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
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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
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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