Cablegate: Secretary Leavitt Concludes Successful Visit To

DE RUEHSA #3029/01 2420437
O 300437Z AUG 07





E.O. 12958: N/A


1. (U) U.S. Secretary of Health and Human Services (HHS)
Michael O. Leavitt completed a successful visit to South
Africa August 18-21, 2007. The Secretary and his delegation
visited four sites in Gauteng and KwaZulu-Natal Provinces
funded by the President's Emergency Plan for Aids Relief to
demonstrate the wide range of activities of our 400-plus
South African and international partners. Secretary Leavitt
and most senior members of the delegation also met with
Minister of Social Development Dr. Zola Skweyiya and Deputy
Minister for Foreign Affairs Aziz Pahad. Secretary Leavitt
stressed the collaborative nature of our work with the South
African Government and our many non-governmental partners
(NGOs). Minister Skweyiya said it was good that Secretary
Leavitt had come, hoped that the U.S. and South African
governments could cooperate more on social issues, and
expressed gratitude for the U.S. Government's assistance.
Secretary Leavitt also held a series of well-attended press

conferences, media roundtables and electronic interviews in
Johannesburg, Pretoria and Durban. The international and
local media responded with great interest, and reported
favorably on his activities and messages. Secretary
Leavitt's visit highlighted the U.S. Government's continuing
commitment to our partnership with the South African
Government and NGOs in the fight against HIV/AIDS. The visit
supported Post's bilateral and public-diplomacy efforts, and
created opportunities to expand America's help to those who
need it the most -- those infected by the HIV/AIDS epidemic,
including the growing number of orphans left in its wake.
End Summary.

Purpose of the Visit

2. (U) HHS Secretary Michael Leavitt completed a successful
visit to South Africa from August 18-21, 2007. A series of
visits to programs implemented under the President's
Emergency Plan for AIDS Relief was the centerpiece of the
South African leg of the visit. Secretary Leavitt's
delegation included U.S. Global Aids Coordinator Ambassador
Mark Dybul; the Director of the HHS Office of Global Health
Affairs (OGHA), Dr. William Steiger; the Director of the
Centers for Disease Control and Prevention (CDC), Dr. Julie
Gerberding; the Assistant Administrator for Global Health at
the U.S. Agency for International Development (USAID), Dr.
Kent Hill; HHS/OGHA Director for African Affairs, Dr. Samuel
Adeniyi-Jones; the Director of the Fogarty International
Center of the HHS National Institutes of Health (NIH), Dr.
Roger I. Glass; and State Department DAS for African Affairs
Carol Thompson. The Charge, HHS/CDC Country Director, USAID
Director, Acting Health Attach, Consul General in Durban
(while in Durban) and Economic Counselor (Control Officer)
accompanied the delegation.

Site Visits

3. (U) Secretary Leavitt and his delegation visited four
sites funded by the Emergency Plan in Gauteng and
KwaZulu-Natal provinces, selected to demonstrate the wide
range of activities of our 400-plus South African (80
percent) and international (20 percent) partners that
implement the South Africa program. The four sites were the
Mercy Clinic in Winterveldt Township, and Heartbeat in
Nellmapius Township, both outside of Pretoria; CAPRISA in
Vulindlela, outside of Pietermaritzburg; and the University
of KwaZulu-Natal (KZN) Medical School in Durban.

Mercy Clinic

On August 20, Secretary Leavitt and his delegation visited
the Mercy Clinic, a large multi-purpose facility located in
Winterveldt township in Gauteng Province. Run by the Order
of Mercy, the facility receives partial funding from the

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Emergency Plan, and provides a range of health care and
community services, including basic health care, dentistry,
vocational education, psychosocial support for orphans and
vulnerable children (OVCs) and their caregivers, nutrition
programs, gardens, skills-training and employment-generation
activities. Emergency Plan funding provides confidential,
voluntary counseling and testing (VCT) and support for the
provision of anti-retrovirals (ARVs), although the South
African Government provides the drugs themselves. Secretary
Leavitt toured the facility, and conversed with patients
about the impact of the Emergency Plan program on their lives
and work, and with home-based caregivers about their
experience with HIV/AIDS in the Winterveldt community. He
also spoke to several children and their guardians who are in
the facility's OVC program.


Later on August 21, Secretary Leavitt visited the Heartbeat
facility in the township of Nellmapius, north of Pretoria.
The site furnishes a range of support for OVCs and their
caregivers (grandmothers, elder siblings, or other family
members and friends). Located in a set of brightly colored
trailers and containers next to a new primary school, the
facility feeds, tutors, counsels, arranges play activities
and holiday programs, provides uniforms and books and
improves the lives of children devastated by the loss of both
parents. In most cases, grandmothers are raising the
children; however, in a significant percentage of cases the
orphans are living in child-headed households. The program
also assists OVCs and their caregivers to access government
grants and services, and provides training in child care and
income-generation to household heads. Secretary Leavitt
interacted with groups of primary school children who were
receiving homework supervision and one-on-one tutoring and
psychosocial support, including the making of memory boxes.
Secondary students shared with Secretary Leavitt their plans
for further study and occupational goals, and a group of
grandmothers who talked about their experiences in raising
their grandchildren and generating additional income.

CAPRISA Vulindlela Research Facility

On August 21, Secretary Leavitt and his delegation traveled
to KwaZulu-Natal, South Africa's most populous province
(nearly 10 million people), and the region most affected by
the HIV/AIDS epidemic. Secretary Leavitt visited a research
facility in Vulindlela run by the Centre for AIDS Programme
of Research in South Africa (CAPRISA). CAPRISA's Vulindlela
facility is located in a rural area (about an hour and a half
outside Durban and 40 minutes from Pietermartizburg)
primarily funded by the Emergency Plan (through USAID and
HHS/CDC) and HHS/NIH. The facility is notable for the local
community's support of its activities. Secretary Leavitt
discussed the integration of the facility into the community
with traditional leaders, a Peace Corps Volunteer, a local
NGO, a Reverend, and a local Department of Health
representative. Secretary Leavitt then interacted with
medical personnel who are running HIV/AIDS prevention
research programs, and had an opportunity to speak with
several participants in a microbicide trial. Secretary
Leavitt also engaged with patients who are receiving
anti-retroviral therapy at the facility. To close the visit,
Secretary Leavitt discussed the challenges faced by the local

community with researchers, traditional leaders, and
community support groups during a lunch hosted by CAPRISA.
All parties agreed that the community's biggest challenge was
to curb the number of new HIV/AIDS infections, but that this
had proven difficult.

University of KZN Nelson R. Mandela School of Medicine

In Durban, also on August 21, Secretary Leavitt visited the
University of KwaZulu-Natal's Doris Duke Medical Research
Institute, where he delivered a speech to over 100 medical
students and researchers, including 15 beneficiaries of U.S.
grants. The Medical School receives nearly 50 percent of its
research funding from U.S. private and public sources (USAID
and HHS, including CDC and NIH, some of which is Emergency

PRETORIA 00003029 003 OF 005

Plan financing). In his speech, Secretary Leavitt reflected
upon his experiences while visiting the Heartbeat and
Winterveldt sites on August 20. He emphasized that he
believed there was hope in the fight against HIV/AIDS. He
also discussed President Bush's personal commitment to the
fight against HIV/AIDS and his request for a doubling of
Emergency Plan funding. Secretary Leavitt added that he
would encourage Congress to approve the proposed increase, as
he had witnessed in South Africa the positive impact of
programs funded by the U.S. Government. Secretary Leavitt
and the audience then engaged in a question-and-answer
session. Most questions revolved around medical education
and training, and South Africa's need to develop the next
generation of scientists and doctors. The University also
used the occasion of Secretary Leavitt's visit to announce a
USD 30 million grant by the Howard Hughes Medical Institute
to build a research institute to focus on tuberculosis (TB)
and extensively drug-resistant TB.

Ministerial Meeting

4. (SBU) Secretary Leavitt and some of the senior members of
the delegation also met with the South African Minister of
Social Development, Dr. Zola Skweyiya. Deputy Minister for
Foreign Affairs Aziz Pahad, Director-General for Social
Development Vusimuzi Madonsela and Director-General for
Health Thami Mseleku accompanied Skweyiya. The Embassy had
requested a meeting with the Deputy President, Phumsile
Mlambo-Ngcuka, who was in Cape Town to meet with Parliament,
and Minister of Health Dr. Manto Tshabalala-Msimang, who was
visiting the Democratic Republic of Congo with President
Thabo Mbeki. The Minister of Health later sent a letter to
express her regret that they had not been able to meet and
her wish that they be able to meet soon, hopefully in South

5. (SBU) Secretary Leavitt stressed the collaborative nature
of our work with the South African Government and our many
NGO partners, while underlining the success of the Emergency
Plan's partnership with the Ministry of Social Development in
the support of OVCs. Minister Skweyiya said it was good
Secretary Leavitt had come and he hoped the U.S. and South

African governments could cooperate more on social issues.
He specifically expressed a need for help in increasing the
number of university-trained social workers and expanding the
cadre of rural social/health workers (such as medical
clinicians/medical extenders) to help extend service to rural
areas where there is a lack of permanent infrastructure, and
he appealed for short-term/bridge funding for additional
personnel. The Director-General of Health added there would
soon be an announcement of new roles for nurses because of
the shortage of doctors. The Director-General of Social
Development said his Ministry was developing a campaign to
address child poverty, and asked for help in creating a data
base of child-headed households so the Ministry can best
target them.

6. (SBU) The Minister said his Ministry was working closely
with civil society and, particularly, the religious sector
because it had a broader network than anyone else, and
because "the government can't do it alone." Dr. Hill thanked
the Minister for the cooperation of the Ministry, and said
their relationship was one of the best cooperative
relationships USAID has. Dr. Hill also offered to
participate in the Ministry's quarterly planning meetings to
look for better ways to cooperate. The Minister ended the
meeting by voicing the South African Government's gratitude
for the assistance from the United States, "especially USAID
and for empowering NGOs."

Secretary Leavitt's Message


7. (U) Secretary Leavitt communicated the following key
messages at the sites and Ministerial meeting:

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-- He had come to South Africa with an intellectual
engagement to the Emergency Plan program but was leaving with
an emotional commitment, generated by his personal
interaction with those who were implementing the program,
and, above all, the men, women and children who were the
recipients of its services;

-- The Emergency Plan was President Bush's program and would
not have been possible without his personal and direct
involvement. The President is 100-percent committed to the
program and the attainment of its goals because it is the
right thing to do;

-- The Emergency Plan has the full and unwavering support of
the American people, who want to help and feel good about
what they are doing;

-- The Emergency Plan and its success is a function of the
partnership between South Africa and the United States.
United States funding is ultimately a catalyst, a way of
helping South Africa address the epidemic, as spelled out in
its well-constructed National Strategic Plan (2007-2011),
which now needs to be implemented;

-- Prevention is the key component of beating HIV/AIDS. The
Emergency Plan has been successful in meeting its treatment
targets, but must now focus on reducing transmission and
lowering incidence rates;

Media Events and Coverage

8. (U) Secretary Leavitt held a series of well-attended
press conferences, media roundtables and electronic
interviews. International and local media responded with
great interest, and reported favorably on his activities and
message. There were two dozen media placements, including
news articles, opinion pieces and radio and TV coverage. All
the placements were positive; none were critical of the
United States. SABC Radio's Channel Africa, which broadcasts
its programs throughout the African continent, interviewed
Secretary Leavitt. Secretary Leavitt later spoke for five

minutes on 702, the highest-rated morning radio talk show in
South Africa. Secretary Leavitt successfully communicated in
all of his media events that the United States has invested
and will continue to invest hundreds of millions of dollars
in HIV/AIDS prevention, care and treatment in South Africa,
and that the South African Government's National Strategic
Plan (2007-2011) is a good plan that needs to be implemented.
Sample headlines from the South African press include: "U.S.
Cash Fights AIDS in SA" (The Citizen); "US Health Secretary
Leavitt Impressed by SA's AIDS Approach" (Business Day); "US
Hopes to Spend More on AIDS in SA" (Mail & Guardian); and
"Howick Centre Gets Powerful Visitor" (Daily News of Durban).
Secretary Leavitt declined to comment on President Mbeki's
recent dismissal of Deputy Minister of Health Nozizwe
Madlala-Routledge, which has dominated local headlines and
has received coverage in the international press during the
past two weeks. When asked about the issue, he consistently
and pointedly referred to the need to focus on the full
implementation of South Africa's National Strategic Plan.
Media and public opinion have not criticized his response.

Outcomes and Follow-Up

9. (SBU) There were a number of significant outcomes from
this visit. The U.S. public profile was raised in a positive
way on a subject that is of great interest to the vast
majority of South Africans. The meeting with the Minister of
Social Development and the Vice Minister of Foreign Affairs
demonstrated the South African Government's public support
and gratitude for the Emergency Plan. The meeting also
opened new avenues for future cooperation, such as increasing
the number of university-trained social workers, training
rural social/health workers, creating a data-base for

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child-headed households, and participating in the Ministry of
Social Development's quarterly planning meetings. The
Embassy will work with the South African Government to
follow-up on these areas.


10. (SBU) Secretary Leavitt's visit highlighted the U.S.
Government's continuing commitment to our partnership with
the South African Government and NGOs in the fight against
HIV/AIDS. The visit supported the post's bilateral and
public-diplomacy efforts, and created opportunities to expand
America's help to those who need it most -- those affected by
the HIV/AIDS epidemic, including the growing number of
orphans left in its wake. End Comment.

11. (U) Secretary Leavitt has approved this cable.

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