P 200101Z JUN 08
FM SECSTATE WASHDC
TO AMEMBASSY BERLIN PRIORITY 
AMEMBASSY MOSCOW PRIORITY 
AMEMBASSY OTTAWA PRIORITY 
AMEMBASSY PARIS PRIORITY 
AMEMBASSY ROME PRIORITY 
INFO USMISSION GENEVA PRIORITY 
USEU BRUSSELS PRIORITY

UNCLAS STATE 066363 
 
 
E.O. 12958: N/A 
TAGS: CA EU FR GM IT PREL RS SENV TBIO WHO
SUBJECT: G-8 HEALTH INITIATIVES DEMARCHE 
 
¶1.  This is an action request.  See paragraphs 5-6. 
 
¶2.  SUMMARY.  During his trip to Europe, the President 
emphasized the importance of G-8 members following through on 
pledges on health assistance made at past G-8 summits.  The 
President also asked for our partners' support for new G-8 
initiatives on neglected tropical diseases (NTDs) and 
training health workers.  The U.S.-EU Summit declaration 
endorsed work on both NTDs and health worker training, but 
France, Germany, Italy and Canada have been skeptical about 
these initiatives.  The U.S. Sherpa and Foreign Affairs Sous 
Sherpa will continue negotiations on the G-8 Summit texts at 
a meeting beginning June 24 in Japan.  In order to achieve 
our goals at the G-8 Summit, Department requests that 
Ambassadors or DCMs reach out to the appropriate Foreign 
Affairs and Development Ministry officials to encourage their 
support for our health-related priorities for the 2008 G-8. 
Posts are requested to report initial replies by COB Monday, 
June 24 and should follow-up, as needed.  END SUMMARY 
 
 
HEALTH PRIORITIES AT THE 2008 G-8 IN TOKYO 
 
 
¶3.  The U.S. has three major goals for the health section of 
the G-8 Development and Africa Declaration: to demonstrate 
accountability for past G-8 commitments, to support at least 
eight partner countries to increase their number of health 
workers, and to alleviate the suffering caused by the seven 
neglected tropical diseases (NTDs) that can be treated by 
mass drug administration: Lymphatic filariasis, 
onchocerciasis, schistosomiasis, trachoma, hookworm, 
roundworm, and whipworm. 
 
¶4.  The G-8 acceptance of the U.S. goals has been mixed. 
While all members agree that the G-8 should deliver on its 
past health commitments, there is continued reluctance to 
demonstrate how each of our countries and the European 
Commission is following through on past commitments.  With 
regard to health worker training all members agree that it is 
important to increase the number of health workers in Africa, 
but there is reluctance to commit to specific targets for the 
G-8 to assist partner countries to meet.  With regard to 
NTDs, the G-8 experts have agreed that "efforts to control or 
eliminate NTDs need to be reinvigorated."  However, there is 
as yet no G-8 consensus on addressing specifically the seven 
NTDs that can be controlled, or in some cases eliminated, 
through mass drug administration per the President's NTD 
Initiative.  The recent U.S.-EU Summit declaration committed 
European Union Member States and the United States to  join 
together to combat NTDs and to increase the number of health 
workers.  We believe that these commitments should be pursued 
by making specific commitments in the G-8. 
 
 
ACTION REQUEST 
 
 
¶5.  To achieve our goals at the G-8 Summit, Department 
requests that Ambassadors or DCMs in G-8 countries draw from 
the background points in paragraph 7 and reach out to the 
appropriate Foreign Affairs and Development Ministry 
officials to reiterate the U.S. health-related priorities for 
the 2008 G-8 and advocate for their support. 
 
¶6.  Posts are requested to report initial replies no later 
than COB  Monday, June 24, slugging reply cables to Tierra 
Copeland, OES.  Additional details and a fact sheet about 
NTDs and the President's announcement can be found at 
www.usaid.gov/press/factsheets/2008/fs080222. html and 
www.whitehouse.gov/news/releases/2008/02/2008 0220.html. 
Should post require additional guidance please contact Tierra 
Copeland (copelandtl@state.gov) in the Bureau of Oceans, 
Environment and Science, Office of International Health and 
Biodefense.  The Department greatly appreciates post efforts. 
 
 
BACKGROUND POINTS 
 
 
¶7.  In making their approaches, Ambassadors or DCMs should 
draw upon the following background information: 
 
--- During his visit to Europe, President Bush stressed the 
importance of all G-8 members following through on past 
commitments, including on health.  He also raised U.S. G-8 
proposals on NTDs and training health workers.  The President 
strongly believes that the G-8 must do more to help people 
needlessly dying in Africa. 
 
--- First, to maintain G-8 credibility, the G-8 need to build 
on progress from prior G-8 Summits and ensure follow-through 
on their commitments, including the specific commitments they 
made at Heiligendamm on HIV/AIDS, TB, malaria, and polio. 
There is, however, no mechanism to monitor performance or 
ensure accountability. 
 
--- Second, we believe the G-8 should take specific steps to 
help interested partner countries such as Ethiopia and 
Mozambique address the severe shortage of trained health care 
workers. 
 
--- Our proposal is that the G-8 join us in helping to 
support at least eight partner countries to train additional 
health workers, as they work toward the WHO goal of 2.3 
health workers per 1,000 persons. 
 
--- We are open to your ideas on the number of countries. 
The United States and UK have already announced plans to work 
in four countries - Ethiopia, Mozambique, Kenya, and Zambia. 
Specific targets are critical to ensure measurable outcomes. 
We have been surprised by the reluctance of some to accept 
mentioning the WHO target of 2.3 health workers per 1000 
people as a goal. 
 
--- Third, we have proposed that the G-8 take up the 
challenge that WHO Director General Chan delivered at the 
World Health Assembly to help the approximately one billion 
people who suffer from NTDs:  "We now see a whole spectrum of 
opportunities that have converged in a most harmonious way. 
Safe and powerful drugs are being donated or made available 
at very low cost.  Integrated approached have been devised 
for tackling several diseases at once( With a comparatively 
modest, time-limited financial push, many of these diseases 
can be controlled by 2015.  Some can even be eliminated by 
that date." 
 
--- We believe an appropriate and achievable target would be 
to work to reach at least 75% of the people affected by seven 
major NTDs in the most affected countries in Africa, Asia, 
and Latin America. 
 
--- We and the WHO agree that there are seven NTDs that can 
be controlled, or in some cases eliminated, if the G-8 and 
other donors come together.  The President announced in 
February an initiative to make a total of $350 million 
available over five years to provide integrated treatment of 
these seven NTDs to more than 300 million people in the most 
affected countries in Africa, Asia, and Latin America. 
 
--- We hope you will be supportive of these initiatives, and 
we look forward to working together on this in the final 
rounds of negotiations and at the Summit itself in July. 
 
 
ADDITIONAL BACKGROUND INFORMATION 
 
 
¶8.  Posts may want to draw from the following background 
points on the need for accountability to past G-8 
commitments, as appropriate. 
 
--- The Global Fund Board recently approved a decision to 
launch a 9th Round of financing at the end of 2008, as part 
of an effort to accelerate the response to the diseases.  Now 
G-8 countries need to support bilateral and multilateral 
technical assistance to affected countries to stimulate 
quality demand through the development of technically-sound 
grant proposals, in accordance with the Fund's model of 
country-led, performance-based funding. 
 
--- Provision of technical assistance for the development of 
strong national strategies and plans will be essential if the 
G-8 countries are to meet their Heiligendamm pledge to commit 
$60 billion in aid for health.  The USG is working in many 
countries to support Global Fund proposal development, and 
all G-8 countries should undertake similar efforts. 
 
¶9.  Posts may want to draw from the following background 
points on the health workers proposal, as appropriate. 
 
--- There is a severe shortage of trained health care workers 
in many developing countries, especially in Africa.  In 
Mozambique, for example, there are around 600 doctors for a 
population of approximately 20 million people.  Mozambique 
and many other countries fall short of the WHO goal of at 
least 2.3 health workers per 1,000 people. 
 
--- On April 17, 2008 the U.S. and UK released a joint 
announcement committing to work together on health systems 
including health workforce development.  We are demonstrating 
this commitment in Ethiopia, Kenya, Mozambique, and Zambia. 
In these four countries the UK is planning to spend at least 
$420 million on health, including the health workforce, over 
the next three years, and the U.S. is planning to invest at 
least $1.2 billion over five years on health workforce 
development. 
 
¶10.  Posts may want to draw from the following background 
points on the Neglected Tropical Disease Initiative, as 
appropriate. 
 
--- Approximately one billion people, mostly in the 
developing world, suffer from one or more NTDs.  Most of 
these diseases blind, deform, or debilitate their victims. 
They can reduce school enrollment, diminish childhood growth 
and cognitive development, and reduce economic productivity 
in adults. 
 
---  On February 20, 2008, President Bush announced an 
initiative to make a total of $350 million available over 
five years to provide integrated treatment of seven major 
NTDs to more than 300 million people in the most affected 
countries in Africa, Asia, and Latin America.  This 
investment increases the Unites States' commitment to NTDs 
from $15 million in 2008 and will expand the targeted number 
of countries from 10 in 2008 to approximately 30 by 2013. 
 
---  Treating the millions of people that suffer from NTDs 
will bolster child development, promote educational 
achievement, and contribute to poverty reduction. 
Interventions in fighting these diseases promise large 
economic payoffs as they improve educational outcomes and 
worker productivity. 
 
---  In her address to the 61st World Health Assembly (WHA) 
on May 19, 2008, WHO Director-General Margaret Chan called on 
all donor countries, particularly the G-8, to support 
President Bush's NTD initiative so it can be funded at $1 
billion.  Based on WHO estimates, $1 billion would be 
required to reach at least 75 percent of the people affected 
by these seven major NTDs, in order to enable an 80-90% 
reduction from the current burden, with elimination of some 
of the diseases after sustained treatment of 3-5 years. 
 
RICE