VZCZCXRO8381
RR RUEHBZ RUEHDU RUEHJO RUEHMR RUEHRN
DE RUEHTO #0729/01 2110946
ZNR UUUUU ZZH
R 290946Z JUL 08
FM AMEMBASSY MAPUTO
TO RUEHC/SECSTATE WASHDC 9180
INFO RUCNSAD/SOUTHERN AFRICAN DEVELOPMENT COMMUNITY
RUEHLO/AMEMBASSY LONDON 0208

UNCLAS SECTION 01 OF 02 MAPUTO 000729 
 
SENSITIVE 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: PREL PGOV EAID KHIV SOCI MZ
SUBJECT: HEALTH MINISTER: WE MUST COOPERATE BETTER 
 
¶1.  (SBU) SUMMARY:  The Charge met with the Mozambican 
Minister of Health, Dr. Ivo Garrido, on July 3 to discuss the 
planned $1 billion USG investment in the Mozambican health 
care sector over the next five years via the President's 
Emergency Plan for Aids Relief (PEPFAR) and President's 
Malaria Initiative (PMI).  The Charge also outlined sizable 
USG-funded programs in maternal and child health, nutrition 
and reproductive health.  Minister Garrido agreed to 
formalize a new level of cooperation and coordination with 
the USG, highlighted several health priorities for 
Mozambique, discussed the reorganization of implementing 
partners, and offered to intervene with the Minister of Labor 
regarding work permits for the USG's third-country national 
health professionals.  Improved coordination with the 
Government of Mozambique (GRM) is necessary to ensure that 
this significant investment in the health sector yields the 
best possible results, and this meeting shows that there is 
clear potential to move forward.  END SUMMARY. 
 
------------ 
COORDINATION 
------------ 
 
¶2.  (U) In a July 3 meeting, the Mozambican Minister of 
Health signaled his appreciation for the large USG investment 
in the Mozambican health sector and agreed with the Charge 
that closer coordination was needed at all levels between his 
ministry and the USG.  The Minister noted that the United 
States is by far the largest donor in the health sector in 
Mozambique, providing more funding to the health sector than 
all other donors combined.  He identified his director of 
planning as the new focal point for coordination with the 
Ministry of Health, and proposed monthly coordination 
meetings between his directors and USG senior technical 
staff.  The Minister also agreed to formalize this new level 
of cooperation in an official letter further detailing 
proposed coordination mechanisms and a calendar of scheduled 
meetings. 
 
------------------------------------------ 
MOZAMBIQUE PRIORITIES IN THE HEALTH SECTOR 
------------------------------------------ 
 
¶3.  (U) Minister Garrido outlined his priorities in the 
health sector as human resources (training and motivation), 
infrastructure (rural health clinics and warehouses), and 
community involvement (health promotion and disease 
prevention) and his follow-up letter also included financial 
management and monitoring and evaluation as priorities.  The 
Minister expressed his pleasure with the recent USG-United 
Kingdom initiative to improve human resources in four focus 
countries, to include Mozambique.  He urged the Charge to 
continue to increase investment in priority areas. 
 
----------------------------------- 
AGREEMENT ON 'COMPACT' NEGOTIATIONS 
----------------------------------- 
 
¶4.  (U) Beyond better coordination and management, the Charge 
strongly urged the Minister to consider jointly developing a 
bilateral compact outlining commitments and responsibilities 
for both sides over the next five years.  Garrido agreed to 
the proposal in principle, and said that discussions should 
begin soonest. 
 
-------------------------------------- 
PARTNER RATIONALIZATION/REORGANIZATION 
-------------------------------------- 
 
¶5.  (SBU) The Charge suggested that our implementing partners 
are not optimally organized in terms of geographic location. 
For example, he said, there is more than one USG implementing 
partner supporting the same GRM facility in several cases. 
The Charge proposed a reorganization of implementing partners 
to streamline support to the GRM.  The Minister agreed with 
this suggestion, stating that the GRM is moving towards a 
district model, where non-governmental organizations would 
provide systems strengthening, training, and support to an 
entire district, rather than play a service-provider role in 
specific health clinics. 
 
--------------------------------- 
HIRING OF THIRD COUNTRY NATIONALS 
--------------------------------- 
 
¶6.  (U) The Charge raised the problem of a severe human 
resource shortage in Mozambique which is inhibiting the USG's 
ability to recruit qualified Mozambican professionals to 
manage portfolios of great size and complexity.  He indicated 
that in some instances, it has been difficult to attract 
Portuguese-speaking AmCits with the required technical 
 
MAPUTO 00000729  002 OF 002 
 
 
qualifications for positions, resulting in a need to recruit 
third-country nationals to maintain necessary professional 
staffing levels.   The Charge noted that recent changes to 
Mozambican labor laws are inhibiting USG abilities to obtain 
work permits for third-country national staff members.  The 
Minister said he recognized the difficulty, stated that he 
discussed this issue with the Ministry of Labor, and promised 
to write the Minister of Labor an official letter on behalf 
of the USG on this issue.  (Note: USG efforts to engage the 
Ministry of Labor on this issue have so far been 
unsuccessful. End Note.) 
 
------- 
COMMENT 
------- 
 
¶7.  (SBU) Minster Garrido's concerns with the dominance of 
NGOs in the health sector has caused some distance between 
the USG and the Ministry of Health until this meeting, which 
marks a reinvigoration of cooperation with the Ministry of 
Health.  Post and Minister Garrido now share similar concerns 
about the implementation of our health-related programming. 
Post believes that Minister Garrido--who is a senior decision 
maker in the FRELIMO party--could be a powerful ally, not 
only in the health sector, but also in our stalemated 
struggle to legalize the status of third-country health 
sector professionals supporting USG initiatives. 
Amani