the conceptual design for the new safe containment structure in 2003 necessitated a revision of the project's budget - the first revision since the initial estimate of $758 million in 1997. The revised budget is now substantially higher. In 2004, the EBRD will be seeking to receive donor commitments to close the budget gap.