SCENE-SETTER FOR CODEL LEWIS' NOVEMBER 8-13, 2008

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SENSITIVE
SIPDIS

AF/S FOR RUSH MARBURG, H FOR DIANE RICH

E.O. 12958: N/A
TAGS: ECON ETRD EINV PREL PGOV SF
SUBJECT: SCENE-SETTER FOR CODEL LEWIS' NOVEMBER 8-13, 2008
VISIT TO SOUTH AFRICA

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APARTHEID AERA TERRORISM AND A NEW EXEMPTION FROM VISA
INELGIBILITIES
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10. (SBU) Visa ineligibilities related to past terrorist and
criminal activity in opposition to the apartheid-era regime
have posed a significant strain on the U.S.- S.A. bilateral
relationship. The need for Nelson Mandela and other South
African leaders, considered heroes of the anti-apartheid
movement, to travel on visa waivers undercut our efforts to
influence SAG policy on issues such as the designation of
terrorist supporters and financiers at the United Nations
Security Council. Earlier this year, Congress took action
to remedy this situation and the result was Public Law
110-257, enacted in July. This law gives discretion to either
the Secretary of State or the Secretary of Homeland Security,
after consultations involving the Departments of State,
Homeland Security, and Justice, to exempt persons from
terrorist and criminal grounds of ineligibility with respect
to activities undertaken in association with the African
National Congress in opposition to apartheid rule in South Africa.
Exemptions for an initial list of seven individuals including
Nelson Mandela and Jacob Zuma have been provisionally
approved by working-level officials at State, and we are waiting
for DHS and DOJ to follow suit in order that the Secretary
of State can formally grant the exemptions.

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FOREIGN POLICY - FOCUS ON PROMOTING AFRICA
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11. (U) South Africa under Mbeki took a high-profile role
promoting Africa's interests -- the African Renaissance.
South Africa served as the first chair of the African Union
until July 2003 and helped establish continental institutions
such as the Pan-African Parliament (which sits in South
Africa) and the AU Peace and Security Council. Mbeki was the
driving force behind the New Partnership for Africa's
Development (NEPAD),an African-developed program based on
international best practices and continental peer review to
strengthen economic and political governance across the
continent. NEPAD is also a framework for African partnerships
with the international community. These initiatives are early in
their evolution and have not yet become effective mechanisms for
development.


12. (SBU) South Africa believes that, by virtue of its
history and regional political, economic, and military clout, it
has a responsibility to lead African conflict resolution efforts
and participate in peace support operations. South Africa
continues to play a lead role in conflict resolution in Burundi
and contributes troops to UN Peace Keeping missions in the
Democratic Republic of Congo (DRC) and Sudan. South Africa
has approximately 3,000 personnel deployed in peace support
operations in Africa. The U.S. has a strong interest in
helping South Africa expand and enhance its peacekeeping
and disaster assistance capabilities. South Africa
participates in the African Contingency Operations
Training and Assistance program (ACOTA) to enhance the
South African National Defence Force's (SANDF) capacity
to participate in multilateral peace support operations.
The U.S. uses International Military Education and Training
QThe U.S. uses International Military Education and Training
(IMET) funds to support professional military education and
technical training of future military leaders. With the
January 2008 repeal of the American Servicemen's Protection
Act (ASPA) prohibitions on provision of military assistance,
we hope to resume Foreign Military Financing (FMF) programs
supporting the South African Air Force's C-130 fleet which
South Africa is using to support troops deployed to the DRC,
Sudan, and Burundi. While South African officials have been
openly critical of U.S. Africa Command, they continue to
engage with the U.S. in a wide range of military-to-military
activities. This month the U.S. completed the successful
first visit by a U.S. Navy aircraft carrier to South Africa
since 1967. Some observers believe that this visit could

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leading cause of death. Despite South Africa's overall
wealth, life expectancy at birth has decreased from 67 to 52,
the regional average, due to HIV/AIDS and HIV/TB co-infection.
Under-five mortality, with the Millennium Development Goal
(MDG) of 24 per 1,000 in 2015, has increased from 60 to 67
per 1,000 between 1990 and 2006. While achieving the MDGs
is the SAG's highest priority, South Africa is moving further
away from these goals in both child and maternal mortality as
a result of HIV/AIDS.


25. (U) An estimated 5.4 million South Africans are
HIV-positive including 2.7 million women and about 300,000
children 14 years old or less. An estimated 18.8 percent of
adults between 15 and 49 are HIV-infected and women in the age
group of 25-29, the most seriously affected, have prevalence
rates of up to 40 percent in some areas. An estimated 530,000 new
infections occur annually In 2006, 350,000 adults and children
died from AIDS; an estimated 1.8 million deaths have occurred
since the start of the epidemic; and 71 percent of all deaths
in 15 to 41-year-olds are due to AIDS. In the last few years,
there is an indication that prevalence may be starting to decline.
Prevalence in antenatal care fell from 29 percent in 2005 to
28 percent in 2008. At least 1.6 million children, approximately 10
percent of South Africa's youth, have had at least one parent die
and 66 percent of these have been orphaned by AIDS. Continuing
AIDS-related mortality will create millions of new orphans and
generate additional social and economic disruption, in part due to
orphans being raised by extended families or in child-headed households


26. (U) The epidemics of HIV and TB are interlinked. TB is
the most common infectious disease in sub-Saharan Africa and
approximately 50 percent of HIV patients in South Africa
also have TB. A high overall prevalence rate of HIV,
HIV/TB co-infection, and lack of continuity in treatment
contribute to the increasing incidence of active TB, including
multi- and extensive drug-resistant TB strains (MDR- and
XDR-TB). The piloting of an SAG-approved rapid test for MDR-TB may
allow more rapid identification and initiation of appropriate
treatment, but staff shortages and skills challenges impede
an effective response to TB. Failure to adequately control and
treat TB may undo all the gains South Africa has made in HIV
care and treatment thus far.


27. (U) The South African National Strategic Plan for HIV &
AIDS and Sexually Transmitted Infections 2007-2011 (NSP)
provides a road map for responding to this crisis and sets out goals
of reducing new HIV infections by 50 percent by 2011 and
increasing access to anti-retroviral treatment (ART). The recall of
Mbeki and the subsequent appointment of Barbara Hogan as the new
Minister of Health under Motlanthe promises new initiatives in health,
particularly as they pertain to HIV and TB. Hogan, unlike
her predecessor, Dr. Manto Tshabalala Msimang, has been outspoken
in affirming the link between HIV and AIDS and has galvanized
support from government and non-governmental organizations (NGOs) to
reach the NSP targets. The South African public health system
suffers from deterioration of the existing health infrastructure,
need for expansion of clinical and laboratory facilities, and a

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BALL