Cablegate: Obasanjo Asks for Pepfar Coordination

This record is a partial extract of the original cable. The full text of the original cable is not available.





E.O. 12958: N/A

1. (SBU) Summary: Global AIDS Coordinator Randall Tobias
met with Nigerian President Obasanjo and key members of the
Nigerian HIV/AIDS community and public health sector. Pres.
Obasanjo acknowledged that the US retains control of funding
but urged coordination during the implementation of PEPFAR in
Nigeria. Amb. Tobias confirmed that the US policy regarding
PEPFAR is to empower Nigeria and build on the strategic
foundation it laid. In response to Nigerian concerns, the
Ambassador also clarified that PEPFAR allows for the use of
FDA approved generic drugs. End Summary.

2. (SBU) Nigerian President Obasanjo received Global AIDS
Coordinator Amb. Randall Tobias at the Presidency June 4. In
addition to Amb. Tobias, the American side consisted of DCM
Rick Roberts, USAID Mission Director Dawn Liberi, S/GAC Press
Officer Amy Black and Special Assistant Alex Hammond.
Accompanying President Obasanjo were Vice President Abubakar,
National Action Committee against AIDS (NACA) Chairman Prof.
Babatunde Osotimehin, Director of Public Health Dr. Edugie
Abebe, and other officials from NACA and the President,s

3. (SBU) The DCM opened the meeting by thanking the
President for taking time out of a busy schedule to meet with
the delegation. He then lauded the President,s leadership
role on combating HIV/AIDS within Nigeria and the broader
regional context. Noting the commitment to help in the fight
against HIV/AIDS that President Bush made during his visit to
Nigeria in July 2003, the DCM introduced Amb. Tobias.

4. (SBU) Amb. Tobias began his remarks by complementing
President Obasanjo on his leadership role. He then stressed
President Bush,s strong personal commitment to the fight
against HIV/AIDS as manifested in PEPFAR. The Ambassador
informed the President that in the first year of PEPFAR,
nearly 59 million USD will be spent in Nigeria to assist in
the effort. Amb. Tobias told the President that he was in
Nigeria to listen to our Nigerian partners and look for ways
to support the indigenous efforts. He concluded saying he
looked forward to working with the Government of Nigeria in
confronting HIV/AIDS in the country.

5. (SBU) President Obasanjo thanked the Ambassador for his
remarks. He pointed out that he had brought his Vice
President to the meeting as an indication of the importance
his administration attaches to the fight against AIDS. Then
he recounted the history of efforts against AIDS under his
leadership. The President noted that national health issues
had been at the forefront of his administration since his
first term. He had convened a summit on malaria in 2000
followed by an AIDS summit in 2001. President Obasanjo noted
that he was present at the launch of the Global Fund at the
White House 2002, when President Bush and UN Secretary
General Annan made the announcement. President Obasanjo then
thanked President Bush for launching PEPFAR in Nigeria.

6. (SBU) Obasanjo went on to note the biannual Sentinel
Survey, which Nigeria conducts that recorded a drop in
HIV/AIDS prevalence from 5.8 percent in 2001 to 5.0 percent
in 2003. The President stated that this most recent survey
identified two states, Cross River and Akwa Ibom, which were
significantly under performing. He said that he planned to
call in the governors, legislators and public health
officials from those two states and ask for a plan of action
from them to fight HIV/AIDS.

7. (SBU) The President next turned his attention to what he
termed a critical issue, coordination. Obasanjo stated that
the US should control PEPFAR funds but their expenditure
should be within the Nigerian national program's priorities.
By implementing a plan of action that would adhere to
Nigerian priorities the President said four things would be
- The US would demonstrate support for Nigeria and its
- Results will be excellent and all can claim credit
- The US would be empowering Nigeria
- The US would learn lessons replicable in the rest of
Africa and the world

8. (SBU) Amb. Tobias responded that the President made an
excellent case and stressed that the US approach was to build
an &edifice on the Nigerian foundation.8 The Ambassador
noted that Pres. Bush through PEPFAR is focusing on
prevention, treatment and care and recognizes that the US
cannot do everything. Sustainability of PEPFAR in the long
run was actually predicated on empowering Nigeria.

9. (SBU) The NACA Chairman in his remarks continued to
stress the need for coordination but noted that Nigeria must
have the lead. Prof. Babatunde stated that Nigeria is
already treating 14,000 persons afflicted with AIDS. He
pointed out that by using generic drugs Nigeria can treat
three to four times the number of people that can be reached
if expensive brand name drugs are used.

10. (SBU) Dr. Abebe followed the NACA Chairman and
addressed concerns about sustainability. Echoing the
Chairman,s remarks about generic drugs, Dr. Abebe stressed
the desire for universal access to ARVs. She noted the need
for Nigeria to begin producing its own ARVs if the program
were to succeed. Citing Brazil as a model, Dr. Abebe spoke
of Nigeria,s desire to produce generic drugs for its own
needs and the region and how manufacturing could avoid
developing &resistance8 problems. The Doctor continued
saying that Nigeria,s infrastructure issues must be
addressed in order to develop the health system. She
concluded saying that she hoped PEPFAR would help Nigeria
scale up its own program to treat 300,000.

11. (SBU) Amb. Tobias responded that the USG was in general
agreement with the points made. He noted that Pres. Bush
anticipated the potential use of generic drugs in PEPFAR and
the process is in place for any drug company to apply to have
its products reviewed rapidly by the FDA and if approved
become eligible for PEPFAR funding. The Ambassador added
that he hoped Nigeria would develop a drug manufacturing
capability and seek approval for PEPFAR funding through the
FDA process.

12. (SBU) Pres. Obasanjo concluded the meeting by saying he
appreciated Pres. Bush,s position on the use of generic
drugs and hoped that Nigeria would be able to produce them.
He then thanked the Ambassador again for his efforts to
assist Nigeria. He indicated he would see President Bush
next week at the G-8 meeting at Sea Island and would report
his meeting with Amb. Tobias.

13. (SBU) Comment: Obasanjo was up beat and clearly
informed about HIV/AIDS. Although he ceded that the US will
control PEPFAR funds, he and his lieutenants made clear that
they expect PEPFAR to conform to Nigeria,s strategy and
priorities. It is likely that there will be a push in the
months and years ahead from the Nigerian side to use PEPFAR
funds to institute generic drug production in the country.
End Comment

14. Amb. Tobias cleared this cable before leaving Abuja.

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