VZCZCXRO8089
RR RUEHROV
DE RUEHDJ #0271/01 0921830
ZNR UUUUU ZZH
R 021830Z APR 09
FM AMEMBASSY DJIBOUTI
TO RUEHC/SECSTATE WASHDC 0261
INFO IGAD COLLECTIVE
RUEHDJ/AMEMBASSY DJIBOUTI

UNCLAS SECTION 01 OF 02 DJIBOUTI 000271 
 
SIPDIS 
DEPARTMENT FOR AF/E AND OES/IHB 
CJTF-HOA FOR POLAD 
USAID FOR USAID/EAST AFRICA 
USAID/AFRICA/EA 
USAID/GH 
 
E.O. 12958: N/A 
TAGS: TBIO SOCI PREL EAID KPAO DJ
SUBJECT: MISSION MARKS WORLD TB DAY 
 
¶1. SUMMARY: Djibouti has the second-highest prevalence 
rate of tuberculosis (TB) in the world.  Through 
coordinated USAID programming and Combined Joint Task 
Force-Horn of Africa (CJTF-HOA) civil affairs projects, 
Post continues to work closely with the GODJ as it 
implements a five-year plan to tackle this key health 
problem.  Combating TB and other chronic diseases is a 
crucial part of the GODJs strategy to develop a 
healthier, more educated workforce, which is ready to 
take part more fully in Djiboutis recent foreign- 
investment-led growth.  In recognition of World TB Day, 
USAID Representative spoke at a high-level event 
organized by the GODJ, while Ambassador joined regional 
officials on a visit to a USG-supported TB ward during a 
trip to the regional capital of Dikhil.  END SUMMARY. 
 
¶2. According to the World Health Organization, in 2008, 
Djibouti registered 1,300 cases of all forms of TB per 
100,000 people.  The estimated incidence of new smear 
positive cases is 356/100,000--up from 271/100,000--with 
a mortality rate of 128 per 100,000.  Djiboutis Ministry 
of Health (MOH) has developed a five-year strategic plan 
(2006-2010) and has created a National TB Control Program 
in order to address this public health problem. 
 
¶3. USAID health programming supports the GODJs National 
Control Program in several ways.  Key areas of assistance 
include: 
--Strengthening the laboratory network in Djibouti: 
Fifteen labs are now operational, meeting international 
standards of serving an average population of 50,000 
each; 
--Establishment of a quality assurance system and a 
laboratory manual with standard operating procedures. 
All 15 labs perform TB microscopy with over 95% correct 
microscopy results; 
--Training for key staff in the national TB recording and 
reporting system, which is now able to provide data in a 
timely manner; 
--Implementation of the decentralization of the TB 
program to improve diagnosis and treatment. 
 
¶4.  The majority of tuberculosis program funds in 
Djibouti are provided by the Global Fund (GF).  The GF is 
positioned to cover the purchase of second line drugs, 
culture testing, drug sensitivity testing, and the 
conduct of a drug resistance survey.  In 2009, USAID will 
complement the GF by continuing support to the National 
TB Program,  providing technical assistance in multidrug 
resistant (MDR) TB management, training doctors on MDR 
management, and supporting infection control.  USAID will 
also help Djibouti improve diagnostic capacity by 
constructing labs in four health posts operating as 
Diagnostic and Treatment Centers, thus helping maintain a 
strategic and comprehensive approach to addressing the 
high incidence of TB in Djibouti. 
 
¶5. On World TB Da, March 24, USAID Representative made 
remarks at a high-profile event organized by GODJ 
officials.  Her remarks, which were covered by local 
media, focused on the growing USG-GODJ partnership to 
fight TB. 
 
¶6. On March 25, the Ambassadors trip to the region of 
Dikhil included a visit to a USG-supported TB ward at the 
districts main hospital.  The Ambassador spoke with 
hospital personnel and local officials about what was 
being done to fight TB, and met with patients undergoing 
treatment.  Dikhil Hospital serves approximately 70,000 
people, and supervises six rural clinics. 
 
¶7. USAID provided support to Dikhil Hospital through 
training for members of the District Health Management 
Team, and through significant improvements in the Health 
Information System (HIS).  Training for the HIS focal 
point, along with the provision of a computer and other 
office equipment, now allows the HIS to collect key data 
and accurately transmit them to the central level.  In 
late 2006, a CJTF-HOA civil affairs project renovated 
Dikhil Hospitals entire TB ward and installed a new 
cistern for the TB latrine, renovated the administration 
building, built a latrine in the general medicine 
building, and installed 15 air conditioners. 
 
DJIBOUTI 00000271  002 OF 002 
 
 
¶8. COMMENT.  In his opening remarks at a mid-March 
National Health Symposium, President Guelleh noted that 
in the field of health in Djibouti, everything is a 
priority.  However, he singled out management of chronic 
diseases--such as TB--as a particularly key area.  END 
COMMENT. 
SWAN