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Viewing cable 08ACCRA505, PRESIDENT CARTER NOTES PROGRESS AND EMPHASIZES

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Reference ID Created Released Classification Origin
08ACCRA505 2008-04-15 08:22 2011-08-26 00:00 UNCLASSIFIED Embassy Accra
VZCZCXRO7671
RR RUEHMA RUEHPA
DE RUEHAR #0505/01 1060822
ZNR UUUUU ZZH
R 150822Z APR 08
FM AMEMBASSY ACCRA
TO RUEHC/SECSTATE WASHDC 6400
INFO RUEHZK/ECOWAS COLLECTIVE
RUEHKH/AMEMBASSY KHARTOUM 0036
UNCLAS SECTION 01 OF 02 ACCRA 000505 
 
SIPDIS 
 
STATE FOR AF/FO, AF/W, AF/PD 
 
SIPDIS 
 
E.O. 12958:N/A 
TAGS: EAID PGOV GH
SUBJECT:  PRESIDENT CARTER NOTES PROGRESS AND EMPHASIZES 
NEED FOR VIGILANCE IN GUINEA WORM ERADICATION 
 
1.  Summary:  Former United States President Jimmy Carter 
visited Ghana March 31-April 1, 2008 to review the 
successes of the Guinea worm eradication program as well as 
to begin discussions on the potential role of the Carter 
Center as election monitors for the upcoming Presidential 
election in Ghana. President Carter was accompanied by his 
wife Roslyn Carter, Cousin Don Carter, and Carter Center senior 
staff Don Hopkins and John Hardman. Over the past year, 
collaborative efforts between the Carter Center, UNICEF, 
the National Guinea Worm Eradication Program (GWEP), USAID, 
WHO and other donors and partners reduced the number of new 
Guinea worm cases in Ghana by 91 percent over the past 
year.  End Summary 
 
2.  During the two-day visit, President Carter and his 
delegation met with a variety of partners, Ghanaian and 
U.S. government officials, NGOs as well as Carter Center 
staff and their implementing partners.  President Carter 
began his visit by meeting President of Ghana, John Agyekum 
Kufuor and complimented his country's efforts against 
Guinea worm by noting that the 91 percent drop of new cases 
in Ghana was the largest reduction seen in the world. 
President Carter underscored the need for surveillance and 
early case detection to ensure that no new cases are 
missed. He also called for a scale-up of safe water systems 
by August.. President Carter outlined 2009 as the target 
year for complete Guinea worm eradication in Ghana. 
 
3.  President Kufuor highlighted 45 million euros of recent 
support from development partners for improvements in water 
systems and noted the assistance empowered districts to 
improve their own water supply. President Carter closed his 
comments by offering Carter Center election monitoring to 
support Ghana's December elections but reached no concrete 
agreement with President Kufuor on his proposal. 
 
President Kufuor tasked his Minister of Health to further 
discuss with President Carter challenges and opportunities 
regarding access to primary health care as well as a 
potential training program for community-based health 
extension workers. 
 
4.  President Carter held follow-up discussions with the 
Minister of Health along with senior staff of the National 
Guinea Worm Eradication Program to discuss the details of 
Ghana's efforts.  The Minister emphasized his commitment to 
"waging war on Guinea worm." The Minister also highlighted 
some best practices of the Guinea Worm Eradication Program 
including meetings with chiefs, local leaders and other 
cross-sections of the population.  The Minister noted that 
the eradication program enlisted support from development 
partners and civil society but needed to involve local 
government and water/sanitation officials outside the 
health sector to ensure broader coverage.  President Carter 
reiterated the importance of vigilance to ensure that all 
at-risk communities have access to an adequate supply of 
safe drinking water. 
 
5.  Discussions also centered on the prevalence of malaria 
within Ghana as a public health problem.  The Ghana Health 
Service Deputy Director related that the entire population 
of Ghana was at risk to contract this disease.  While 
support for bed nets is growing, the Deputy Director called 
for more support in the areas of treatment, diagnostics, 
education, and implementation.  The Minister also stated 
that a recent economic modeling exercise showed that Ghana 
loses approximately $762 million in labor productivity each 
year to malaria.  The Ghana Health Services also reported 
that 
 4 million bed nets had been distributed to Ghana's 
population of 22 million but that another 4 million were 
necessary to provide two bed nets per household.  They 
called for additional focus on indoor residual spraying and 
possibly insect sterilization as well as 
improvement of procurement and distribution channels. 
President Carter raised concern over the high cost of 
latrines in the country and asked if the Ministry of Health 
could work with the water program to help reduce these 
costs. 
 
6.  Following President Kufuor's advice, the Minister and 
President Carter discussed the idea of community health 
extension workers similar to community health nurses. This 
program would aim to fit into the currently existing 
Community-based Health Planning Services (CHPS) program 
with the overall goal of one nurse per 500 persons. The 
Minister stated that there are currently at least 22,000 
nurses in the country who are working towards this goal. 
(Comment: USAID disputes this number as well as some 
 
ACCRA 00000505  002 OF 002 
 
 
of the claims made around health extension workers, and has 
promised President 
Carter to follow-up with additional information on this 
topic.  End Comment.) 
 
7.  During the discussions, it was noted that the Ghanaian 
Parliament has proposed free medical care for Guinea worm 
patients, provisions to support mobile clinics, and 
legislation to control contamination by infected 
individuals. The Ministry of Health has also committed to 
double the budget for Guinea worm to one million Ghana 
Cedis (approximately one million USD) from its previous 
2007 total of 500,000.  Ghana currently reports only 195 
Guinea worm cases with 94% of all cases in the Northern 
Region.. During the last transmission cycle, 60% of cases 
were distributed among a population of 35,000 people 
(approximately 4-5 townships).  UNICEF also notes that 60% 
of cases occur in children under age 5. 
 
8.  President Carter met with all other relevant 
development partners working on Guinea worm eradication. 
There are currently 180 villages with Guinea worm and 
President Carter discussed the need to be careful about 
over-confidence.  He also stated that countries that have 
eradicated Guinea worm do not want to see a return of 
cases. Ghana has had some set backs when poorly managed 
water provision, caused a breakdown in the system. He 
encouraged everyone to learn lessons from these 
experiences. 
 
9.  Partners agreed that areas of achievement included 
improvement in surveillance and containment as well as 
better supervision and expanded water control. There was 
also consensus on many of the remaining challenges 
including maintaining a "security program" to guard dams 
against access by infected individuals (until they are 
treated), monitoring program discipline, ensuring there is 
an adequate water supply, implementing surveillance for 
non-endemic areas (to ensure no new cases are introduced), 
making sure volunteers stay motivated, and improving 
Behavior Change Communication (BCC) and better coordination 
with other sectors. 
 
10. Comment:  Overall, President Carter was very impressed 
with the huge success of the Guinea worm eradication 
program in Ghana.  The Partners collectively agreed that 
there is a strong-shared vision and commitment to eradicate 
the disease and that coordination and vigilance are 
essential to the success of Ghana's final push towards 
complete guinea worm eradication. End Comment. 
 
BROWN