HIV/AIDS AND THE GLOBAL FUND: EMBASSY TUNIS

UNCLAS TUNIS 002492 SIPDIS SENSITIVE SIPDIS STATE FOR NEA/MAG (HARRIS) AND S/GAC (JEFFERS, MAMACOS, MAZZONE) STATE PASS FOR USAID/GH (MILLER AND WRIGHT),HHS (STEIGER) E.O. 12958: N/A TAGS: EAID KHIV SOCI TBIO TS SUBJECT: HIV/AIDS AND THE GLOBAL FUND: EMBASSY TUNIS PARALLEL REVIEW REF: STATE 158244 ¶1. (U) Per reftel, an interagency committee, comprised of participants from the Health Unit, Public Affairs, the Political and Economic Section, and DOD's Office of Defense Cooperation reviewed the GOT submission to the Global Fund. The following comments are keyed to reftel para 8 questions: ¶A. (U) Proposing group and amount: Tunisia Country Coordinating Mechanism, 17.383 million USD ¶B. (SBU) Overall comments and recommendations for the U.S. Government delegation position: Embassy Tunis recommends that the U.S. delegation support the Tunisian proposal. Despite what is currently a low reported prevalence of HIV/AIDS in Tunisia, growing urbanization and a continued lack of awareness of risk factors and prevention methods on the part of Tunisians increase the likelihood that the disease will continue to spread. The absence of effective epidemiological data collection and monitoring make it difficult to assess the true extent of infection in the country. Embassy Tunis believes that the GOT proposal represents a sound strategy that will begin to address deficiencies in the GOT's epidemiological data collection and monitoring, educational outreach, and medical services for persons living with HIV/AIDS. Educational outreach is critical in the GOT's efforts to prevent not only the spread of HIV/AIDS, but also to removing the stigma currently attached to those suffering from the disease. For these reasons, educational outreach must extend beyond high-risk groups and touch all segments of Tunisian society. The proposal also involves the participation of health-related non-governmental organizations. Such activities would help further the Embassy goal of supporting and strengthening Tunisian civil society. ¶C. (U) Comments on TRP review: Post agrees with the analysis provided by the TRP. ¶D. (U) Public health and scientific considerations: The GOT has proven its ability to implement effective health care initiatives in the face of potentially sensitive social issues. Launched in the 1950s, Tunisia's revolutionary family planning program successfully led to a reduction in the birth rate through widespread educational campaigns, as well as contraceptive distribution. Due to a relatively effective public health system and well-trained medical personnel, Tunisia's technical assistance requirements should be minimal. Embassy contacts have reported, however, that the Ministry of Health has little funding available for specialized treatment and prevention programs beyond the scope of primary health care. ¶E. (U) Coordination with other partners: The project activities outlined in the proposal represent activities which have not been undertaken by any other entities in Tunisia on a large scale and will therefore not duplicate current HIV/AIDS programs in country. In addition, the CCM includes members from a wide-range of health-related civil society organizations, which should encourage successful coordination between the GOT and other organizations with a stake in HIV/AIDS prevention. ¶F. (SBU) Political considerations: Consistent with the President's Freedom Agenda, strengthening and supporting Tunisian civil society represents a core objective of Embassy Tunis. The inclusion of health-related civil society organizations in the CCM will further this important Embassy goal. ¶G. (U) Additional Comments: Director of UNAIDS in Tunisia, Jean-Michele Delmotte, recently contacted the Embassy to convey UNAIDS Tunisia's support for this proposal and to request Embassy backing as well. ¶H. (U) Embassy point of contact: Economic Officer Victoria Taylor, E-mail: TaylorVJ@state.gov, Phone: 216-71-107-431 BALLARD