Cablegate: Ambassador Retzer Discusses Hiv/Aids, Malaria

VZCZCXRO7927
PP RUEHDU RUEHJO RUEHMR
DE RUEHDR #1090/01 1841217
ZNR UUUUU ZZH
P 031217Z JUL 06
FM AMEMBASSY DAR ES SALAAM
TO RUEHC/SECSTATE WASHDC PRIORITY 4261
INFO RUCNSAD/SOUTHERN AFRICAN DEVELOPMENT COMMUNITY PRIORITY
RUEHJB/AMEMBASSY BUJUMBURA PRIORITY 2385
RUEHKM/AMEMBASSY KAMPALA PRIORITY 2790
RUEHLGB/AMEMBASSY KIGALI PRIORITY 0834
RUEHNR/AMEMBASSY NAIROBI PRIORITY 0154

UNCLAS SECTION 01 OF 03 DAR ES SALAAM 001090

SIPDIS

SENSITIVE
SIPDIS

DEPT AF/E FOR BYODER, ALSO FOR OES
PASS TO USAID, AF/W
PASS ALSO TO CDC AND DEPT OF HHS

E.O. 12958: N/A
TAGS: PGOV PREL EAID TZ
SUBJECT: AMBASSADOR RETZER DISCUSSES HIV/AIDS, MALARIA
STRATEGIES AND NEXT STEPS ON IRAN WITH TANZANIAN PRIME
MINISTER

SUMMARY
--------
1. (SBU) In an hour-long lively exchange on June 23,
Ambassador Retzer and Tanzania's Prime Minister Edward
Lowassa discussed the recent PEPFAR conference in Durban,
South Africa, USG plans to accelerate HIV/AIDS testing and to
ramp up anti-malaria programs on both the Mainland and in
Zanzibar, the need for a National HIV/AIDS Coordinator for
the Tanzanian armed forces, as well as the importance of
Parliament's passing the HIV Omnibus legislation. The
Ambassador and Prime Minister explored possible strategies to
include more Tanzanians in many of the non-governmental
organizations (NGOs) implementing these programs. They also
discussed ways to cooperate both bilaterally and regionally
to resolve "hot spot" issues, including Iran and North Korea.
END SUMMARY.

2. (U) Prime Minister Lowassa thanked the Ambassador for
facilitating the May 2006 visit of Tanzania,s President
Jakaya Kikwete to the United States stating that President
Kikwete was very pleased with the visit and hoped that
President Bush would reciprocate with a visit to Tanzania.
Ambassador Retzer indicated that such a visit was always a
possibility.

3. (U) Ambassador Retzer reminded the Prime Minister that
several members of the Government of Tanzania (GOT) had
participated in a meeting of partners to the President,s
Emergency Plan for AIDS Relief (PEPFAR) in Durban, South
Africa June 12 to 16 and that the Ambassador wanted to
discuss recent developments and matters arising from Durban.

Updated PM on HIV/AIDS and Malaria Programs
-------------------------------------------
4. (U) The Ambassador shared that USG funding for HIV/AIDS
would be increasing from USD 104 million in 2006 to USD 157
million in 2007. He also confirmed that funding for the
Presidential Malaria Initiative (PMI) would increase from USD
11.5 in 2006 to USD 28 million in 2007. The Ambassador noted
that residual spraying was beginning in Zanzibar.

5. (U) Prime Minister Lowassa inquired about malaria
resources for the mainland and was told that:

-- PMI activities began on Zanzibar because its physical
situation (i.e. being an island) made it a good environment
to pilot a range of interventions and provided an opportunity
to significantly reduce malaria burden.

-- USD 8 million of the $11.5 available in 2006 was used
for the mainland.

-- a significant portion of the proposed $27 million for
2007 will be for the mainland.

-- PMI is supporting the national voucher system and will
provide enough vouchers for all infants.

-- PMI is expanding from three to seven countries in 2007.

Importance of Increasing HIV Testing
------------------------------------
6. (U) Ambassador Retzer then noted that to meet national
treatment targets he believed the following needed to be
addressed: there is a need for a significant increase in
testing, and to achieve this objective, approaches to testing
needed to be modified, such as "opt-out" (provider initiated)
testing which is not currently endorsed in the national
policy. Dr. J. Temba of TACAIDS responded that a revised
policy is being drafted and needs to be approved particularly
now that ARVs are available.

7. (U) The Prime Minister observed that he knows that
villagers want testing so he does not understand why these
modifications have not been made. He stated that he would
follow-up with the Ministry. Ambassador Retzer then noted
that the testing protocol is out of date and hinders
scale-up. Access is also limited by the exclusive use of
health care providers. Dr. Temba agreed that the policy
prohibits lay counselors. Finally, the Ambassador noted
that the GOT has run out of test kits and the procurement
coordination process does not seem to be working. The Prime

DAR ES SAL 00001090 002 OF 003

Minister and Dr. Temba conferred briefly in Kiswahili, and
subsequently the Prime Minister stated that he would get back
to the Ambassador on this matter.

8. (U) Ambassador Retzer shared that the USG intends to
implement mobile testing services and home testing in 2007.
In addition, he stressed the need to enforce national
treatment guidelines that allow Stage IV, HIV patients to
begin ART without CD-4 blood testing. Dr. Temba agreed that
a provider can use clinical assessment to start ARVs. PM
Lowassa said he had been told that there are insufficient
ARVs in Tanzania to accelerate the scale-up of the ART plan.
The USG delegation were surprised and replied that they had
no such information. On the contrary, the USG understanding
was that some ARVs had expired in storage due to slow
roll-out. The Prime Minister stated that he did not
understand why there was such a discrepancy between his
information and the delegation,s and promised to follow-up
with his Minister. The Ambassador told the Prime Minister
he needed to know if indeed there was a shortage so he could
expedite the scale-up of ART.

National Coordinator and HIV Omnibus Legislation Both Key
--------------------------------------------- -------------
9. (U) The Ambassador stressed that a National HIV/AIDS
Coordinator needs to be hired for the Tanzanian People's
Defense Force (TPDF); this is an important and long-standing
issue that has yet to be resolved. The Prime Minister made
no comment. Equally importantly, the HIV omnibus legislation
needs to be moved forward as it appears to be "bogged down."
Dr. Temba stated that the legislation is still in draft and
is presently being discussed with communities throughout the
&zones8 to solicit comment, feedback, and buy-in. In
conclusion, the Ambassador urged that the Emergency Hiring
Plan must be implemented as quickly as possible. PM Lowassa
said that he was not aware of this initiative but would ask
for a briefing.

10. (U) Ambassador Retzer then addressed GOT concerns that
non-governmental organizations (NGOs) do not hire enough
Tanzanians. He recommended that Tanzania consider the South
African model in which the government recommends hiring
targets at the same time notifying companies that these
targets would become mandatory at a later date. The Prime
Minister replied that he believed a better approach would be
job creation; however, he also stated that NGOs do not try
hard enough to find qualified Tanzanians. He noted his
appreciation for the Ambassador,s suggestion, and assured
him that Tanzania would develop its own model.

Asked Tanzania to Take Proactive Role to Speak out on Iran
--------------------------------------------- -------------
11. (SBU) The Ambassador stated that, while the Tanzanian
Foreign Minister had said in early June that it was
"premature" to comment on Iranian reprocessing of nuclear
materials, the U.S. government would appreciate if Tanzania
would take a stand and urge the Iranians to begin
negotiating. The Prime Minister responded that Tanzania
would have no problem responding individually, but that these
kinds of public statements needed to be made by regional
blocks. The Ambassador acknowledged the need to have
consultations among members of regional, blocks but
reiterated the U.S. government,s hope that Tanzania would
take a lead in these consultations.

12. (SBU) Both parties agreed that North Korea is emerging as
a serious problem. The Prime Minister added that the
Iranians are playing on the "ill-will created by the
situation in Iraq." This was followed by a congenial
dialogue regarding the context of the question of Iranian
processing of nuclear materials. As part of the discussion,
cooperation was discussed; an example given by the Prime
Minister was Tanzania,s good cooperation on peacekeeping in
the region.

Meeting Participants
--------------------
13. (USG): Ambassador Michael Retzer
Dr. Stefan Wiktor, Director
Center for Disese Control/Tanzania
Pamela White, Director USAID/Tanzania
Elise Jensen, USAID (notetaker)

DAR ES SAL 00001090 003 OF 003

(GOT): Prime Minister Edward Lowassa
Dr. J.M.V. Temba, TACAIDS
Additional staff
WHITE

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