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