AMBASSADOR RETZER DISCUSSES HIV/AIDS, MALARIA

UNCLAS SECTION 01 OF 03 DAR ES SALAAM 001090 SIPDIS SENSITIVE SIPDIS DEPT AF/E FOR BYODER, ALSO FOR OES PASS TO USAID, AF/W PASS ALSO TO CDC AND DEPT OF HHS E.O. 12958: N/A TAGS: PGOV PREL EAID TZ SUBJECT: AMBASSADOR RETZER DISCUSSES HIV/AIDS, MALARIA STRATEGIES AND NEXT STEPS ON IRAN WITH TANZANIAN PRIME MINISTER SUMMARY -------------- ¶1. (SBU) In an hour-long lively exchange on June 23, Ambassador Retzer and Tanzania's Prime Minister Edward Lowassa discussed the recent PEPFAR conference in Durban, South Africa, USG plans to accelerate HIV/AIDS testing and to ramp up anti-malaria programs on both the Mainland and in Zanzibar, the need for a National HIV/AIDS Coordinator for the Tanzanian armed forces, as well as the importance of Parliament's passing the HIV Omnibus legislation. The Ambassador and Prime Minister explored possible strategies to include more Tanzanians in many of the non-governmental organizations (NGOs) implementing these programs. They also discussed ways to cooperate both bilaterally and regionally to resolve "hot spot" issues, including Iran and North Korea. END SUMMARY. ¶2. (U) Prime Minister Lowassa thanked the Ambassador for facilitating the May 2006 visit of Tanzania,s President Jakaya Kikwete to the United States stating that President Kikwete was very pleased with the visit and hoped that President Bush would reciprocate with a visit to Tanzania. Ambassador Retzer indicated that such a visit was always a possibility. ¶3. (U) Ambassador Retzer reminded the Prime Minister that several members of the Government of Tanzania (GOT) had participated in a meeting of partners to the President,s Emergency Plan for AIDS Relief (PEPFAR) in Durban, South Africa June 12 to 16 and that the Ambassador wanted to discuss recent developments and matters arising from Durban. Updated PM on HIV/AIDS and Malaria Programs -------------- ¶4. (U) The Ambassador shared that USG funding for HIV/AIDS would be increasing from USD 104 million in 2006 to USD 157 million in 2007. He also confirmed that funding for the Presidential Malaria Initiative (PMI) would increase from USD 11.5 in 2006 to USD 28 million in 2007. The Ambassador noted that residual spraying was beginning in Zanzibar. ¶5. (U) Prime Minister Lowassa inquired about malaria resources for the mainland and was told that: -- PMI activities began on Zanzibar because its physical situation (i.e. being an island) made it a good environment to pilot a range of interventions and provided an opportunity to significantly reduce malaria burden. -- USD 8 million of the $11.5 available in 2006 was used for the mainland. -- a significant portion of the proposed $27 million for 2007 will be for the mainland. -- PMI is supporting the national voucher system and will provide enough vouchers for all infants. -- PMI is expanding from three to seven countries in 2007. Importance of Increasing HIV Testing -------------- ¶6. (U) Ambassador Retzer then noted that to meet national treatment targets he believed the following needed to be addressed: there is a need for a significant increase in testing, and to achieve this objective, approaches to testing needed to be modified, such as "opt-out" (provider initiated) testing which is not currently endorsed in the national policy. Dr. J. Temba of TACAIDS responded that a revised policy is being drafted and needs to be approved particularly now that ARVs are available. ¶7. (U) The Prime Minister observed that he knows that villagers want testing so he does not understand why these modifications have not been made. He stated that he would follow-up with the Ministry. Ambassador Retzer then noted that the testing protocol is out of date and hinders scale-up. Access is also limited by the exclusive use of health care providers. Dr. Temba agreed that the policy prohibits lay counselors. Finally, the Ambassador noted that the GOT has run out of test kits and the procurement coordination process does not seem to be working. The Prime DAR ES SAL 00001090 002 OF 003 Minister and Dr. Temba conferred briefly in Kiswahili, and subsequently the Prime Minister stated that he would get back to the Ambassador on this matter. ¶8. (U) Ambassador Retzer shared that the USG intends to implement mobile testing services and home testing in 2007. In addition, he stressed the need to enforce national treatment guidelines that allow Stage IV, HIV patients to begin ART without CD-4 blood testing. Dr. Temba agreed that a provider can use clinical assessment to start ARVs. PM Lowassa said he had been told that there are insufficient ARVs in Tanzania to accelerate the scale-up of the ART plan. The USG delegation were surprised and replied that they had no such information. On the contrary, the USG understanding was that some ARVs had expired in storage due to slow roll-out. The Prime Minister stated that he did not understand why there was such a discrepancy between his information and the delegation,s and promised to follow-up with his Minister. The Ambassador told the Prime Minister he needed to know if indeed there was a shortage so he could expedite the scale-up of ART. National Coordinator and HIV Omnibus Legislation Both Key -------------- -------------- ¶9. (U) The Ambassador stressed that a National HIV/AIDS Coordinator needs to be hired for the Tanzanian People's Defense Force (TPDF); this is an important and long-standing issue that has yet to be resolved. The Prime Minister made no comment. Equally importantly, the HIV omnibus legislation needs to be moved forward as it appears to be "bogged down." Dr. Temba stated that the legislation is still in draft and is presently being discussed with communities throughout the &zones8 to solicit comment, feedback, and buy-in. In conclusion, the Ambassador urged that the Emergency Hiring Plan must be implemented as quickly as possible. PM Lowassa said that he was not aware of this initiative but would ask for a briefing. ¶10. (U) Ambassador Retzer then addressed GOT concerns that non-governmental organizations (NGOs) do not hire enough Tanzanians. He recommended that Tanzania consider the South African model in which the government recommends hiring targets at the same time notifying companies that these targets would become mandatory at a later date. The Prime Minister replied that he believed a better approach would be job creation; however, he also stated that NGOs do not try hard enough to find qualified Tanzanians. He noted his appreciation for the Ambassador,s suggestion, and assured him that Tanzania would develop its own model. Asked Tanzania to Take Proactive Role to Speak out on Iran -------------- -------------- ¶11. (SBU) The Ambassador stated that, while the Tanzanian Foreign Minister had said in early June that it was "premature" to comment on Iranian reprocessing of nuclear materials, the U.S. government would appreciate if Tanzania would take a stand and urge the Iranians to begin negotiating. The Prime Minister responded that Tanzania would have no problem responding individually, but that these kinds of public statements needed to be made by regional blocks. The Ambassador acknowledged the need to have consultations among members of regional, blocks but reiterated the U.S. government,s hope that Tanzania would take a lead in these consultations. ¶12. (SBU) Both parties agreed that North Korea is emerging as a serious problem. The Prime Minister added that the Iranians are playing on the "ill-will created by the situation in Iraq." This was followed by a congenial dialogue regarding the context of the question of Iranian processing of nuclear materials. As part of the discussion, cooperation was discussed; an example given by the Prime Minister was Tanzania,s good cooperation on peacekeeping in the region. Meeting Participants -------------- ¶13. (USG): Ambassador Michael Retzer Dr. Stefan Wiktor, Director Center for Disese Control/Tanzania Pamela White, Director USAID/Tanzania Elise Jensen, USAID (notetaker) DAR ES SAL 00001090 003 OF 003 (GOT): Prime Minister Edward Lowassa Dr. J.M.V. Temba, TACAIDS Additional staff WHITE