ESTONIA: COORDINATION ON HIV/AIDS PROGRAMS

UNCLAS SECTION 01 OF 02 TALLINN 000010 SIPDIS COPENHAGEN FOR EST OFFICE SIPDIS SENSITIVE E.O. 12958: N/A TAGS: EAID KHIV TBIO EN SUBJECT: ESTONIA: COORDINATION ON HIV/AIDS PROGRAMS This is an Action Request - see para 6, below. ¶1. (SBU) Summary: At a meeting organized and hosted by the Embassy in December, key GOE officials briefed the diplomatic community on Estonia's HIV/AIDs epidemic and the status of GOE prevention/treatment programs. Estonian officials used the forum to suggest areas for international coordination, and Finnish diplomats stepped forward to offer to collaborate with the GOE on developing an HIV/AIDS curriculum for use in Estonian schools. GOE officials also proposed that Global Fund donor countries (such as the U.S.) revise its criteria for determining eligibility for Global Fund programs. Currently, using World Bank income guidelines, Estonia is considered a "high income" country and therefore ineligible for GF funds. End Summary. ¶2. (U) Estonia has the highest HIV growth rate in Europe and considers itself on the frontlines of this vital health issue. The GOE is committed to preventing the further spread of the epidemic, but as is the case with any transnational issue, cannot do so successfully alone. As part of our efforts to support Estonian goals in this regard, the Embassy hosted an HIV/AIDS briefing in December featuring presentations from the lead agencies responsible for HIV/AIDS prevention and treatment in Estonia: the Ministries of Social Affairs (MOSA),Justice (MOJ) and Education and Research (MOER) and the National Institute for Health Development. Diplomats from the Finnish, Swedish, Norwegian, Danish and British Embassies and the WHO's local representative took part. In his welcome to participants, the Ambassador emphasized that good cooperation between Estonia and other countries will help keep Estonia's HIV/AIDS epidemic under control. ¶3. (SBU) MOSA provided participants with an excellent overview of the HIV/AIDS situation in Estonia, including the general HIV epidemiological situation, implementation of the GOE's HIV strategy (adopted in December 2005) and new funding challenges following the conclusion of the Global Fund's (GF) four-year assistance program (reftel). MOSA identified rapidly rising treatment costs and the scarcity of human resources as two of the biggest problems facing the GOE. The MOJ gave an overview of HIV programs in prisons, noting that while testing programs are voluntary, over 90 percent of all prisoners have been tested. ¶4. (SBU) The MOER outlined the Ministry's ongoing efforts to develop an HIV curriculum for schools and expressed hope MOER will get the new curriculum in place in 2008. (Note: the MOER has been working on this since 2001. Under the GF program, HIV NGOs implemented prevention training courses in schools. However, when GF programs ended last fall, MOER discontinued cooperation with these NGOs. Most schools do not currently have HIV prevention programs. End Note.) MOSA raised its own concerns with the pace of MOER's curriculum development efforts, but assured participants the GOE had discussed the issue at the cabinet level and is committed to dealing with it. The Finnish diplomat noted Finland's success incorporating HIV/AIDS into its own national health curriculum and proposed the two countries collaborate on curriculum development. The Finnish Embassy later told us that they, in coordination with the Finnish Ministry of Education, have proposed hosting a joint seminar on curriculum development with the GOE in early 2008. ¶5. (SBU) MOSA lobbied diplomats to support changing GF funding criteria to make Estonia eligible again for GF programs. GF uses World Bank income guidelines to determine eligibility. Now that Estonia is considered a "high-income" country, it is no longer eligible for funding. However, MOSA argued -- and Embassy agrees -- that Estonia makes a persuasive case for continued Global Fund activities here. While most Estonians still contract the disease through intravenous drug use, the HIV/AIDs crisis in Estonia is now starting to spread into the general population. The majority of Estonia's HIV patients are very young (14-24 years). GF programs were instrumental in advancing Estonia's understanding of, and battle against, HIV/AIDs, and the GOE's track record in implementing GF programs was excellent. While the GOE committed to take over all programs previously funded by GF, rapidly rising treatment costs and slowing GDP growth will make this difficult in the short to medium term, a crucial time in stemming the further spread of HIV/AIDs into the Estonian population. (NOTE: As an EU member, Estonia no longer receives bilateral donor assistance. END NOTE.) TALLINN 00000010 002 OF 002 ¶6. (SBU) Action request: Following departure of the GOE participants, Embassy representatives noted to the diplomatic community it would be useful to meet again to discuss Estonian eligibility for GF programs. To prepare for this, post requests the Department provide guidance on the USG position on Global Fund eligibility criteria and the likelihood the USG would support a proposal to revise the criteria (beyond income guidelines). Decker