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Cablegate: Estonia: Coordination On Hiv/Aids Programs

VZCZCXRO7923
RR RUEHAG RUEHAST RUEHDA RUEHDF RUEHFL RUEHIK RUEHKW RUEHLA RUEHLN
RUEHLZ RUEHPOD RUEHROV RUEHSR RUEHVK RUEHYG
DE RUEHTL #0010/01 0091507
ZNR UUUUU ZZH
R 091507Z JAN 08
FM AMEMBASSY TALLINN
TO RUEHC/SECSTATE WASHDC 0421
INFO RUEHZL/EUROPEAN POLITICAL COLLECTIVE

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

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