C) SOUTH AFRICA: KUDOS WITH FOLLOW-UP FOR

C O N F I D E N T I A L STATE 037352 NOFORN PRETORIA PLEASE PASS TO JOHANNESBURG E.O. 12958: DECL: 04/15/2034 TAGS: PINR SOCI SF SUBJECT: C) SOUTH AFRICA: KUDOS WITH FOLLOW-UP FOR REPORTING ON EDUCATION AND HEALTH (C-AL9-00674) REF: A. PRETORIA 002684 ¶B. PRETORIA 000213 ¶C. CAPE TOWN 000255 ¶D. JOHANNESBURG 000185 Classified By: SUZANNE MCCORMICK, DIR., INR/OPS. REASON: 1.4(C). ¶1. (C/NF) WASHINGTON ANALYSTS WANT TO THANK POSTS FOR EXCELLENT REPORTING ON SOUTH AFRICA'S DEVELOPMENTS AND CHALLENGES IN THE AREAS OF EDUCATION, SOCIAL DEVELOPMENT, AND HEALTH. THESE CABLES PROVIDED IMPORTANT INSIGHT INTO THE SPECIFIC ISSUES SOUTH AFRICA IS FACING AND HOW THESE ISSUES ARE BEING ADDRESSED AT THE LOCAL LEVEL. THE REPORTS ALSO REVEALED CONCERNS REGARDING PRETORIA'S APPROACH TO REGIONAL DEVELOPMENT, WHICH ANALYSTS FIND HELPFUL FOR BETTER UNDERSTANDING THE DIFFICULTIES FACING SPECIFIC REGIONS OF THE COUNTRY AND THE GOVERNMENT'S RESPONSE. ANALYSTS WELCOME ADDITIONAL REPORTING, AS TIME AND RESOURCES ALLOW, ON THESE ISSUES FOR ALL PROVINCES, AND WOULD GREATLY APPRECIATE ANY FURTHER INSIGHT POSTS CAN PROVIDE ON THE FOLLOWING TOPICS AND QUESTIONS. MANY THANKS, AND WARM REGARDS FROM WASHINGTON. ¶A. (SBU) ANALYSTS WOULD APPRECIATE ANY ADDITIONAL INFORMATION ON: 1) (SBU) THE KINDS OF ARV SHORTAGES THAT CURRENTLY EXIST, POSSIBLE REASONS BEHIND THE SHORTAGE, HOW LONG AND WHERE THE SHORTAGE HAS BEEN IN EFFECT, AND THE PERCENTAGE OF PEOPLE AFFECTED BY THE SHORTAGE. 2) (SBU) WHAT HIV POSITIVE PEOPLE ARE DOING TO AUGMENT ARV SHORTAGES (I.E. ARE THEY BUYING ARV OFF THE STREET, CROSSING THE BORDER IN SEARCH OF ALTERNATIVES, GOING WITHOUT, ETC). 3) (SBU) THE EXPECTATIONS SOUTH AFRICANS HAVE FOR PEPFAR IN LIGHT OF THE NEW US ADMINISTRATION. 4) (SBU) THE SHORTAGE OF HEALTH CARE WORKERS (PHYSICIANS, NURSES, MIDWIVES),LABORATORIES, PHARMACEUTICALS, AND COMMUNITY HEALTH PROGRAMS. 5) (SBU) THE PREVENTION AND TREATMENT OF SPECIFIC DISEASES, FLUCTUATIONS IN MALNUTRITION RATES AND INFANT, CHILD OR MATERNAL DEATH RATES, AND SOUTH AFRICA'S ABILITY TO MITIGATE THE IMPACT OF CROSS BORDER HEALTH ISSUES, LIKE IMPORTED CHOLERA. 6) (SBU) THE STRENGTHS AND WEAKNESSES OF SOUTH AFRICA'S DISEASE SURVEILLANCE CAPACITY IN GENERAL. CAN SOUTH AFRICA IDENTIFY THE DISEASES THAT CAUSE THE LARGEST HEALTH BURDEN AND DOES IT HAVE THE ANALYTIC CAPABILITY TO USE DISEASE SURVEILLANCE INFORMATION TO GOOD EFFECT IN FORMULATING PUBLIC HEALTH POLICY? ¶B. (SBU) ANALYSTS WOULD ALSO APPRECIATE NATIONAL AND PROVINCIAL-LEVEL DATA ON EXTREMELY DRUG RESISTANT TUBERCULOSIS (XDR-TB) AND MULTI-DRUG RESISTANT TUBERCULOSIS (MDR-TB),PARTICULARLY THE NATIONAL PREVALENCE RATES AND CURRENT CASE NUMBERS FOR EACH PROVINCE. 1) (SBU) WHAT ARE THE TREATMENT COMPLETION RATES FOR TUBERCULOSIS IN SOUTH AFRICA? HOW MANY PATIENTS DEFAULT DURING THEIR INITIAL COURSE OF TB TREATMENT? 2) (SBU) WHAT ARE THE HEALTH MINISTER'S SPECIFIC PLANS FOR COMBATING THE XDR-TB EPIDEMIC IN SOUTH AFRICA? HOW DOES COMBATING HIV FIT INTO HER PLANS FOR TUBERCULOSIS? 3) (SBU) DOES SOUTH AFRICA RECEIVE THE MAJORITY OF THEIR TUBERCULOSIS FUNDING FROM INTERNATIONAL GRANTS OR FROM INTERNAL GOVERNMENT FUNDS? IF INTERNATIONAL GRANTS, WHO ARE THE MAJOR GRANT PROVIDERS? 4) (SBU) WHAT DRUGS ARE SOUTH AFRICAN HOSPITALS AND PHYSICIANS PRIMARILY USING TO TREAT MDR-TB AND XDR-TB PATIENTS? 5) (SBU) FOR EACH XDR-TB AND MDR-TB, HOW MUCH DOES IT COST IN SOUTH AFRICA TO TREAT A PATIENT PER DAY AND WHAT IS THE ESTIMATED COST FOR THE ENTIRE COURSE OF TREATMENT PER PERSON? ¶2. (U) PLEASE CITE C-AL9-00674 IN THE SUBJECT LINE OF REPORTING IN RESPONSE TO THE ABOVE QUESTIONS. CLINTON