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Cablegate: Health Minister: We Must Cooperate Better

VZCZCXRO8381
RR RUEHBZ RUEHDU RUEHJO RUEHMR RUEHRN
DE RUEHTO #0729/01 2110946
ZNR UUUUU ZZH
R 290946Z JUL 08
FM AMEMBASSY MAPUTO
TO RUEHC/SECSTATE WASHDC 9180
INFO RUCNSAD/SOUTHERN AFRICAN DEVELOPMENT COMMUNITY
RUEHLO/AMEMBASSY LONDON 0208

UNCLAS SECTION 01 OF 02 MAPUTO 000729

SENSITIVE
SIPDIS

E.O. 12958: N/A
TAGS: PREL PGOV EAID KHIV SOCI MZ
SUBJECT: HEALTH MINISTER: WE MUST COOPERATE BETTER

1. (SBU) SUMMARY: The Charge met with the Mozambican
Minister of Health, Dr. Ivo Garrido, on July 3 to discuss the
planned $1 billion USG investment in the Mozambican health
care sector over the next five years via the President's
Emergency Plan for Aids Relief (PEPFAR) and President's
Malaria Initiative (PMI). The Charge also outlined sizable
USG-funded programs in maternal and child health, nutrition
and reproductive health. Minister Garrido agreed to
formalize a new level of cooperation and coordination with
the USG, highlighted several health priorities for
Mozambique, discussed the reorganization of implementing
partners, and offered to intervene with the Minister of Labor
regarding work permits for the USG's third-country national
health professionals. Improved coordination with the
Government of Mozambique (GRM) is necessary to ensure that
this significant investment in the health sector yields the
best possible results, and this meeting shows that there is
clear potential to move forward. END SUMMARY.

------------
COORDINATION
------------

2. (U) In a July 3 meeting, the Mozambican Minister of
Health signaled his appreciation for the large USG investment
in the Mozambican health sector and agreed with the Charge
that closer coordination was needed at all levels between his
ministry and the USG. The Minister noted that the United
States is by far the largest donor in the health sector in
Mozambique, providing more funding to the health sector than
all other donors combined. He identified his director of
planning as the new focal point for coordination with the
Ministry of Health, and proposed monthly coordination
meetings between his directors and USG senior technical
staff. The Minister also agreed to formalize this new level
of cooperation in an official letter further detailing
proposed coordination mechanisms and a calendar of scheduled
meetings.

------------------------------------------
MOZAMBIQUE PRIORITIES IN THE HEALTH SECTOR
------------------------------------------

3. (U) Minister Garrido outlined his priorities in the
health sector as human resources (training and motivation),
infrastructure (rural health clinics and warehouses), and
community involvement (health promotion and disease
prevention) and his follow-up letter also included financial
management and monitoring and evaluation as priorities. The
Minister expressed his pleasure with the recent USG-United
Kingdom initiative to improve human resources in four focus
countries, to include Mozambique. He urged the Charge to
continue to increase investment in priority areas.

-----------------------------------
AGREEMENT ON 'COMPACT' NEGOTIATIONS
-----------------------------------

4. (U) Beyond better coordination and management, the Charge
strongly urged the Minister to consider jointly developing a
bilateral compact outlining commitments and responsibilities
for both sides over the next five years. Garrido agreed to
the proposal in principle, and said that discussions should
begin soonest.

--------------------------------------
PARTNER RATIONALIZATION/REORGANIZATION
--------------------------------------

5. (SBU) The Charge suggested that our implementing partners
are not optimally organized in terms of geographic location.
For example, he said, there is more than one USG implementing
partner supporting the same GRM facility in several cases.
The Charge proposed a reorganization of implementing partners
to streamline support to the GRM. The Minister agreed with
this suggestion, stating that the GRM is moving towards a
district model, where non-governmental organizations would
provide systems strengthening, training, and support to an
entire district, rather than play a service-provider role in
specific health clinics.

---------------------------------
HIRING OF THIRD COUNTRY NATIONALS
---------------------------------

6. (U) The Charge raised the problem of a severe human
resource shortage in Mozambique which is inhibiting the USG's
ability to recruit qualified Mozambican professionals to
manage portfolios of great size and complexity. He indicated
that in some instances, it has been difficult to attract
Portuguese-speaking AmCits with the required technical

MAPUTO 00000729 002 OF 002


qualifications for positions, resulting in a need to recruit
third-country nationals to maintain necessary professional
staffing levels. The Charge noted that recent changes to
Mozambican labor laws are inhibiting USG abilities to obtain
work permits for third-country national staff members. The
Minister said he recognized the difficulty, stated that he
discussed this issue with the Ministry of Labor, and promised
to write the Minister of Labor an official letter on behalf
of the USG on this issue. (Note: USG efforts to engage the
Ministry of Labor on this issue have so far been
unsuccessful. End Note.)

-------
COMMENT
-------

7. (SBU) Minster Garrido's concerns with the dominance of
NGOs in the health sector has caused some distance between
the USG and the Ministry of Health until this meeting, which
marks a reinvigoration of cooperation with the Ministry of
Health. Post and Minister Garrido now share similar concerns
about the implementation of our health-related programming.
Post believes that Minister Garrido--who is a senior decision
maker in the FRELIMO party--could be a powerful ally, not
only in the health sector, but also in our stalemated
struggle to legalize the status of third-country health
sector professionals supporting USG initiatives.
Amani

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