VZCZCXRO6615
RR RUEHMA RUEHPA
DE RUEHBP #0606/01 1821652
ZNR UUUUU ZZH
R 301652Z JUN 08
FM AMEMBASSY BAMAKO
TO RUEHC/SECSTATE WASHDC 9371
INFO RUEHZK/ECOWAS COLLECTIVE
RUEHAB/AMEMBASSY ABIDJAN 0143
RUEHDS/AMEMBASSY ADDIS ABABA 0032
RUEHLMC/MCC WASHINGTON DC 0116

UNCLAS SECTION 01 OF 05 BAMAKO 000606 
 
SENSITIVE 
SIPDIS 
 
DEPT PASS TO HHS/OGHA 
DEPT PASS TO USAID 
 
E.O. 12958: N/A 
TAGS: PREL EAID ML
SUBJECT: SCENESETTER FOR HHS SECRETARY MICHAEL O. LEAVITT'S 
VISIT TO MALI 
 
BAMAKO 00000606  001.2 OF 005 
 
 
1.(SBU)  Summary: We warmly welcome Secretary Leavitt's 
upcoming visit to Mali.  The Secretary's visit will provide 
an important opportunity to highlight U.S. support for a 
moderate, majority Muslim democracy that stands as an example 
for West Africa and beyond.  Mali has made considerable 
progress since its 1991-1992 transition to democracy. 
Unfortunately, Mali's health, education and economic 
indicators remain among the lowest in the world.  U.S. 
assistance plays a crucial role in helping Mali to address 
these challenges by ensuring that Mali's political successes 
translate into tangible improvements for Mali's estimated 13 
million people.  U.S. support for Mali and its people is 
particularly apparent in the health sector.  USAID/Mali's 
budget for health related activities is approximately USD 32 
million per year, with nearly half of this amount dedicated 
to malaria prevention under the President's Malaria 
Initiative.  The Centers for Disease Control and Prevention 
(CDC) and National Institutes of Health (NIH) provided 
approximately USD 4.4. million for health related programs in 
FY07.  Mali is one of the few countries in West Africa not 
currently facing a food shortage.  Rising food prices have, 
however, affected consumption patterns and the Ministry of 
Economy has predicted eventual food shortages for some remote 
areas.  Mali also faces serious security challenges.  Renewed 
fighting between Tuareg rebel groups and the Malian military 
in the northern region of Kidal has endangered the 
implementation of a peace agreement, known as the Algiers 
Accords, that was signed by the Malian government and Tuareg 
rebels in July 2006.  Northern Mali also serves as a 
safe-haven for the Islamic extremist  group al Qaeda in the 
Islamic Maghreb (AQIM) which continues to hold two Austrian 
hostages.  Mali is an important ally in the global war on 
terrorism and a key member of the Trans-Sahara 
Counter-Terrorism Partnership (TSCTP).  Although security 
concerns are currently confined to specific areas of northern 
Mali, increased levels of instability in the north has forced 
us to begin scaling back some of our assistance efforts for 
Mali's northern regions and we are concerned that further 
unrest will have a profound impact on our development and 
security  goals.  End Summary. 
 
--------------------------------------------- 
Malian Democracy and International Engagement 
--------------------------------------------- 
 
2.(U)  As a moderate majority Muslim democracy with over 15 
years of democratic experience,  Mali serves as an example 
for west Africa and beyond.  President Amadou Toumani Toure, 
who is known to Malians as "ATT," was re-elected to a second 
and final five year term as President in 2007 with more than 
70 percent of the vote.  His closest presidential challenger, 
former National Assembly president Ibrahim Boubacar Keita, 
finished second with less then 20 percent. 
 
3.(U)  Mali is a responsible and engaged international 
partner.  It has a strong human rights record and is one of 
the few members of the Organization of the Islamic Conference 
to be rated as "free" by Freedom House.  Mali is also a 
leader in sub-Saharan Africa in terms of press freedoms, 
although this record was tarnished somewhat by the 2007 
arrest and conviction of several journalists for "offending" 
the Head of State.  The journalists were given small fines 
and suspended sentences.  In addition to serving as the 2007 
Chair of the Community of Democracies, Mali is active in the 
United Nations and other international organizations and has 
participated in several international peacekeeping operations. 
 
4.(SBU)  Unfortunately, Mali's political progress has not 
been matched by improved social and economic indicators. 
Mali ranked 173 out of 177 countries on the United Nation's 
2007 Human Development Index.  Mali's poor ranking is due in 
large part to literacy rates, health indicators and a per 
capita GNP that rank among the lowest in the world.  These 
factors, along with renewed Tuareg unrest and the continued 
presence of al Qaeda-aligned terrorist elements in the 
country's sparsely populated northern regions, constitute 
serious threats to Malian democracy and regional stability. 
The U.S. plays a significant role in helping Mali to meet 
these challenges and reinforce almost two decades of 
democratic progress. 
 
----------------------- 
U.S. Assistance to Mali 
----------------------- 
 
 
BAMAKO 00000606  002.2 OF 005 
 
 
5.(U)  The November 2006 signing of a Millennium Challenge 
Account compact with Mali made the U.S. the largest bilateral 
donor to Mali.  It also cemented strong U.S.-Mali relations 
and better positioned Mali as a force for stability in a 
politically fragile region.  The USD 461 million compact 
entered into force in September 2007 and includes a USD 234 
million irrigation project north of Segou and a USD 183 
million airport renovation project.  USAID/Mali has an annual 
budget of approximately USD 55 million, which is divided 
between the health, education, governance and communications, 
and economic growth sectors.  Mali is host to one of the 
largest Peace Corps programs in Africa, with on average more 
than 120 Peace Corps volunteers in country working on health, 
sanitation, water conservation and economic development. 
 
6.(SBU)  Mali is an important ally in the global war on 
terror and a key member of the Trans-Sahara Counter-Terrorism 
Partnership (TSCTP).  TSCTP programming in Mali can be 
divided into programs focused on counter-terrorism and 
counter-extremism.  Important counter-terrorism  programs 
include bilateral training exercises like Joint Combined 
Exercise Training (JCET) events.  Counter-extremism 
activities include a broad range of Department of Defense 
supported humanitarian assistance, USAID development programs 
and public diplomacy outreach.  The Department of Defense's 
Humanitarian Assistance Program has contributed over USD 3 
million to Mali since 1999 to build wells, construct schools 
and renovate health clinics.  Mali is an active participant 
in the DOD's International Military Education and Training 
(IMET) program.  We also provide resources to train three 
Malian units in peacekeeping operations through the African 
Contingency Operations Training and Assistance (ACOTA) 
program. 
 
7.(SBU)  Malians practice a predominately open and tolerant 
form of Islam and are therefore unreceptive to extremist 
messages.  Our TSCTP counter-extremism programs are designed 
to promote moderate messages and ensure that Malians remain 
unreceptive to extremist ideologies.  TSCTP programs 
administered jointly by the State Department, USAID and the 
Department of Defense are designed to ensure that this 
remains the case and counter the possible spread of extremist 
ideologies.  USAID/Mali considers the northern region of Mali 
an important area and has undertaken activities there in a 
concerted effort since 1999.  USAID/Mali implemented 
approximately $3.7 million worth of activities in the north 
during FY07, including support to 35 rural health centers, 
the construction and reinforcement of 17 community radio 
stations, the establishment of six community telecenters 
offering internet access, the conduct of conflict-mitigation 
activities, support to rice and horticultural commodities, 
the expansion of access to financial services, the provision 
of scholarships and mentoring to 6,500 girls under the 
Ambassador's Girls Scholarship Fund, and the creation of 
teacher training and radio-based instruction for children of 
nomadic populations.  USAID/Mali received an additional $9.5 
million in TSCTP funds and the majority of these resources 
have been earmarked for activities in the north that aim to 
expand economic opportunities for youth, construct additional 
community radio stations, build capacity for local 
government, and support madersas throughout the country. 
 
8.(U)  On the Public Affairs side, we have used cultural 
preservation grants to help Mali honor its Islamic heritage 
by protecting thousands of ancient Islamic manuscripts in 
Djenne and Timbuktu and helping to preserve an ancient mosque 
in Gao.  We additionally recently celebrated the year 
anniversary of the only American Corner in Mali.  Located in 
Gao, it has allowed us to quadruple our outreach to key 
contacts in the region and to further promote mutual 
understanding between Malians and Americans. 
 
-------------------------------------------- 
U.S. Assistance to the Health Sector in Mali 
-------------------------------------------- 
 
9.(U)  The majority of Mali's approximately 13 million people 
live in rural areas with limited access to essential health 
services.  Although there has been a steady decline in 
maternal and child mortality, these indicators remain 
alarmingly high.  Mali has one of the world's highest 
fertility rates, which increases health risks to mothers and 
contributes to poverty levels.  The average number of births 
per Malian woman is 6.6. children.  The current maternal 
mortality rate is 464 deaths per 100,000 live births. 
 
BAMAKO 00000606  003.2 OF 005 
 
 
Under-five child mortality has decreased from 229 to 191 per 
1000 live births since 2001.  Infant mortality, which is at 
96/1000 live births, accounts for more than half of 
under-five child mortality.  Malnutrition among children 
remains a crucial problem as 2 out of 5 children are 
chronically malnourished.  In addition, 81 percent of 
children from 6 to 59 months in age are anemic.  Mali has 
seen a decline from 1.7 percent to 1.3 percent in the 
HIV/AIDS prevalence of the general population over the past 5 
years.  An estimated 85 percent of Malian women are victims 
of female genital cutting. 
 
10.(U)  USAID/Mali receives approximately USD 32 million per 
year for health related activities.  Nearly half of this 
money is for malaria control via the President's Malaria 
Initiative (PMI).  USAID/Mali is currently implementing the 
High Impact Health Services (HIHS) approach launched in 2003. 
 The HIHS framework supports the Government of Mali's 
ten-year health and social development plan and covers six 
primary technical areas: maternal health and family planning; 
malaria control; HIV/AIDS and child health; nutrition; 
vaccinations; and control of diarrheal disease.  HIHS is 
designed to increase levels of access, availability and 
quality of health services offered at local health facilities 
throughout the country.  HIHS also encourages the use of high 
impact health behaviors at the household level.  The key 
strategies behind HIHS aim to link and involve communities 
with health services, deliver key interventions within 
communities and promote and support essential health 
practices. 
 
11.(U)  CDC Mali operates from within the Ministry of 
Health's committee for coordinating efforts to fight the 
spread of HIV/AIDS.  In Mali, CDC's Global AIDS Program (GAP) 
currently focuses on three areas of intervention: HIV 
prevention, surveillance and laboratory strengthening.  In 
the area of prevention, CDC supports two local 
community-based organizations (ASDAP and Soutoura) that 
provide comprehensive prevention and community health 
services to at risk populations.  Both groups operate 
voluntary counseling and testing centers as part of their 
comprehensive service package.  The CDC also works with the 
Malian Government to implement two major epidemiological 
surveys which have identified important statistical trends 
and data among high risk groups.  CDC's GAP program also 
provides technical assistance to the National Institute for 
Public Health Research (INRSP) laboratory on the development 
and use of laboratory testing algorithms, manuals and other 
guidelines as well as reinforcing national diagnostic 
capabilities to support surveillance efforts. 
 
12.(U)  NIH is a founding partner of Mali's Malaria Research 
and Training Center (MRTC), which was created in 1989.  The 
MRTC is a unique and truly African operation whose work is 
planned, directed and executed by Malian staff.  The MRTC was 
presented as a model for development efforts at the Second 
International Meeting of the Multilateral Initiative on 
Malaria in South Africa in 2000.  NIH has designated the MRTC 
as a recipient of one of NIH's highly competitive and coveted 
Tropical Medicine Research Center grants.  In FY07, NIH 
funding for the MRTC exceeded USD 2.7 million.  These funds 
provide vital training opportunities for Malian medical 
students and researchers, and support important vaccine 
research. 
 
------------- 
Food Security 
------------- 
 
13.(U)  According to the World Bank and Mali's Commissioner 
for Food Security, Mali is one of the few countries in the 
region that does not currently face a food crisis.  The World 
Bank and other donors have, in fact, criticized Mali for 
exacerbating the regional food crisis by blocking the export 
of cereals.  Mali currently has enough course grains to carry 
over until the October harvests.  However, many Malians have 
already begun replacing staple goods with alternative, 
cheaper commodities due to rising food prices.  The Minister 
of Economy predicted eventual food shortages in certain 
remote areas and has signaled his intention to request 
assistance from the international community.  Higher prices 
will hit Mali's northern regions harder because these areas 
produce less and import more agricultural products, making 
them more susceptible to exogenous shocks. 
 
 
BAMAKO 00000606  004.2 OF 005 
 
 
14.(U) USAID provides almost $1 million in annual support to 
Mali's rice sector, including in the areas of irrigation, 
access to arable land, wells, financing, and support for the 
commercial sales of rice.  This is in addition to the USD 6 
million spent annually by USAID, in collaboration with 
American universities, to help introduce new technology into 
the cultivation of sorghum and millet, fisheries, and other 
crops to provide broader food security.  The MCC's USD 234 
million project in Alatona is focused on modernizing the 
irrigation system and developing 14,000 hectares of 
additional irrigable land. 
 
------------------- 
Security Challenges 
------------------- 
 
15.(SBU)  Security concerns in northern Mali constitute a 
significant challenge for the Malian government. Mali has 
weathered two Tuareg rebellions (one in 1963 and a second 
during the 1990s) since independence.  In May 2006 Tuareg 
rebels attacked two Malian military outposts in northern Mali 
and rekindled fears of another prolonged rebellion. 
President Toure resisted calls from some Malian political 
leaders to force a military confrontation with the rebels and 
instead opted for dialogue mediated by Mali's northern 
neighbor, Algeria.  In July 2006 Mali and the Tuareg rebels 
signed a peace agreement, known as the Algiers Accords, which 
pledged to provide increased development and infrastructure 
support to Mali's three northern regions.  In 2007 a 
dissident group of Tuareg rebels led by Ibrahim Bahanga 
resumed attacks against Malian military posts and convoys. 
Bahanga held several dozen Malian soldiers hostage for nearly 
six months until Libya helped negotiate their release in 
March 2008.  Less than two weeks later Bahanga seized another 
group of Malian soldiers.  He and another rebel group, the 
Alliance for Democracy and Change (ADC), are now holding 
approximately 80 Malian soldiers as "prisoners of war." 
 
16.(SBU)  Although Tuareg unrest is generally confined to the 
region of Kidal, rebels have orchestrated early morning 
attacks against military outposts in the regions of Gao and 
Segou.  Algerian-brokered discussions aimed at uniting 
disparate Tuareg rebel factions and facilitating a return to 
the Algiers Accords framework are currently on-going. 
President Toure remains committed to a negotiated settlement 
with Tuareg rebel leaders.  Key aspects of the Algiers 
Accords not yet implemented include the creation of special 
military units composed of northern and southern Malians, and 
the reduction of Malian forces in the north to pre-2006 troop 
levels.  Neither of these components can be implemented 
without a cease-fire that is respected by all Tuareg rebel 
groups.  Tuareg rebels are also demanding a credible 
investigation into the April 10 executions of two Tuareg 
rebels who had been re-integrated into the Malian army in the 
northern city of Kidal.  In addition to supporting Malian 
efforts to respect the Algiers Accords, we have urged the 
Malian government to investigate these killings and have 
noted that credible allegations of human rights abuses 
perpetrated by members of the Malian military could adversely 
affect our ability to provide military training to Malian 
units in the future. 
 
17.(SBU)  In addition to the unfolding Tuareg crisis, Mali's 
sparsely populated and vast northern regions also serve as a 
haven for smugglers, bandits and terrorist elements.  The 
Malian government is unable to fully secure these zones due 
to their size and remote nature.  Algerian Islamic extremists 
formerly known as the Salafist Group for Preaching and Combat 
(GSPC) but now called al Qaeda in the Lands of the Islamic 
Mahgreb (AQIM) continue to use northern Mali as a safe haven 
and are currently holding two Austrian hostages on Malian 
territory. 
 
------------------------------ 
Comment: U.S. Support for Mali 
------------------------------ 
 
18.(SBU)  Mali's status as a leader in democracy, human 
rights and tolerance make U.S. engagement with Mali, and 
support for Mali's development in crucial areas like the 
health sector, even more critical. The number and variety of 
U.S. government agencies involved in health care in Mali, as 
well as the presence of award winning institutions like 
Mali's Malaria Research and Training Center, are a testament 
to U.S. commitment in this regard.  Your visit to Mali will 
 
BAMAKO 00000606  005.2 OF 005 
 
 
serve as a further demonstration of U.S. Government support 
for Mali and its people at a time when Mali is confronted 
with serious development and security challenges.  Your visit 
will also afford an important opportunity for us to engage 
with Malian officials and members of civil society on 
important issues like malaria prevention and the fight 
against HIV/AIDS. 
MCCULLEY