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### Viewing cable 02ABUJA1347, NIGERIA: FPOTUS CARTER AND BILL GATES, SR. VISIT

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Reference ID | Created | Released | Classification | Origin
--- | --- | --- | --- | ---
02ABUJA1347 | 2002-05-02 14:51 | 2011-08-25 00:00 | UNCLASSIFIED | Embassy Abuja

`

    This record is a partial extract of the original cable. The full text of the original cable is not available.

` `

    UNCLAS SECTION 01 OF 04 ABUJA 001347

    SIPDIS

    E.O. 12958: N/A
    TAGS: PREL PGOV TBIO SOCI KWMN NI HIV AIDS
    SUBJECT: NIGERIA: FPOTUS CARTER AND BILL GATES, SR. VISIT
    ON HIV/AIDS

     --------
    Summary:
    --------
    ¶1. FPOTUS Jimmy Carter and Bill Gates, Sr. and staff from The
    Carter Center and The Bill and Melinda Gates Foundation paid
    a very successful, well-publicized March 8-10 visit to
    Nigeria. The purpose of the visit was to galvanize greater
    domestic support for the fight against HIV/AIDS in Nigeria,
    increase the international spotlight on the HIV/AIDS crisis
    in Africa, and to help destigmatize HIV/AIDS and encourage
    leaders to interact with people living with HIV/AIDS (PLWHA).
     Carter and Gates met with President Obasanjo, visited a
    Commercial Sex Worker (CSW) community, addressed Nigeria's
    first-ever National HIV/AIDS Summit, and met high-level
    officials in the Ministry of Health and the National Action
    Committee on Aids (NACA).  President Carter also gave an
    inspirational HIV/AIDS focused message at the Presidential
    Villa Chapel on Sunday, March 10.

    ¶2.  Throughout the visit, the delegation specifically asked
    about local solutions and how to garner more support for
    combating the pandemic. They commended the positive programs
    instituted by the Nigerian government and encouraged it to
    recognize and use proven prevention methods. The delegation
    particularly emphasized Mother-to-Child transmission (MTCT)
    and prevention programs, which can dramatically halve the
    risk of HIV transmission to new-borns. They supported
    widespread implementation of HIV/AIDS prevention efforts,
    especially among groups at high-risk of contracting or
    spreading HIV, such as commercial sex workers, migrant
    workers, truckers, and intravenous drug-users.  The
    Carter/Gates team also encouraged all segments of society,
    including government, faith-based groups, businesses, and
    civil society organizations to engage in the fight against
    HIV/AIDS. The visit fulfilled the objectives of the
    delegation and more. End Summary.

    ------------------------------------
    Some Facts About HIV/AIDS In Nigeria
    ------------------------------------
    ¶3. Officially, 5.8% of Nigeria's population between the ages
    of 15-49 is HIV positive, which equals an estimated 3.5
    million infected people.  Projections are that over four
    million Nigerians will be HIV positive by the year 2005. By
    the end of this year, 1.3 million Nigerians will have died of
    AIDS since the start of the epidemic. The toll has reached
    the point where it is estimated that one person dies of AIDS
    every 2 minutes (over 700 people a day). If nothing is done,
    it is estimated that a further one million will die by 2005.

    ----------------------------
    Breakfast with the President
    ----------------------------

    ¶4. The delegation met privately with President Obasanjo the
    morning of March 9.  Carter/Gates encouraged Obasanjo's
    continued leadership on HIV/AIDS and talked about increased
    funding and more effective policies, particularly focused on
    high-risk groups. (Comment: President Carter and President
    Obasanjo have been friends since Carter visited Nigeria in
    1978 when Obasanjo was then military Head of State.  This
    relationship was reportedly strained after Carter refused to
    certify the 1999 election as free and fair.  However, the
    long-standing relationship appeared to be intact during the
    visit.  End Comment.)

    ¶5. The Carter/Gates team described the Obasanjo meeting as
    "successful".  They characterized President Obasanjo as
    personally engaged in the fight against HIV/AIDS and the
    Embassy concurs with that conclusion. Obasanjo told
    Carter/Gates that Nigeria's biggest need is funding and
    stressed that everyone in his government must be involved in
    the fight against HIV/AIDS.  Obasanjo's goal is to hold the
    infection rate at the official estimate of 5.8%, then push
    for an eventual reduction.  After seeing posters of President
    Obasanjo with PLWHAs, President Carter praised Obasanjo for
    his personal commitment, his public display of compassion,
    saying Obasanjo's efforts were an important part of reducing
    the social stigma associated with HIV/AIDS in Nigeria.

    ¶6. When asked about religious leadership, Obasanjo responded
    that some of the new generation churches and mosques are
    engaged, but in general faith-based institutions needed to be
    more active.  Commercial sex work is another area where more
    must be done.  In the area of public awareness, Obasanjo
    commented the GON has published pamphlets and booklets and
    erected billboards to reach the non-literate. The government
    provides condoms to all military barracks.  (This policy was
    established after it was learned that military peacekeepers
    returning from Sierra Leone had an estimated 11% HIV/AIDS
    infection rate.)  The GON has started the voluntary testing
    of pregnant women, but found it challenging because there are
    not enough counselors to reach all of those in need.
    Moreover, the utility of large-scale testing is of uncertain
    value at this point because there are few treatment options
    and the MTCT program is still in its infancy. The federal
    government is also giving money to each of the states to help
    establish HIV/AIDS prevention programs. (Comment: Only three
    of 36 governors have demonstrated a sustained personal
    involvement in the campaign against HIV/AIDS. End Comment.)

    -------------------
    You're Going Where?
    -------------------

    ¶7.  Leaving the comfort of the President's Villa, the
    delegation next visited Mabushi village to meet with peer
    educators being trained by the NGO Women's Health Education
    and Development (WHED).  These peer educators are themselves
    CSWs, trained in HIV/AIDS awareness and prevention, now
    educating other CSWs.  President Carter and Mr. Gates met six
    women who explained how their involvement in commercial sex
    work began.  Carter and Gates asked specific questions and
    received some very frank answers during this discussion. This
    experience proved a valuable reference point to help the
    delegation speak credibly about the role commercial sex work
    plays in spreading HIV.  Carter/Gates mentioned Mabushi in
    every subsequent meeting, interview and speech, including
    Carter's interview with NBC and his speech at the HIV/AIDS
    Summit.  U.S. media personnel also asked questions of the sex
    workers during the session, and scheduled follow-up
    interviews in the afternoon. Both the NBC Nightly News and
    the Today Show aired significant footage of the Mabushi
    visit, and highlighted the nexus between commercial sex work
    and HIV/AIDS.

    ¶8.  At the same time a larger group of CSWs and other members
    of the Carter/Gates delegation met with the Minister of
    Health and his Deputy who accompanied Carter/Gates to
    Mabushi. The Minister promised to provide WHED with over two
    million condoms free-of-charge by the end of the year, and
    also agreed to help with re-education and relocation of the
    women.  The Minister of Health confided that he was unaware
    of the depth of the CSW problem prior to his visit to
    Mabushi.  According to Sylvia Matthews of the Gates
    Foundation, these promises alone validated the entire Africa
    trip. WHED also received a $20,000 grant from the Aids
    Prevention Initiative in Nigeria (APIN) to expand the WHED
    program. Based on the results of WHED's initial efforts,
    future funding is possible. (Comment: Poloff met with the
    director of WHED two weeks after the visit.  She has been
    contacted by the Minister of Women's Affairs, and dialog on
    the re-education program has begun. End Comment.)

    -----------------------------------
    Nigerian National Forum on HIV/AIDS
    -----------------------------------

    ¶9. After Mabushi, the delegation attended a special HIV/AIDS
    forum convened by President Obasanjo entitled "HIV/AIDS in
    Nigeria: the Road Ahead". The purpose of this first ever
    HIV/AIDS summit was to mobilize greater domestic political
    support, particularly at the state and local levels, for the
    national campaign against HIV/AIDS.  Along with the
    Carter/Gates delegation, Cabinet Ministers, governors,
    parliamentarians, religious and traditional leaders, PLWHAs,
    donors and leading HIV/AIDS experts were in attendance. Prior
    to the forum many National Assembly members, state governors,
    and other opinion leaders had shown little or no support for
    HIV/AIDS intervention.  The Saturday Forum was meant to
    convince these important players to join the fight. The Forum
    was well attended and well publicized by the domestic media,
    and was characterized by all as a  major success. Comment:
    The one disappointment was the relatively small number of
    governors who showed up, only about six of the total 36.
    This was surprising in view of the fact that the forum was a
    presidential initiative.  End Comment. USAID/Nigeria will
    capitalize on the momentum created by the Forum by
    implementing a new program that focuses on HIV/AIDS advocacy
    with National Assembly members.

    ¶10. In his opening address, President Obasanjo stated the
    Saturday Forum was intended to bring national and
    international experts from various sectors together. One year
    after the Africa Summit on HIV/AIDS, the message was not
    getting down to "every nook and cranny" in the nation, he
    lamented.  The President referred to his inaugural address
    when he said that human resources were a nation's most
    valuable resource. However, the fact that 3.6 million
    Nigerians were already infected with the virus and that
    number was growing undermined the notion of economic
    development.   Due to denial and the inaction of the past,
    the HIV/AIDS epidemic now was felt at all levels of society.
    Denial and government inaction also meant that past HIV/AIDS
    programming was donor-driven and lacked adequate grass-roots
    participation.   Obasanjo thanked donors "( for keeping at
    it while the Federal Government of Nigeria was in denial."
    He ended his address by challenging the Forum's participants
    to "reexamine our commitment and target a zero increase in
    the prevalence rate and a decline in the rate from 2003 on."

    ¶11.  Two of the most noteworthy Nigerian speakers were Dr.
    Pat Matemilola, Chairman of the Network of People Living with
    AIDS in Nigeria, and Dr. Peter Odili, Governor of Rivers
    State.    Governor Odili characterized the epidemic in his
    state, which has the third highest HIV prevalence rate
    nationally, as one fueled by the oil and gas industry. That
    industry has brought an influx of highly paid expatriate and
    Nigerian workers to the poverty-plagued state.  This influx
    of affluent oil industry personnel attracts a comparable
    influx of commercial sex workers.  As proof of the expansion
    of the problem, he said Rivers State HIV prevalence rate
    increased from 3.3% in 1999 to 7.7% in 2001. Unlike most
    states, however, Rivers has responded to the epidemic. The
    state has established a multi-sectoral State Action Committee
    on AIDS (SACA). The state government also provides a subsidy
    of 10,000 naira per month (approximately $85) towards
    anti-retroviral treatments and will soon provide free
    treatment for HIV/AIDS positive women. Finally, on World AIDS
    Day this year, Odili's government sponsored a social
    mobilization campaign called "the Million Man March". Dr.
    Matemilola's speech targeted "the waste (of funding) on
    research" in an environment where poor HIV- positive women
    cannot access Nevriapine in order to lessen mother-to-child
    transmission of the virus.  He also chided NACA and the
    Ministry of Health for their on-going bureaucratic struggle
    for control of the national HIV/AIDS effort.  Matemilola
    quoted the African proverb, "When two elephants fight, the
    grass suffers", indicating that the national HIV/AIDS program
    in general and people living with HIV/AIDS in particular have
    suffered the negative consequences of the bureaucratic
    tug-of-war. This statement drew a round of applause from the
    audience.

    ¶12.  In his speech, President Carter challenged the forum
    participants to face their responsibility for combating
    HIV/AIDS.  He criticized African leaders who were in denial
    and ignore the epidemic, while praising President Obasanjo
    for leading the fight against HIV/AIDS in Nigeria and in
    Africa. He also stated that the battle against AIDS could not
    be won if every government official were not actively engaged
    in the fight.  Carter challenged the forum to overcome the
    social stigma of talking about HIV/AIDS and stressed the need
    for information and education.  The former President ended
    his speech by saying: "My prayer is that everyone assembled
    here, and everyone with whom you come in contact, will be
    inspired to be active and enthusiastic and dedicated to the
    control of this terrible disease."

    ¶13. The Aids Prevention Initiative in Nigeria (APIN), a $25
    million, three-year grantee of the Bill and Melinda Gates
    Foundation, which had previously been criticized by the GON,
    was showcased during the Forum.  Seven of the program's
    twenty speakers were associated with either the Gates
    Foundation or with APIN, including Bill Gates, Sr., Dr.
    Helene Gayle, Professor Jeffrey Sachs, and Phyllis Kanki.
    APIN was applauded by the Minister of Health for helping
    prepare Nigeria's proposals to the Global Fund.  Jeffrey
    Sachs received the greatest applause of the Forum following
    his suggestion to "write postcards" to the international
    lending institutions saying that Nigeria would no longer pay
    its debts.    According to Sachs, "The debt is unpayable and
    should no longer be paid".  Sachs estimated that Nigeria
    needs $1 billion annually to fight HIV/AIDS, contrary to the
    estimate of $226 million given by the NACA chairperson. He
    also suggested that most of the $1.5 billion Nigeria pays
    every year in debt servicing could be used to meet this gap
    once the "postcards were sent".   In addition, Sachs called
    for greater involvement by the oil industry saying "no world
    class business can be in this country without joining the
    fight as their own economic survival is at stake."   Dr. Pia
    Malaney, also from Harvard, posited that Nigeria's GNP is
    already 5% lower because of the HIV/AIDS epidemic and, if not
    contained, the toll will reach 25% by 2025.

    -------------------
    Goin' to the Chapel
    -------------------

    ¶14.  The final event of the visit was the Sunday Church
    service at Aso Villa Chapel. Reverend Y.A. Obaje, the Villa
    Chaplain, said, "We consider President Carter to be a
    brother. He cares about the poor. He cares about the sick. He
    cares about the downtrodden. We consider him one of us."
    Accordingly, the congregation was pleased to have President
    Carter in their midst and to hear his sermon: "A Faith Based
    Approach to HIV/AIDS."  President Carter spoke directly to
    issues of stigma and prevention, and emphasized that it was
    imperative for religious leaders to discuss HIV/AIDS from the
    pulpit. Carter's inspirational sermon reached an audience
    beyond the immediate congregation. His message was broadcast
    live on Nigerian TV and radio, and was replayed several times
    during that day. Initial estimates indicate the radio
    broadcast reached approximately 26 million people and the TV
    broadcast reached an estimated 13 million.  The Gates
    Foundation is pursuing other avenues for wide dissemination
    of Carter's message within the Christian media.  (Note: After
    consultation with some Islamic leaders, the delegation
    decided that a different message was needed to reach the
    Muslim population. End Note.)

    -------
    Comment
    -------

    ¶15.  There were numerous highlights of the Carter/Gates
    visit.  First, it helped educate the delegation on the
    HIV/AIDS situation in Nigeria, emphasising the areas of
    greatest needs.  Secondly, the delegation was able to
    generate unprecedented local attention while also focusing
    the international spotlight on the problem of HIV/AIDS in
    Nigeria. Accompanying the Carter/Gates team were Karen
    DeYoung of the Washington Post and Lynelle Gradwell, Robert
    Grant, Howard Smith and Keith Miller from NBC News.  HIV/AIDS
    received broad media coverage and attention from national,
    state and local officials and policy-makers that otherwise
    would have never occurred.  Finally the delegation was able
    to show the GON facets of the HIV/AIDS problem about which it
    had previously been unaware, particularly the enormity of the
    CSW issue. President Obasanjo has embraced the challenge that
    HIV/AIDS presents, and appears ready not only to continue,
    but to redouble his own efforts and efforts the of his
    government to confront seriously the growing menace of
    HIV/AIDS in Nigeria. From our perspective the Carter/Gates
    Visit was well worth the effort. End Comment.

    JETER

`