UNCLAS SECTION 01 OF 02 BRASILIA 001993

SIPDIS

SIPDIS

STATE PASS USAID FOR MARK DYBUL
STATE PLS PASS TO DHHS WASHDC FOR SECRETARY LEAVITT

E.O. 12958: N/A
TAGS: ECON KFLU KHIV SOCI TBIO PGOV BR
SUBJECT: BRAZIL READY TO RE-ENGAGE ON HIV/AIDS COOPERATION

REF: BRASIILIA 931


1. SUMMARY: Ambassador Sobel, USAID Mission Director Jennifer Adams
and CDC Country Director Suzanne Westman met with GOB Minister of
Health Agenor Alvares and the director of the National HIV/AIDS
program, Mariangela Simao, to discuss the potential for expanded
collaboration in health on September 13. Alvares stated his
willingness to reinitiate collaboration with USAID on those aspects
of policy to combat HIV/AIDS where both countries agreed. GoB
priorities for USAID assistance on HIV AIDS are in the areas of:
addressing mother to child transmission, a focus on people living
with AIDS, and selected activities in research and social marketing.
The Ambassador and Alvares also discussed the potential for
cooperation in an Avian Influenza early warning network, as well as
potential for Brazilian technical assistance to Africa. Alvares
will be in Washington for the September 25-27 Pan American Health
Organization (PAHO) meetings and hopes to meet with DHHS Secretary
Leavitt. End Summary.


2. Ambassador Sobel, accompanied by USAID Director Jennifer Adams
and CDC Director Suzanne Westman, met on September 13 with Minister
of Health Agenor Alvares da Silva, who was accompanied by Santiago
Alcazar, Head of the International Affairs Office, and Dr.
Mariangela Batista Galvao Simao, the Director of the National
HIV/AIDS Program. Ambassador Sobel and Dr. Alvares discussed
mechanisms for expanding collaboration on health issues between the
U.S. and Brazil; and addressed specifically Brazil's interest in
resuming USAID assistance for HIV/AIDS activities in Brazil.


3. The Ambassador expressed his satisfaction with the long and
productive collaboration in the health care sector between Brazil
and the U.S. The Minister concurred, and noted that this
collaboration had encompassed several key public health areas, and
involved multiple agencies. Both the Ambassador and the Minister
noted that

last year's disagreement over HIV/AIDS policy and the
termination of USAID's assistance program was an unfortunate
exception. Both he and the National HIV/AIDS Director noted that
there continue to be areas of divergence in U.S. and Brazilian
policy on HIV/AIDS, but that there is ample opportunity to
collaborate on activities of mutual interest. They suggested that
we "agree to disagree" on issues related to abstinence and "Be
Faithful" as a means of HIV prevention, and restrictions related to
prostitution, and focus instead on activities related to people
living with AIDS, mother to child transmission, research, social
marketing and other mutually agreeable components. Ambassador Sobel
indicated that he would take this message to Washington, and
specifically raise it with Mark Dybul, Director of the Office of
Global AIDS Coordination.


4. Ambassador Sobel and Minister Alvares also discussed a broader
agenda of cooperation. The Minister indicated his strong interest
in support for Avian Influenza, including proposed assistance from
CDC and participation in a global early warning network being
established by the Department of Health and Human Services (DHHS).
He also indicated a strong interest in collaboration related to
malaria in the Amazon, and other infectious diseases. The Minister
mentioned the highly developed training capacity in Brazil for
auxiliary health workers, and its suitability for training personnel
from other countries, along with Brazil's interest in making its
technical expertise in health, particularly HIV/AIDS, available to
other countries, including Lusophone Africa.


5. Ambassador Sobel informed the Minister about the imminent arrival
of a health fellow. It was agreed that the health fellow would work
with Ministry representatives to devise a longer-term agenda for
collaboration, including university exchanges and mechanisms to
promote greaterunderstanding of how each country's health system is
structured and operates. Ambassador Sobel noted his personal
interest in corporate social responsibility and his hope that such
efforts could be expanded in the future in support of US/Brazilian
health projects.


6. Minister Alvares told the Ambassador that he would travel to
Washington (September 25-27) for meetings at PAHO. The Ambassador
offered to facilitate a meeting with DHHS Secretary Leavitt.


7. On September 15, Ambassador Sobel, again accompanied by CDC and
USAID Directors, visited the offices of the National HIV/AIDS
Program. Dr. Simao outlined the history of the national program,
highlighting some specific circumstances, such as an early national
response that included an emphasis on treatment, that characterized
the program. In response to the Ambassador's question, Dr. Simao
reiterated that limited assistance in addressing mother to child
transmission, a focus on people living with AIDS, and selected
activities in research and social marketing would be her priorities
for USAID assistance. Dr. Simao concluded that any future program
would be assured of a "relationship of mutual respect."


BRASILIA 00001993 002 OF 002



8. Comment. Despite the tensions between USG and GOB policies on
HIV/AIDS in the past, this is the second time in the last four
months that the Ministry of Health has expressed its interest in
expanding cooperation with the USG in areas of mutual interest
(reftel). We take this as a very positive sign and will coordinate
with USAID and DHHS on steps for moving forward. End Comment.

SOBEL