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### Viewing cable 08STATE66363, G-8 HEALTH INITIATIVES DEMARCHE

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Reference ID | Created | Released | Classification | Origin
--- | --- | --- | --- | ---
08STATE66363 | 2008-06-20 01:01 | 2011-04-28 00:12 | UNCLASSIFIED | Secretary of State

`

    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

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