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DE RUEHSA #3029/01 2420437
ZNR UUUUU ZZH
O 300437Z AUG 07
FM AMEMBASSY PRETORIA
TO RUEAUSA/DEPT OF HHS WASHDC IMMEDIATE
RUEHPH/CDC ATLANTA GA IMMEDIATE 2088
RUEHC/SECSTATE WASHDC IMMEDIATE 1435
INFO RUEHDR/AMEMBASSY DAR ES SALAAM PRIORITY 2517
RUEHLGB/AMEMBASSY KIGALI PRIORITY 0988
RUEHTO/AMEMBASSY MAPUTO PRIORITY 5684
RUEHTN/AMCONSUL CAPE TOWN PRIORITY 4751
RUEHDU/AMCONSUL DURBAN PRIORITY 9098
RUEHJO/AMCONSUL JOHANNESBURG PRIORITY 7261

UNCLAS SECTION 01 OF 05 PRETORIA 003029 
 
SIPDIS 
 
SENSITIVE BUT UNCLASSIFIED 
SIPDIS 
 
HHS FOR OGHA, CDC ATLANTA FOR JULIE GERBERDING AND STEVE 
BLOUNT, USAID FOR GH/KENT HILL AND KEN YAMASHITA, NSC FOR 
BOBBY PITTMAN AND MIKE MAGAN, AF FOR A/S FRAZER 
 
E.O. 12958: N/A 
TAGS: ECON SOCI PGOV PREL SF
SUBJECT:  SECRETARY LEAVITT CONCLUDES SUCCESSFUL VISIT TO 
SOUTH AFRICA 
 
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SUMMARY 
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¶1.  (U) U.S. Secretary of Health and Human Services (HHS) 
Michael O. Leavitt completed a successful visit to South 
Africa August 18-21, 2007.  The Secretary and his delegation 
visited four sites in Gauteng and KwaZulu-Natal Provinces 
funded by the President's Emergency Plan for Aids Relief to 
demonstrate the wide range of activities of our 400-plus 
South African and international partners.  Secretary Leavitt 
and most senior members of the delegation also met with 
Minister of Social Development Dr. Zola Skweyiya and Deputy 
Minister for Foreign Affairs Aziz Pahad.  Secretary Leavitt 
stressed the collaborative nature of our work with the South 
African Government and our many non-governmental partners 
(NGOs).  Minister Skweyiya said it was good that Secretary 
Leavitt had come, hoped that the U.S. and South African 
governments could cooperate more on social issues, and 
expressed gratitude for the U.S. Government's assistance. 
Secretary Leavitt also held a series of well-attended press 
 
SIPDIS 
conferences, media roundtables and electronic interviews in 
Johannesburg, Pretoria and Durban.  The international and 
local media responded with great interest, and reported 
favorably on his activities and messages.  Secretary 
Leavitt's visit highlighted the U.S. Government's continuing 
commitment to our partnership with the South African 
Government and NGOs in the fight against HIV/AIDS.  The visit 
supported Post's bilateral and public-diplomacy efforts, and 
created opportunities to expand America's help to those who 
need it the most -- those infected by the HIV/AIDS epidemic, 
including the growing number of orphans left in its wake. 
End Summary. 
 
-------------------- 
Purpose of the Visit 
-------------------- 
 
¶2.  (U) HHS Secretary Michael Leavitt completed a successful 
visit to South Africa from August 18-21, 2007.  A series of 
visits to programs implemented under the President's 
Emergency Plan for AIDS Relief was the centerpiece of the 
South African leg of the visit.  Secretary Leavitt's 
delegation included U.S. Global Aids Coordinator Ambassador 
Mark Dybul; the Director of the HHS Office of Global Health 
Affairs (OGHA), Dr. William Steiger; the Director of the 
Centers for Disease Control and Prevention (CDC), Dr. Julie 
Gerberding; the Assistant Administrator for Global Health at 
the U.S. Agency for International Development (USAID), Dr. 
Kent Hill; HHS/OGHA Director for African Affairs, Dr. Samuel 
Adeniyi-Jones; the Director of the Fogarty International 
Center of the HHS National Institutes of Health (NIH), Dr. 
Roger I. Glass; and State Department DAS for African Affairs 
Carol Thompson.  The Charge, HHS/CDC Country Director, USAID 
Director, Acting Health Attach, Consul General in Durban 
(while in Durban) and Economic Counselor (Control Officer) 
accompanied the delegation. 
 
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Site Visits 
----------- 
 
¶3.  (U) Secretary Leavitt and his delegation visited four 
sites funded by the Emergency Plan in Gauteng and 
KwaZulu-Natal provinces, selected to demonstrate the wide 
range of activities of our 400-plus South African (80 
percent) and international (20 percent) partners that 
implement the South Africa program.  The four sites were the 
Mercy Clinic in Winterveldt Township, and Heartbeat in 
Nellmapius Township, both outside of Pretoria; CAPRISA in 
Vulindlela, outside of Pietermaritzburg; and the University 
of KwaZulu-Natal (KZN) Medical School in Durban. 
 
Mercy Clinic 
 
On August 20, Secretary Leavitt and his delegation visited 
the Mercy Clinic, a large multi-purpose facility located in 
Winterveldt township in Gauteng Province.  Run by the Order 
of Mercy, the facility receives partial funding from the 
 
PRETORIA 00003029  002 OF 005 
 
 
Emergency Plan, and provides a range of health care and 
community services, including basic health care, dentistry, 
vocational education, psychosocial support for orphans and 
vulnerable children (OVCs) and their caregivers, nutrition 
programs, gardens, skills-training and employment-generation 
activities.  Emergency Plan funding provides confidential, 
voluntary counseling and testing (VCT) and support for the 
provision of anti-retrovirals (ARVs), although the South 
African Government provides the drugs themselves.  Secretary 
Leavitt toured the facility, and conversed with patients 
about the impact of the Emergency Plan program on their lives 
and work, and with home-based caregivers about their 
experience with HIV/AIDS in the Winterveldt community.  He 
also spoke to several children and their guardians who are in 
the facility's OVC program. 
 
Heartbeat 
 
Later on August 21, Secretary Leavitt visited the Heartbeat 
facility in the township of Nellmapius, north of Pretoria. 
The site furnishes a range of support for OVCs and their 
caregivers (grandmothers, elder siblings, or other family 
members and friends).  Located in a set of brightly colored 
trailers and containers next to a new primary school, the 
facility feeds, tutors, counsels, arranges play activities 
and holiday programs, provides uniforms and books and 
improves the lives of children devastated by the loss of both 
parents.  In most cases, grandmothers are raising the 
children; however, in a significant percentage of cases the 
orphans are living in child-headed households.  The program 
also assists OVCs and their caregivers to access government 
grants and services, and provides training in child care and 
income-generation to household heads.  Secretary Leavitt 
interacted with groups of primary school children who were 
receiving homework supervision and one-on-one tutoring and 
psychosocial support, including the making of memory boxes. 
Secondary students shared with Secretary Leavitt their plans 
for further study and occupational goals, and a group of 
grandmothers who talked about their experiences in raising 
their grandchildren and generating additional income. 
 
CAPRISA Vulindlela Research Facility 
 
On August 21, Secretary Leavitt and his delegation traveled 
to KwaZulu-Natal, South Africa's most populous province 
(nearly 10 million people), and the region most affected by 
the HIV/AIDS epidemic.  Secretary Leavitt visited a research 
facility in Vulindlela run by the Centre for AIDS Programme 
of Research in South Africa (CAPRISA).  CAPRISA's Vulindlela 
facility is located in a rural area (about an hour and a half 
outside Durban and 40 minutes from Pietermartizburg) 
primarily funded by the Emergency Plan (through USAID and 
HHS/CDC) and HHS/NIH.  The facility is notable for the local 
community's support of its activities.  Secretary Leavitt 
discussed the integration of the facility into the community 
with traditional leaders, a Peace Corps Volunteer, a local 
NGO, a Reverend, and a local Department of Health 
representative.  Secretary Leavitt then interacted with 
medical personnel who are running HIV/AIDS prevention 
research programs, and had an opportunity to speak with 
several participants in a microbicide trial.  Secretary 
Leavitt also engaged with patients who are receiving 
anti-retroviral therapy at the facility.  To close the visit, 
Secretary Leavitt discussed the challenges faced by the local 
 
SIPDIS 
community with researchers, traditional leaders, and 
community support groups during a lunch hosted by CAPRISA. 
All parties agreed that the community's biggest challenge was 
to curb the number of new HIV/AIDS infections, but that this 
had proven difficult. 
 
University of KZN Nelson R. Mandela School of Medicine 
 
In Durban, also on August 21, Secretary Leavitt visited the 
University of KwaZulu-Natal's Doris Duke Medical Research 
Institute, where he delivered a speech to over 100 medical 
students and researchers, including 15 beneficiaries of U.S. 
grants.  The Medical School receives nearly 50 percent of its 
research funding from U.S. private and public sources (USAID 
and HHS, including CDC and NIH, some of which is Emergency 
 
PRETORIA 00003029  003 OF 005 
 
 
Plan financing). In his speech, Secretary Leavitt reflected 
upon his experiences while visiting the Heartbeat and 
Winterveldt sites on August 20.  He emphasized that he 
believed there was hope in the fight against HIV/AIDS.  He 
also discussed President Bush's personal commitment to the 
fight against HIV/AIDS and his request for a doubling of 
Emergency Plan funding.  Secretary Leavitt added that he 
would encourage Congress to approve the proposed increase, as 
he had witnessed in South Africa the positive impact of 
programs funded by the U.S. Government.  Secretary Leavitt 
and the audience then engaged in a question-and-answer 
session.  Most questions revolved around medical education 
and training, and South Africa's need to develop the next 
generation of scientists and doctors.  The University also 
used the occasion of Secretary Leavitt's visit to announce a 
USD 30 million grant by the Howard Hughes Medical Institute 
to build a research institute to focus on tuberculosis (TB) 
and extensively drug-resistant TB. 
 
------------------- 
Ministerial Meeting 
------------------- 
 
¶4.  (SBU) Secretary Leavitt and some of the senior members of 
the delegation also met with the South African Minister of 
Social Development, Dr. Zola Skweyiya.  Deputy Minister for 
Foreign Affairs Aziz Pahad, Director-General for Social 
Development Vusimuzi Madonsela and Director-General for 
Health Thami Mseleku accompanied Skweyiya.  The Embassy had 
requested a meeting with the Deputy President, Phumsile 
Mlambo-Ngcuka, who was in Cape Town to meet with Parliament, 
and Minister of Health Dr. Manto Tshabalala-Msimang, who was 
visiting the Democratic Republic of Congo with President 
Thabo Mbeki.  The Minister of Health later sent a letter to 
express her regret that they had not been able to meet and 
her wish that they be able to meet soon, hopefully in South 
Africa. 
 
¶5.  (SBU) Secretary Leavitt stressed the collaborative nature 
of our work with the South African Government and our many 
NGO partners, while underlining the success of the Emergency 
Plan's partnership with the Ministry of Social Development in 
the support of OVCs.  Minister Skweyiya said it was good 
Secretary Leavitt had come and he hoped the U.S. and South 
 
SIPDIS 
African governments could cooperate more on social issues. 
He specifically expressed a need for help in increasing the 
number of university-trained social workers and expanding the 
cadre of rural social/health workers (such as medical 
clinicians/medical extenders) to help extend service to rural 
areas where there is a lack of permanent infrastructure, and 
he appealed for short-term/bridge funding for additional 
personnel.  The Director-General of Health added there would 
soon be an announcement of new roles for nurses because of 
the shortage of doctors.  The Director-General of Social 
Development said his Ministry was developing a campaign to 
address child poverty, and asked for help in creating a data 
base of child-headed households so the Ministry can best 
target them. 
 
¶6.  (SBU) The Minister said his Ministry was working closely 
with civil society and, particularly, the religious sector 
because it had a broader network than anyone else, and 
because "the government can't do it alone."  Dr. Hill thanked 
the Minister for the cooperation of the Ministry, and said 
their relationship was one of the best cooperative 
relationships USAID has.  Dr. Hill also offered to 
participate in the Ministry's quarterly planning meetings to 
look for better ways to cooperate.  The Minister ended the 
meeting by voicing the South African Government's gratitude 
for the assistance from the United States, "especially USAID 
and for empowering NGOs." 
 
--------------------------- 
Secretary Leavitt's Message 
 
SIPDIS 
--------------------------- 
 
¶7.  (U) Secretary Leavitt communicated the following key 
messages at the sites and Ministerial meeting: 
 
 
PRETORIA 00003029  004 OF 005 
 
 
-- He had come to South Africa with an intellectual 
engagement to the Emergency Plan program but was leaving with 
an emotional commitment, generated by his personal 
interaction with those who were implementing the program, 
and, above all, the men, women and children who were the 
recipients of its services; 
 
-- The Emergency Plan was President Bush's program and would 
not have been possible without his personal and direct 
involvement.  The President is 100-percent committed to the 
program and the attainment of its goals because it is the 
right thing to do; 
 
-- The Emergency Plan has the full and unwavering support of 
the American people, who want to help and feel good about 
what they are doing; 
 
-- The Emergency Plan and its success is a function of the 
partnership between South Africa and the United States. 
United States funding is ultimately a catalyst, a way of 
helping South Africa address the epidemic, as spelled out in 
its well-constructed National Strategic Plan (2007-2011), 
which now needs to be implemented; 
 
-- Prevention is the key component of beating HIV/AIDS.  The 
Emergency Plan has been successful in meeting its treatment 
targets, but must now focus on reducing transmission and 
lowering incidence rates; 
 
------------------------- 
Media Events and Coverage 
------------------------- 
 
¶8.  (U) Secretary Leavitt held a series of well-attended 
press conferences, media roundtables and electronic 
interviews.  International and local media responded with 
great interest, and reported favorably on his activities and 
message.  There were two dozen media placements, including 
news articles, opinion pieces and radio and TV coverage.  All 
the placements were positive; none were critical of the 
United States.  SABC Radio's Channel Africa, which broadcasts 
its programs throughout the African continent, interviewed 
Secretary Leavitt.  Secretary Leavitt later spoke for five 
 
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minutes on 702, the highest-rated morning radio talk show in 
South Africa.  Secretary Leavitt successfully communicated in 
all of his media events that the United States has invested 
and will continue to invest hundreds of millions of dollars 
in HIV/AIDS prevention, care and treatment in South Africa, 
and that the South African Government's National Strategic 
Plan (2007-2011) is a good plan that needs to be implemented. 
 Sample headlines from the South African press include: "U.S. 
Cash Fights AIDS in SA" (The Citizen); "US Health Secretary 
Leavitt Impressed by SA's AIDS Approach" (Business Day); "US 
Hopes to Spend More on AIDS in SA" (Mail & Guardian); and 
"Howick Centre Gets Powerful Visitor" (Daily News of Durban). 
 Secretary Leavitt declined to comment on President Mbeki's 
recent dismissal of Deputy Minister of Health Nozizwe 
Madlala-Routledge, which has dominated local headlines and 
has received coverage in the international press during the 
past two weeks.  When asked about the issue, he consistently 
and pointedly referred to the need to focus on the full 
implementation of South Africa's National Strategic Plan. 
Media and public opinion have not criticized his response. 
 
 
---------------------- 
Outcomes and Follow-Up 
---------------------- 
 
¶9.  (SBU) There were a number of significant outcomes from 
this visit.  The U.S. public profile was raised in a positive 
way on a subject that is of great interest to the vast 
majority of South Africans.  The meeting with the Minister of 
Social Development and the Vice Minister of Foreign Affairs 
demonstrated the South African Government's public support 
and gratitude for the Emergency Plan.  The meeting also 
opened new avenues for future cooperation, such as increasing 
the number of university-trained social workers, training 
rural social/health workers, creating a data-base for 
 
PRETORIA 00003029  005 OF 005 
 
 
child-headed households, and participating in the Ministry of 
Social Development's quarterly planning meetings.  The 
Embassy will work with the South African Government to 
follow-up on these areas. 
 
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Comment 
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¶10.  (SBU) Secretary Leavitt's visit highlighted the U.S. 
Government's continuing commitment to our partnership with 
the South African Government and NGOs in the fight against 
HIV/AIDS.  The visit supported the post's bilateral and 
public-diplomacy efforts, and created opportunities to expand 
America's help to those who need it most -- those affected by 
the HIV/AIDS epidemic, including the growing number of 
orphans left in its wake.  End Comment. 
 
¶11.  (U) Secretary Leavitt has approved this cable. 
Teitelbaum