VZCZCXRO2874
PP RUEHDU RUEHJO
DE RUEHMR #0254/01 1511153
ZNR UUUUU ZZH
P 311153Z MAY 06
FM AMEMBASSY MASERU
TO RUEHC/SECSTATE WASHDC PRIORITY 2073
INFO RUCNSAD/SOUTHERN AFRICAN DEVELOPMENT COMMUNITY
RUCNDT/USMISSION USUN NEW YORK PRIORITY 0050
RUEHMR/AMEMBASSY MASERU 2347

UNCLAS SECTION 01 OF 02 MASERU 000254 
 
SIPDIS 
 
SIPDIS 
 
SENSITIVE 
FOR AF/S 
 
E.O. 12958: N/A 
TAGS: UNGA PREL PGOV KHIV LT
SUBJECT: UNGASS:  HIGH LEVEL AIDS ISSUES 
 
 
MASERU 00000254  001.2 OF 002 
 
 
Summary 
-------------- 
 
¶1.  (SBU)  In recent discussions (May 29) with The First Lady of 
Lesotho and Prime Minister Mosisili, we have learned their major 
concerns about combating HIV/AIDS in Lesotho.  We have advised 
them that the U.S. Delegation will be led by First Lady Mrs. 
Laura Bush, and that a number of U.S. experts would be expected 
to participate as well.   The major concern of the Head of State 
and his wife is that Lesotho still ranks No. 3 with the world's 
highest percentage rate of infection.  They both focused on the 
need for human and material resources during this emergency and 
are particularly concerned about the degree of care and lack of 
sensitive service providers on the ground throughout the 
Mountain Kingdom.  The First Lady stated that at many of these 
international conferences, governments will say "everything is 
going well" and therefore she plans to spend as much time as 
possible with the NGOs who can relate the actual circumstances 
that ordinary citizens face when they seek counseling and 
treatment.  The leaders of Lesotho's delegation are looking 
forward to exchanges with representatives of other countries 
facing these problems as well as members of the U.S. delegation. 
 They have both offered gracious thanks to the U.S. for the 
assertive and expansive efforts being made through PEPFAR as 
well as by U.S. universities and private institutions.  End 
Summary. 
 
The First Lady's Views 
--------------------------------- 
 
¶2.  (SBU) Early on May 29, the Ambassador and First Lady had a 
lengthy discussion about the tragedy of hundreds of individuals 
lined up outside the main public hospital in Lesotho and the 
abusive treatment many of them have endured by clinicians, only 
to be informed that the one doctor who could treat them was not 
available.  The Ambassador related a specific case to the First 
Lady of an individual who had waited in line since 5:00 AM only 
to receive this type of treatment and, further, to be told that 
her daughter, who was no longer able to stand, had to walk into 
the hospital to even be seen.  The First Lady responded that she 
remained shocked at the lack of a sense of service by health 
care clinicians and providers not only in the capital of Maseru 
and other towns, but also in rural areas.  She continued that 
even though institutions such as the Baylor Institute of 
Excellence and the Clinton Foundation have focused on pediatrics 
care, even some of these young patients had not always been 
treated by clerks with the human dignity they warranted.  The 
Ambassador shared with the First Lady conversations with private 
doctors concerning this problem and also expressed her view that 
while a number of institutions have geared their programs 
towards infants (which is understandable to save that 
generation), there seemed to be a clear lack of behavior change, 
prevention, care and treatment for the 18-40 age group. 
 
¶3.  (SBU)  Mrs. Mosisili agreed that donors as well as local 
organizations, PVOs and NGOs need to direct their attention to 
this group of Basotho even though they may be at various stages 
of the HIV/AIDS disease.  We reviewed with her the objectives of 
U.S. PEPFAR programs indicating that our contributions to 
Lesotho had tripled in the past year and a half and that we had 
been approached by additional private organizations as well as 
educational institutions who are interested in supporting the 
government's efforts.  The Ambassador commended the First Lady, 
her husband the Prime Minister, religious and other leaders in 
Lesotho for their publicization on the HIV/AIDS problem and for 
their efforts to diminish the stigmatization and discrimination 
associated with this disease.  Mrs. Mosisili thanked the 
Ambassador for the continuing work by USG agencies in this 
regard as well. 
 
¶4.  (SBU)  Concerning the UNGASS, she said that she planned to 
talk as much as possible with NGO representatives even during 
the high level session because she felt the problems that needed 
to be addressed were problems on the ground; that government 
representatives would also say "everything is going well" when 
in fact the community based organizations would indicate the 
true state of affairs in local areas. 
 
¶5.  (SBU)  The Ambassador took the opportunity to brief the 
First Lady on the work in progress concerning the possible 
Millennium Challenge Account (MCA) to include renovation of 
almost 100 clinics as well as potential reconstruction or 
construction of new hospitals once the Government of Lesotho 
(GOL) presented a final compact pending GOL Cabinet and U.S. MCC 
Board approval. 
 
Prime Minister Echoes Spouse's Comments 
--------------------------------------------- ------------------ 
 
 
MASERU 00000254  002.2 OF 002 
 
 
¶6.  (SBU)  In a later meeting (May 29) with Prime Minister 
Mosisili on a range of issues (septel), the Head of State was 
most engaged when discussing the issue of HIV/AIDS.  He said he 
remained stunned in looking at a recent study showing Lesotho 
with the 3rd highest HIV/AIDS infection rate in the world.  He 
remarked that this state of affairs could not continue and that 
he was committed to changing this situation whatever it took. 
In that regard, he discussed the enormous need for human and 
material resources.  We responded that we had initiated capacity 
building programs within Lesotho and also felt strongly that we 
must work in partnership with Lesotho's health partners.  In 
other words, if there are U.S. preceptors, clinicians such as 
doctors, residents, nurses and nurse practitioners, they must be 
on the ground side-by-side with Basotho health workers and 
service providers in both rural and urban districts; otherwise, 
sustainability would not be possible.  The Prime Minister leapt 
on the term "sustainability" by saying that "this is absolutely 
necessary," otherwise, once the donor experts leave, there is no 
residual capability left behind to handle the still large 
numbers of AIDS patients in the country. 
 
¶7.  (SBU) The Ambassador discussed her continuing dialogue with 
all of the American partners to include not only USG personnel, 
but university, NGO and PVO representatives, to ensure 
collaboration with other development partners, support of the 
goals as set forth by the GOL and with the officials of the 
relevant ministries, notably the Ministry of Health.  She 
referenced her regular meetings with the Minister of Health 
often on a one-on-one basis to deal with misperceptions of U.S. 
institutions and the importance of working within the cultural 
context of Lesotho to decrease the feminization of AIDS and to 
provide partnership training in such a manner that it would be 
both accepted and carried out on the ground within the context 
of Lesotho.  The Prime Minister expressed his very deep 
gratitude to the Ambassador on a personal level for her own 
efforts to make sure that the cross cultural aspects of handling 
this disease are recognized and are being dealt with given the 
perception that donors might be imposing their views rather than 
working hand-in-hand to effectively communicate their commitment 
to partnership.    (We note that perception of diplomatic, 
("guest workers", if you will), can be distorted simply because 
of strong western personalities who have the good of specific 
countries at heart, but do not convey that message in such a way 
that can be heard effectively by the host country population.) 
 
¶8.  (SBU) The Prime Minister welcomed the pending visit of 
Deputy Assistant Secretary Carol Thompson to Lesotho and agreed 
that her site visits and conversations with Basotho would 
enhance the excellent relationship that already exists between 
the Kingdom of Lesotho and the U.S. 
 
Comment 
-------------- 
 
¶9.  (SBU) The Prime Minister seemed deeply interested in the 
materials that we presented to him on the UNGASS and told us 
that he had devoted a significant amount of time in studying 
documents he had obtained concerning this special session and 
felt that it was important for him to understand the 
international community's overall interest in the issues and its 
commitment through the Global Fund to which the U.S. is a major 
contributor.  It was clear that he also appreciated the 
extensive personnel commitment that the USG has made in terms of 
technical advisors to assist Lesotho in its responses to the 
Global Fund.  Without the expertise of official U.S. personnel, 
it is doubtful that Lesotho would be able to meet the stringent 
administrative requirements of various international funding 
sources.  We should add that USG officers have been intensely 
involved with their UN and other counterparts in developing both 
papers and strategies to address the pandemic and to obtain the 
resources necessary immediately to solve this problem in the 
long term. 
 
¶10.  (SBU) The 2005 visit of Ambassador Tobias made a lasting 
impression upon the GOL and on all stakeholders.  It served as a 
visible validation of the depth of the President's commitment to 
eradicate this pandemic and we expect that both the Prime 
Minister and First Lady will take the opportunity during the 
UNGASS to convey their gratitude for this assistance and to also 
indicate their realization that they, Basotho themselves, must 
learn as much as possible through U.S. programs about combating 
this disease in order to overcome it and ensure Lesotho's future 
as a nation. 
 
¶11.  (SBU)  Post encourages the U.S. Delegation to interact not 
only with the leaders of the Lesotho delegation, but with other 
GOL members such as the Ministers of Foreign Affairs and Health 
and their staff who will also be involved.  End Comment. 
PERRY