Cablegate: Scenesetter for Codel Durbin Visit to Tanzania


DE RUEHDR #0061/01 0280404
P 280404Z JAN 10




E.O. 12958: N/A

1. Your visit to Tanzania comes at a time when our bilateral
relationship with Tanzania is at an historic highpoint, in part
because of our expansive assistance efforts in multiple sectors.
Tanzania's unbroken record of political stability, sound
macroeconomic management and enormous development needs have made it
a favored recipient of donor funds, although the recent slow pace of
reform and of efforts to fight corruption are increasingly of
concern to donors. Roughly one third of the government's budget is
financed by direct budget support. The U.S. has its largest
Millennium Challenge compact with Tanzania, significant PEPFAR and
PMI programs, and a range of other foreign assistance activities.
For specific information on the Mwanza region, which you will visit,
please see paragraphs 18-22.

Political Background
2. Tanzania's long record of peace and stability sets a positive
example for the region. Tanzanians have a well-deserved reputation
for having a strong national identity which takes precedence over
ethnic identity, distinguishing Tanzania from many other African
nations. President Kikwete's landslide election in 2005 marked the
country's third peaceful presidential transition; he is expected to
stand again and is heavily favored for the elections due in October
2010. Multi-party democracy, reintroduced in the early 1990s, has
not shaken the dominance of the Chama Cha Mapinduzi (CCM -
Revolutionary Party), the ruling party since independence. However,
the long dormant parliament is increasingly exercising its oversight
function on an executive branch accustomed to governing unchecked.
While elections on the mainland have generally been free and fair,
serious irregularities and violence have marred elections in the
semi-autonomous islands of Zanzibar, where support is evenly divided
between CCM and the main opposition party. The start of voter
registration for 2010 was disrupted by clashes between opposition
supporters and security forces and the opposition is maintaining a
boycott. However, the opposition's recent recognition of the 2005
results as legitimate has raised hopes of reconciliation and
possible power-sharing between the two main parties.

Regional Leadership
3. Under the leadership of President Kikwete, a former Foreign
Minister, Tanzania has played an increasingly prominent role in
regional issues. Kikwete finished a one-year term as Chairman of
the African Union (AU) in January 2009. In that role, he spoke out
against military coups in Mauritania and Guinea and the
unconstitutional change in power in Madagascar. Within the Southern
Africa Development Community (SADC), Tanzania has played a
relatively quiet but positive role with respect to Zimbabwe.

East African Community
4. The 2005 establishment of a customs union in the East African
Community (EAC) has increased Tanzania's regional trade, especially
with Kenya. The EAC leaders concluded an agreement on a common
market protocol in November. However, Tanzania's concerns about
economic competition, particularly from Kenya, and the designs of
its neighbors on Tanzania's abundant land, have led it to resist
more rapid and more comprehensive integration within the East
African Community. Tanzania has balked at provisions that would
permit other EAC citizens to buy land, establish residence, or enter
without a passport. Kenyans have a reputation for being more market
savvy, commercially aggressive and better educated than most
Tanzanians. For that reason, many Tanzanians also fear labor
mobility liberalization within the EAC.

5. Tanzania has long hosted refugees from the region's conflict
areas. The number has declined from more than a million in the late
1990s to about 100,000 currently (the U.S. has provided significant
support for UN operations in the refugee camps and is one of the
main resettlement destinations), mainly from Burundi and the
Democratic Republic of Congo. Tanzania has offered naturalization
to more than 100,000 Burundi who came as refugees in 1972, an
unprecedented act. Tanzania is also host to the International
Criminal Tribunal for Rwanda.

Economic Background
6. Tanzania began an incomplete transition from socialism towards a
free-market system with macroeconomic reforms in the mid-1980s,
which have provided a basis for sustained moderately high economic
growth. However, even with growth averaging 7 percent over the last
decade, the percentage of people living in poverty has declined only
slightly, to one-third of the population, while continued rapid
population growth has increased the absolute numbers of the poor by
more than a million since 2001 and threatens to overwhelm an already
fragile social service system. Roughly 80 percent of the population
is engaged in mostly small-scale agriculture, while per capita GDP
is about USD 415. Although the global financial crisis
significantly affected the tourism industry, one of Tanzania's top
foreign-exchange earners, 2009 saw economic growth of nearly 5
percent. High food prices since a spike in 2008 have contributed to
a rise in inflation to over ten percent, a substantial increase from
more moderate inflation earlier in the decade.

Business and Investment Climate
7. Two years after the World Bank Doing Business Index called
Tanzania a "top reformer," the pace of reform has stalled. In
addition to bureaucratic obstacles, investors face poor
infrastructure, a population with a limited skills base, and
widespread corruption. Strained capacity at the port of Dar es
Salaam delays cargo twice as long as at the competing port of
Mombasa (which itself is inefficient by international standards).
Power generation, heavily reliant on hydropower, has run far behind
rising demand, leading to frequent blackouts. On Zanzibar's main
island, damage to the cable connecting with the mainland has left
the island reliant on inadequate and expensive diesel generation
since December 10, 2009. The Kikwete government's efforts to fight
corruption have been fitful. Late 2008 saw the first major court
cases on grand corruption, with the arrests of individuals whose
companies allegedly siphoned funds from the Bank of Tanzania, along
with several Bank employees, and the separate arrests of two
long-serving former ministers on corruption-related changes. Since
then, the cases have progressed slowly and several other
well-publicized scandals have yet to result in prosecutions.

U.S. - Tanzanian Bilateral Relationship
8. Since the election of President Kikwete in December 2005,
U.S.-Tanzanian bilateral relations have deepened and broadened
significantly. President Kikwete's pro-American stance, coupled
with an increasing level of U.S. assistance, has been the catalyst
for this change, enhancing cooperation in sectors from health and
education to counterterrorism and military affairs. Over the 45
years between Tanzania's independence and the Kikwete
Administration, American-Tanzanian cooperation in the security
sector was extremely limited or nil. It is now robust and growing.
President Kikwete has visited the U.S. several times since taking
office, including an official visit in August 2008 and a meeting
with President Obama in May 2009 (the first African Head of State
received in the White House by President Obama). The public signing
of the MCC compact during President Bush's February 2008 visit to
Tanzania, and the favorable public reaction to the visit, had
earlier deepened the relationship.

USG Assistance
9. The U.S. is one of the top donors in Tanzania, with total FY 2009
bilateral assistance of over USD 400 million. Taking into account
the U.S. share of contributions from multilateral donors such as the
World Bank and African Development Bank, U.S. assistance totaled
over USD 630 million in 2009. This does not include major private
U.S. benefactors such as the Gates Foundation. Other major
bilateral donors include the U.K., Sweden, Netherlands, Denmark,
Norway, and the European Commission; for several of the other
donors, Tanzania is among the top recipients of assistance.

Health Challenges
10. HIV/AIDS: Tanzania faces a mature generalized HIV epidemic, with
a prevalence rate of approximately 5.8 percent and 1.4 million
people living with HIV/AIDS. An estimated 440,000 individuals are
clinically eligible for antiretroviral treatment; however, available
services can support less than half of those in need. In FY 2008,
PEPFAR provided Tanzania with over USD 313 million to support
treatment, care, and prevention programs. In FY 2009, the PEPFAR
budget was USD 313 million with a planning budget of 308 for FY
2010. We will have access to an additional USD 50 million under an
approved Partnership Framework. The PEPFAR program has exceeded its
original PEPFAR targets of providing anti-retroviral treatment for
150,000 individuals and care for 750,000 individuals, including
orphans and vulnerable children. Although the U.S. has fostered
positive relationships with the Tanzanian government in the health
sector, significant challenges remain, including: the need for
stronger leadership in line ministries; poor health infrastructure;
a shortage of health care workers; a weak government procurement
system; and allegations of corruption in the public and private
sectors. Productive negotiations with the GOT on a PEPFAR
Partnership Framework Agreement, which would deepen our relationship
over the coming five years, are nearing completion. We are also
working to increase our coordination with - and the effectiveness of
- Global Fund grants to Tanzania for HIV/AIDS, HIV/TB and malaria.

11. Malaria: Malaria is the number one killer of children in
Tanzania and continues to be a major cause of maternal mortality.
As a focus country under the President's Malaria Initiative (PMI),
Tanzania received USD 35 million in FY 2009 to support the delivery
of long-lasting, insecticide treated bed-nets (LLINs), the care and
treatment of malaria, the malaria in pregnancy program, and indoor
residual insecticide spraying (IRS). The 2007-2008 Malaria
Indicator Survey (MIS) shows malaria prevalence at less than 1
percent on the islands, advancing Zanzibar to a pre-elimination
phase in malaria control. While support to the Zanzibar Malaria
Control Program continues focusing on capacity building and systems
strengthening for sustainability, PMI interventions in mainland
Tanzania are rapidly scaling up through IRS and partnership with GOT
on a multi-donor campaign to distribute LLINs to children under five
and pregnant women with the goal of achieving universal bednet
coverage in the near term.

12. Maternal and Child Health and Family Planning: USG assistance
through USAID has played a role in reducing infant mortality by 32
percent since 1999, but the rate is still unacceptably high (112 per
1000 lives births; 2004 DHS). Maternal mortality and fertility
rates remain unacceptably high (578 per 100,000 and 5.7 per woman
respectively; 2004 DHS) and have not changed appreciably for the
past 15 years. USAID will continue to use Child Survival and Health
funds (USD 26 million in FY 2009) to reduce infant mortality by 25
percent over the next five years by controlling malaria, provili~'-sk\'`mHvAership with the
Government of Tanzania and NGOs to upgrade health care systems,
norms and standards at the national and local levels.

13. Like other countries undergoing a rapid expansion of their
education system, Tanzania is faced with challenges of capacity and
education quality. Schools lack sufficient teaching and learning
materials at all levels. Classrooms are overcrowded despite double
or triple shifts. There is an acute shortage of teachers and the
majority of teachers lack adequate qualifications, particularly in
English, science and mathematics. USAID and Tanzania recently
approved a new Education Assistance Objective with USD 11 million in
FY 2009 funds focused on: improved quality in lower primary
education (reading, math and science); teacher training; learning
materials such as provision of textbooks; and improved educational
quality through capacity building for educational management

Millennium Challenge Corporation
14. In September 2008, the MCC Compact signed by Presidents Kikwete
and Bush entered into full force and effect. It is the largest
Compact signed to date (USD 698.136 million) and is targeted to
address significant weaknesses in Tanzania's long-neglected
transport (roads and an airport), energy, and water infrastructure.
A significant amount of required preparatory work (environmental
studies, finalization of technical designs, and planning for
resettlement and compensation) has been completed. Construction
supervision contracts for all main roads have been competed and
awarded, and the first construction works contract was awarded in
December. Several other contracts for energy activities are
currently being tendered. On the strategic political front, our
message continues to be that a Compact is an agreement of reciprocal
responsibilities; to sustain it over five years, Tanzania must pay
heed to its corruption index and be vigilant at all levels to ensure
transparency and accountability in governance. A planned hydropower
plant in Kigoma was recently stalled due to the discovery of three
newly identified endemic species (two fish and a snail) whose
habitat would be destroyed or critically altered by the plant as
designed. However we are working closely with the government to
develop a substitute activity that could be completed by MCC's
September 2013 deadline and help bring power to Kigoma.

Food Security
15. While Tanzania performs relatively better than its neighbors in
food self-sufficiency, regional and seasonal imbalances exist and
malnutrition is rampant among children under five. USAID's proposed
food security program is designed to increase food production and
availability (staples), and strengthen secondary value chains
(horticulture and livestock), in order to improve household income
diversification and nutrition, particularly for women and
smallholder farmers. The plan is aligned with Tanzania's
Agricultural Sector Development Plan (through 2015) and the 2009
"Agriculture First" initiative. The USD 37.7 million Financial
Crisis Initiative (FCI) for Tanzania, announced in November, is
targeted at enhancing food security in the short-term (18 months)
through school feeding and employment programs in areas most
affected by the global economic slowdown. FCI funds will also
contribute to improved access to credit for agri-businesses and
strengthening of economic forecasting and budget processes at the
central level to cushion the effects of future economic shocks.

Democratic Governance
16. With USD 4.2 million in FY 2009 funding, USAID is supporting
ongoing programs to build civil society capacity and accountability
and transparency in local government spending through Public
Expenditure Tracking at the community level. Governance funds will
also be used for election monitoring and civic education in the
run-up to the October 2010 elections.

Military-to-Military Relations
17. Under the Kikwete administration, the GOT has begun
participating in international peacekeeping operations. Most
significantly, Tanzania is in the process of deploying a battalion
to Darfur as part of the UN peacekeeping mission. The U.S. provided
training to that battalion and plans to train others through the
African Contingency Training and Assistance (ACOTA) program.
Evidence of deepening military-to-military ties between the USG and
GOT include the establishment of a Civil Affairs Team, which is
carrying out humanitarian projects and helping build civil military
operations capacity within the Tanzania Peoples Defense Forces
(TPDF), increasingly routine U.S. naval ship visits (the one in 2007
was the first since Tanzania's independence), and an expanding DOD
PEPFAR program.

Mwanza Region and U.S. Programs
18. Mwanza is a relatively small region in Northwest Tanzania with a
rapidly growing population of approximately three million. The
northern part of Mwanza is bounded by Lake Victoria, which Tanzania
shares with Uganda and Kenya. The economy in Mwanza Region is
dominated by smallholder agriculture, employing about 85 per cent of
the region's population, and complemented by an expanding fisheries
sector. Leading foreign exchange earners for the region are
fishing, agriculture and mining, which has expanded rapidly in the
past decade. In agriculture, the main food crops are corn, cassava
and sweet potato, with cotton and rice as the main cash crops. The
region is generally not self-sufficient for food.

19. The city of Mwanza, with an estimated population of one million,
is Tanzania's second largest town after Dar es Salaam and the
economic heart of the Lake Region. Mwanza is an important transport
hub, with a rail line connecting to Dar es Salaam (although recent
flooding in central Tanzania has cut the rail line) a busy
freshwater port, and an airport. Mwanza is a central area for the
Sukuma ethnic group, Tanzania's largest at roughly 12% of the

20. Health issues: HIV prevalence in Mwanza (5.6% 15-49, 3.8% 15-24)
is near the national average, but is higher than average for youth.
The region has one of the highest prevalence rates for malaria:
31.4% of children six months to five years test positive for
falciparum malaria. Over one-half of households in Mwanza travel
more than 2 km to their nearest improved water source, while
residents live an average of 4 km from primary care facilities and
21 km from hospitals. As elsewhere in the country, facilities often
lack skilled workers, water, power, access to communication, and
emergency transportation.

21. The USG Response in Mwanza Region: Through PEPFAR, the USG
supports HIV prevention, treatment, care and system strengthening
activities. In addition to supporting HIV treatment services at
public, private and faith-based sites, the USG supports numerous
local organizations that provide home- and community based services,
including services targeted to vulnerable children and their
caregivers. In partnership with the Government of Tanzania and the
Baylor International Pediatric AIDS Initiative, PEPFAR Tanzania is
building the skills of pediatric providers at Bugando Medical
Center. Similarly, working in collaboration with the Touch
Foundation, PEPFAR is supporting medical training scholarships at
the Bugando University of Health Sciences. Because of the
complexity of the Mwanza region population, PEPFAR has brought
voluntary HIV counseling and testing to mobile, mining and Lake
Victoria island populations through several innovative programs.
Finally, PEPFAR-funded operational research on the prevention of
mother-to-child transmission is being undertaken by Tanzania's
National Institute for Medical Research facility in Mwanza.

22. Under the President's Malaria Initiative, the USG partnered with
the Government of Tanzania and other donors including the Global
Fund and the World Bank to provide free long-lasting insecticide
treated nets (LLIN) to every child under five years old in the Lake
Zone (July 2008)as part of Tanzania's Under-Five Catch Up Campaign.
Indoor Residual Spraying will target every house in the Mwanza
region beginning in late summer 2010. The USG also supports a
voucher program for pregnant women and infants to receive subsidized
LLINs. As part of national programs, the USG also supports the
Ministry of Health in efforts to provide contraceptive choice to
residents in Mwanza region through training, rehabilitating
facilities, supporting the provision of quality voluntary
contraceptive methods, and social marketing. The USG also supports
quality improvement in antenatal care focusing on reducing maternal
mortality through improved basic emergency obstetrical care,
supporting vitamin A distribution twice a year for under-fives, and
supporting oral rehydration therapy and zinc therapy, which reduces
mortality due to diarrheal diseases.


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