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