HHS DEPUTY SECRETARY ALLEN'S JANUARY 18-21 GHANA

UNCLAS SECTION 01 OF 03 ACCRA 000226 SIPDIS E.O. 12958: N/A TAGS: EAID ECON SUBJECT: HHS DEPUTY SECRETARY ALLEN'S JANUARY 18-21 GHANA TRIP Summary -------------- ¶1. Department of Health and Human Services (HHS) Deputy Secretary Claude Allen traveled to Ghana January 18-21, SIPDIS accompanying the President and Board members of the Africa Development Foundation (ADF). The purpose of the trip was to review ADF projects in Ghana and meet with representatives of health and faith-based NGOs to discuss HIV/AIDS and other health-related issues. The HHS/ADF group and Ambassador met January 21 with President Kufuor, during which they emphasized that the Government of Ghana (GoG) needs to improve the investment climate if it expects to compete for funding from the Millennium Challenge Account (MCA). They also discussed ways to increase USG/GoG cooperation in the health field. End Summary. HHS and ADF Visit to Ghana -------------- ¶2. HHS Deputy Secretary (D/S) Claude Allen, ADF President Nathaniel Fields, and ADF Board Members Ernest Green, Ephraim Batameuze and William Ford, visited Ghana January 18-21, 2004, to review ongoing and potential ADF projects in Ghana. D/S Allen also used the visit to discuss health issues, particularly HIV/AIDS, meeting with Ghana's Deputy Minister of Health, Ghana's Country Coordinating Mechanism of the Global Fund, and representatives of health and faith-based organizations. The HHS/ADF delegation and Ambassador Yates met with President Kufuor on January 21 to discuss ADF,s activities in Ghana. Meeting with President Kufuor -------------- ¶3. On January 21, D/S Allen met with President Kufuor and ministers (Private Sector Development Minister Bartels, Energy Minister Nduom, Foreign Minister Akufo-Addo, Finance Minister Osafo-Maafo, Deputy Health Minister Moses Dani-Bah). Ambassador Yates, ADF President Fields and the ADF members also attended. Discussions centered on HIV AIDS programs and Ghana's prospects for economic development. Allen praised Ghana's commitment on fighting HIV/AIDS, and explored in some depth the community philanthropy program of the ADF. President Kufuor responded by thanking the USG for its help on HIV/AIDS, and welcoming ADF's continuing involvement in Ghana. He asked for more USG assistance for Ghana's health care sector and to address Ghana's professional brain drain. "We are a poor country," he said, and asked that ADF's "one-for-one" matching funds requirements be relaxed to a "two-to-one" ratio. Fields said their organization would have 40-50 projects open in Ghana in the coming years, and had high praise for Ghana's efforts in working with ADF. ¶4. D/S Allen encouraged Kufuor to contact Senator Bill Frist, who has made frequent trips to Africa offering medical services, and ask him to assist Ghana,s health care system. Allen would also contact the Senator's office as well. Allen also pledged that HHS would "take a look" at Ghana's brain drain, and offer programmatic support. He praised Ghana's good work on Polio eradication, and said the USG stood ready to assist Ghana on many health care concerns. Allen closed by noting Ghana's potential for qualifying for MCA funds, and its need to improve its performance on various criteria. In particular he focused on Ghana's business climate, saying Ghana needed to do more, and that with "diligence and hard work," Ghana could make itself more open to outside business, and better qualified for MCA funding. Media Coverage -------------- ¶5. D/S Allen and ADF's visit enjoyed wide press coverage, both in state-owned and private media. Most reporting focused on ADF's contributions to Ghana. President Kufuor even mentioned these when listing Ghana's 2003 successes in his January 22 State of the Nation speech. Allen's praise for Ghana's democratic achievement, low HIV/AIDS infection rate, and efforts to eradicate polio during his meeting with President Kufuor also received extensive media attention. Several private papers did note that Ghana is not a recipient of the USG's 2002 USD 15 billion pledge to fight HIV/AIDS tuberculosis and malaria, even though this is not new information in Ghana. Allen also gave a lengthy interview with the Daily Graphic's Health Editor, where he noted possible future U.S.-Ghana links in the area of health. Meeting with Ministry of Health (MOH) -------------- ¶6. During a January 19 meeting with Deputy Minister of Health Moses Dani-Bah, D/S Allen noted the strong collaboration between the two countries, evidenced by significant numbers of Ghanaians, including health personnel, residing in the U.S. Dani-Bah acknowledged the benefits accorded to Ghana through remittances, as well as the development of health care skills through higher education in the U.S. Nevertheless, he requested USG assistance with stemming the "brain drain" of health-industry workers by providing or funding capacity training for health personnel and trainers. Allen noted Ghana,s recent passage of health insurance legislation, to which he drew similarities to recent U.S. reform on Medicare, and noted the importance of the role of the private sector in contributing to objectives and ensuring that public funds are use efficiently and appropriately. Dani-Bah cited geographic and financial access to health services/care as its biggest concern. He also asserted that while HIV/AIDS prevalence in Ghana is relatively low, the GOG would remain vigilant. Meeting with Global Fund Representatives -------------- ¶7. D/S Allen me with local members of the Global Fund Country Coordinating Mechanism (CCM) to discuss programs in Ghana and gauge how the process is working. CCM members explained that while the GoG initially took the lead on establishing the CCM and pushing forward Global Fund activities, the CCM is now encouraging greater private sector participation. Of the 44 current CCM members, only eight represent GoG entities, although the GOG's Ghana Health Service is leading the process. USAID's representative on the CCM commented that Ghana is one of the countries where the CCM process is working well. In fact, many of the problems the CCM-Ghana has experienced were due to slow disbursements and changing guidelines from Geneva. The CCM just received funding for its malaria programs, and is in the process of completing Ghana's malaria drug policy. They set up two HIV/AIDS treatment centers and anti-retroviral drugs just arrived. They are also implementing a TB program, which involves the private sector. One weak area of the local process is that NGOs do not coordinate well, and CCM reps wondered if Global Fund money could be used to improve NGO cooperation. Allen responded that capacity-building funds may be available, and he would look into it upon his return to Washington. Lunch with Health and Faith-Based Organizations -------------- -- ¶8. D/S Allen lunched January 19 with representatives of MOH, Ghana Health Service, faith-based organizations (Papal Nuncio, Christian Council, CRS),technical advisors (WHO Country Rep, Ghana AIDS Commission),and USAID. The discussion focused on HIV/AIDS, with participants explaining that they fight the stigma of AIDS in Ghana through dissemination of information, encouraging public discussions of HIV/AIDS, and making drugs and support services widely available. The discussion also touched on social change interventions targeting cultural practices, and the &a, b, c8 approach ("abstinence, be faithful, condom use"). ¶9. The role of faith-based organizations in addressing individual practices is important, and participants noted that this is a difficult area given deep cultural traditions that transcend religious principles. Much has been learned from Africa's experience in combating HIV/AIDS to date, particularly the significant contribution of abstinence and being faithful, alongside appropriate condom use. HIV/AIDS interventions largely target women's empowerment, but men are a major contributor if not driver of the epidemic. More needs to be done to instill male responsibility, and there is an important role for prevention education among the youth to begin instilling a change in behavior. All agreed that more work is need to strengthen institutional capabilities of on-the-ground organizations working with the infected (or affected). ¶10. Ghanaian representatives asked what insights U.S. institutions could provide on Buruli ulcer, an infectious disease involving the skin, which has reached epidemic levels in Ghana. D/S Allen indicated he would pursue this with NIH. January 19 HIV/AIDS Site Visits -------------- ¶11. D/S Allen traveled to the Coca-Cola (CC) bottling plant in Accra to learn about its workplace HIV/AIDS policy. CC views HIV/AIDS as a business issue, affecting consumers and employees, and feels its corporate responsibility is to enact workplace policies to halt the spread and effects of the virus and ensure a healthy and safe work environment for maximum productivity. CC,s strategy involves awareness programs, using employee training courses, promotions and peer educators. CC also runs an on-site clinic and pays all but 10 percent of HIV treatments. D/S Allen also traveled just outside Accra to see a site where Living Water International (LWI),a U.S. faith-based NGO, provides safe drinking water to a facility for disabled children and adults, many with cerebral palsy. LWI is drilling boreholes with OPIC-financed equipment. ADF Programs in Ghana -------------- ¶12. ADF is supporting 17 projects in Ghana in its effort to support grass-roots economic development to help alleviate poverty. It recently designed and funded four new projects: tomato processing and canning, maize grits production, organic citrus peel and juice processing, and bamboo furniture manufacturing. ADF officials and Ambassador Yates participated on January 20 in a high profile, public signing ceremony for the tomato processing company. Finance Minister Osafo-Maafo, Energy Minister Nduom, and Private Sector Development Minister Bartels participated for the GoG (Comment: Such high-level engagement is unusual, and is a sign of GoG support for ADF's work in Ghana. End Comment). ADF President emphasized that ADF is committed to increasing its funded-projects in Ghana over the next ten years, with a maximum grant support of approximately USD 20 million. Including the four recent projects, ADF hopes to invest in eight to ten new projects in Ghana by summer 2004. ADF Focus on HIV/AIDS -------------- ¶13. On January 21 D/S Allen and ADF reps visited a community in Accra where the ADF-funded group YPEP (Youngsters Peer Education Project) promotes adolescent reproductive health and development through peer education and youth-friendly integrated services. YPEP is a youth AIDS education project where educators provide information on health issues and HIV/AIDS. The goal is to promote responsible sexual behavior and control the incidence and spread of HIV among youths. Comment -------------- ¶14. With the extensive media coverage of the HHS/ADF visit, especially during D/S Allen's meeting with President Kufuor, the trip served to raise awareness in Ghana of health issues, specifically those related to HIV/AIDS, and highlighted USG efforts to assist Ghana in the health sector. The GoG showed itself an enthusiastic partner in the ADF programs in Ghana, and appears eager to support efforts to increase ADF investment into the country. Also useful was D/S Allen's message to President Kufuor that Ghana needs to move past the rhetoric of "The Golden Age of Business" and take concrete steps to improve its investment climate if it is to compete for MCA funds and attract greater foreign investment. End Comment Lanier