VZCZCXYZ0009
PP RUEHWEB

DE RUEHTU #2492 2770917
ZNR UUUUU ZZH
P 040917Z OCT 06
FM AMEMBASSY TUNIS
TO SECSTATE WASHDC PRIORITY 1967

UNCLAS TUNIS 002492 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
STATE FOR NEA/MAG (HARRIS) AND S/GAC (JEFFERS, MAMACOS, 
MAZZONE) 
STATE PASS FOR USAID/GH (MILLER AND WRIGHT), HHS (STEIGER) 
 
E.O. 12958: N/A 
TAGS: EAID KHIV SOCI TBIO TS
SUBJECT: HIV/AIDS AND THE GLOBAL FUND: EMBASSY TUNIS 
PARALLEL REVIEW 
 
REF: STATE 158244 
 
¶1. (U) Per reftel, an interagency committee, comprised of 
participants from the Health Unit, Public Affairs, the 
Political and Economic Section, and DOD's Office of Defense 
Cooperation reviewed the GOT submission to the Global Fund. 
The following comments are keyed to reftel para 8 questions: 
 
¶A. (U) Proposing group and amount: Tunisia Country 
Coordinating Mechanism, 17.383 million USD 
 
¶B. (SBU) Overall comments and recommendations for the U.S. 
Government delegation position: Embassy Tunis recommends that 
the U.S. delegation support the Tunisian proposal.  Despite 
what is currently a low reported prevalence of HIV/AIDS in 
Tunisia, growing urbanization and a continued lack of 
awareness of risk factors and prevention methods on the part 
of Tunisians increase the likelihood that the disease will 
continue to spread.  The absence of effective epidemiological 
data collection and monitoring make it difficult to assess 
the true extent of infection in the country.  Embassy Tunis 
believes that the GOT proposal represents a sound strategy 
that will begin to address deficiencies in the GOT's 
epidemiological data collection and monitoring, educational 
outreach, and medical services for persons living with 
HIV/AIDS.  Educational outreach is critical in the GOT's 
efforts to prevent not only the spread of HIV/AIDS, but also 
to removing the stigma currently attached to those suffering 
from the disease.  For these reasons, educational outreach 
must extend beyond high-risk groups and touch all segments of 
Tunisian society.  The proposal also involves the 
participation of health-related non-governmental 
organizations.  Such activities would help further the 
Embassy goal of supporting and strengthening Tunisian civil 
society. 
 
¶C. (U) Comments on TRP review: Post agrees with the analysis 
provided by the TRP. 
 
¶D. (U) Public health and scientific considerations: The GOT 
has proven its ability to implement effective health care 
initiatives in the face of potentially sensitive social 
issues.  Launched in the 1950s, Tunisia's revolutionary 
family planning program successfully led to a reduction in 
the birth rate through widespread educational campaigns, as 
well as contraceptive distribution.  Due to a relatively 
effective public health system and well-trained medical 
personnel, Tunisia's technical assistance requirements should 
be minimal.  Embassy contacts have reported, however, that 
the Ministry of Health has little funding available for 
specialized treatment and prevention programs beyond the 
scope of primary health care. 
 
¶E. (U) Coordination with other partners: The project 
activities outlined in the proposal represent activities 
which have not been undertaken by any other entities in 
Tunisia on a large scale and will therefore not duplicate 
current HIV/AIDS programs in country.  In addition, the CCM 
includes members from a wide-range of health-related civil 
society organizations, which should encourage successful 
coordination between the GOT and other organizations with a 
stake in HIV/AIDS prevention. 
 
¶F. (SBU) Political considerations: Consistent with the 
President's Freedom Agenda, strengthening and supporting 
Tunisian civil society represents a core objective of Embassy 
Tunis.  The inclusion of health-related civil society 
organizations in the CCM will further this important Embassy 
goal. 
 
¶G. (U) Additional Comments: Director of UNAIDS in Tunisia, 
Jean-Michele Delmotte, recently contacted the Embassy to 
convey UNAIDS Tunisia's support for this proposal and to 
request Embassy backing as well. 
 
¶H. (U) Embassy point of contact: Economic Officer Victoria 
Taylor, E-mail: TaylorVJ@state.gov, Phone: 216-71-107-431 
BALLARD