AMBASSADOR AND MINISTER PLEDGE HEALTHY BILATERAL

C O N F I D E N T I A L GABORONE 000957 STATE FOR AF, AF/S, AND S/GAC E.O. 12958: DECL: 11/03/2018 TAGS: PREL PGOV KHIV TBIO EAID BC SUBJECT: AMBASSADOR AND MINISTER PLEDGE HEALTHY BILATERAL TIES Classified By: DCM Philip R. Drouin; Reasons 1.4 (b) and (d). ¶1. (SBU) During Ambassador Nolan's initial October 30 meeting with GOB Minister of Health Lesego Motsumi, the Minister said that Botswana truly appreciates the "phenomenal" support it receives from the United States in the health sector. She pledged her ongoing cooperation, and that from her Ministry of Health (MOH) collegues as well, hoping that the United States and Botswana will continue to work closely as a team across the health spectrum -- from HIV/AIDS to TB of course but also including non-communicable diseases like cancer and diabetes that also take a toll in Botswana. ¶2. (C) She also wishes that our mutual medical and health sector efforts will not "sour" due to misperceptions and the issue of cultural differences on how we approach health-related problems and research. She pointed to the ongoing BOTUSA (CDC) Truvada study on the efficacy of this drug as an anti-HIV/AIDS prophylaxis on a population of sexually-active, HIV-negative Batswana youth, saying that there is still misunderstanding in some circles here that perhaps Batswana are being used as "guinea pigs" in a survey that risks infection or encourages greater promiscuity. ¶3. (C) The Ambassador, accompanied by the DCM and the BOTUSA Chief of Party to this courtesy call, also reaffirmed that the United States looks forward to continuing its health sector partnership with Botswana, pointing to the past world-class medical research conducted by BOTUSA and the real impact and difference that PEPFAR has made here. As for the Truvada study, the Ambassador reiterated that this is being conducted under the most stringent of ethical and scientific protocols, and that BOTUSA and the USG have been in close and frequent contact with key GOB and MOH officials each step of the way, from study formulation, through May 2007 roll-out, to its current implementation. He also previewed that the USG will continue its collaboration with PEPFAR focus country Botswana, as we move beyond the first five years of the "Emergency Plan" and into longer-term sustainability via a new, bilateral PEPFAR "Compact." ¶4. (C) Comment: This was a useful intial call that moved beyond pure "courtesies." Minister Lesego expressed the GOB's genuine gratitude for all that the USG and other U.S. entities like the Gates Foundation, Harvard, UPenn and Baylor have done in the health field and especially in fight against AIDS. She will also become the ruling Botswana Democratic Party's floor leader when Parliament reconvenes November 3, and flagged for the Ambassador concerns about the Truvada study which has evoked budding but not yet widespread controversy here, especially among certain politicians such as Minister of Communications, Science and Technology (MCST) Venson-Moitoi. The DCM had accompanied two senior members of BOTUSA professional staff back on October 2 to a frank and spirited briefing on the Truvada study, which Motsumi and the MCST had attended, where we attempted to allay GOB concerns. The Minister of Health appears to be more convinced than before on Truvada, but there are still indications that GOB questions persist, perhaps going all the way up to President Khama himself. The Ambassador, BOTUSA, and other key elements of the U.S. Mission will continue to engage closely with GOB counterparts on the value to Botswana and the world of the landmark Truvada study, and also as we move forward in the months ahead on the negotiation of the nascent PEPFAR Compact, as health matters remain -- and deepen -- as a fundamental focus of our diplomacy here. End Comment. NOLAN