US embassy cable - 04ACCRA226

UNCLAS SECTION 01 OF 03 ACCRA 000226 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: EAID, ECON 
SUBJECT: HHS DEPUTY SECRETARY ALLEN'S JANUARY 18-21 GHANA 
TRIP 
 
 
Summary 
------- 
1. Department of Health and Human Services (HHS) Deputy 
Secretary Claude Allen traveled to Ghana January 18-21, 
 
SIPDIS 
accompanying the President and Board members of the Africa 
Development Foundation (ADF).  The purpose of the trip was to 
review ADF projects in Ghana and meet with representatives of 
health and faith-based NGOs to discuss HIV/AIDS and other 
health-related issues.  The HHS/ADF group and Ambassador met 
January 21 with President Kufuor, during which they 
emphasized that the Government of Ghana (GoG) needs to 
improve the investment climate if it expects to compete for 
funding from the Millennium Challenge Account (MCA).  They 
also discussed ways to increase USG/GoG cooperation in the 
health field.  End Summary. 
 
HHS and ADF Visit to Ghana 
-------------------------- 
2. HHS Deputy Secretary (D/S) Claude Allen, ADF President 
Nathaniel Fields, and ADF Board Members Ernest Green, Ephraim 
Batameuze and William Ford, visited Ghana January 18-21, 
2004, to review ongoing and potential ADF projects in Ghana. 
D/S Allen also used the visit to discuss health issues, 
particularly HIV/AIDS, meeting with Ghana's Deputy Minister 
of Health, Ghana's Country Coordinating Mechanism of the 
Global Fund, and representatives of health and faith-based 
organizations.  The HHS/ADF delegation and Ambassador Yates 
met with President Kufuor on January 21 to discuss ADF,s 
activities in Ghana. 
 
Meeting with President Kufuor 
----------------------------- 
3. On January 21, D/S Allen met with President Kufuor and 
ministers (Private Sector Development Minister Bartels, 
Energy Minister Nduom, Foreign Minister Akufo-Addo, Finance 
Minister Osafo-Maafo, Deputy Health Minister Moses Dani-Bah). 
 Ambassador Yates, ADF President Fields and the ADF members 
also attended.  Discussions centered on HIV AIDS programs and 
Ghana's prospects for economic development.  Allen praised 
Ghana's commitment on fighting HIV/AIDS, and explored in some 
depth the community philanthropy program of the ADF. 
President Kufuor responded by thanking the USG for its help 
on HIV/AIDS, and welcoming ADF's continuing involvement in 
Ghana.  He asked for more USG assistance for Ghana's health 
care sector and to address Ghana's professional brain drain. 
"We are a poor country," he said, and asked that ADF's 
"one-for-one" matching funds requirements be relaxed to a 
"two-to-one" ratio.  Fields said their organization would 
have 40-50 projects open in Ghana in the coming years, and 
had high praise for Ghana's efforts in working with ADF. 
 
4. D/S Allen encouraged Kufuor to contact Senator Bill Frist, 
who has made frequent trips to Africa offering medical 
services, and ask him to assist Ghana,s health care system. 
Allen would also contact the Senator's office as well. Allen 
also pledged that HHS would "take a look" at Ghana's brain 
drain, and offer programmatic support.  He praised Ghana's 
good work on Polio eradication, and said the USG stood ready 
to assist Ghana on many health care concerns.  Allen closed 
by noting Ghana's potential for qualifying for MCA funds, and 
its need to improve its performance on various criteria.  In 
particular he focused on Ghana's business climate, saying 
Ghana needed to do more, and that with "diligence and hard 
work," Ghana could make itself more open to outside business, 
and better qualified for MCA funding. 
 
Media Coverage 
-------------- 
5. D/S Allen and ADF's visit enjoyed wide press coverage, 
both in state-owned and private media.  Most reporting 
focused on ADF's contributions to Ghana.  President Kufuor 
even mentioned these when listing Ghana's 2003 successes in 
his January 22 State of the Nation speech.  Allen's praise 
for Ghana's democratic achievement, low HIV/AIDS infection 
rate, and efforts to eradicate polio during his meeting with 
President Kufuor also received extensive media attention. 
Several private papers did note that Ghana is not a recipient 
of the USG's 2002 USD 15 billion pledge to fight HIV/AIDS 
tuberculosis and malaria, even though this is not new 
information in Ghana.  Allen also gave a lengthy interview 
with the Daily Graphic's Health Editor, where he noted 
possible future U.S.-Ghana links in the area of health. 
 
Meeting with Ministry of Health (MOH) 
------------------------------------- 
6. During a January 19 meeting with Deputy Minister of Health 
Moses Dani-Bah, D/S Allen noted the strong collaboration 
between the two countries, evidenced by significant numbers 
of Ghanaians, including health personnel, residing in the 
U.S.  Dani-Bah acknowledged the benefits accorded to Ghana 
through remittances, as well as the development of health 
care skills through higher education in the U.S. 
Nevertheless, he requested USG assistance with stemming the 
"brain drain" of health-industry workers by providing or 
funding capacity training for health personnel and trainers. 
Allen noted Ghana,s recent passage of health insurance 
legislation, to which he drew similarities to recent U.S. 
reform on Medicare, and noted the importance of the role of 
the private sector in contributing to objectives and ensuring 
that public funds are use efficiently and appropriately. 
Dani-Bah cited geographic and financial access to health 
services/care as its biggest concern.  He also asserted that 
while HIV/AIDS prevalence in Ghana is relatively low, the GOG 
would remain vigilant. 
 
Meeting with Global Fund Representatives 
---------------------------------------- 
7. D/S Allen me with local members of the Global Fund Country 
Coordinating Mechanism (CCM) to discuss programs in Ghana and 
gauge how the process is working.  CCM members explained that 
while the GoG initially took the lead on establishing the CCM 
and pushing forward Global Fund activities, the CCM is now 
encouraging greater private sector participation.  Of the 44 
current CCM members, only eight represent GoG entities, 
although the GOG's Ghana Health Service is leading the 
process.  USAID's representative on the CCM commented that 
Ghana is one of the countries where the CCM process is 
working well.  In fact, many of the problems the CCM-Ghana 
has experienced were due to slow disbursements and changing 
guidelines from Geneva.  The CCM just received funding for 
its malaria programs, and is in the process of completing 
Ghana's malaria drug policy.  They set up two HIV/AIDS 
treatment centers and anti-retroviral drugs just arrived. 
They are also implementing a TB program, which involves the 
private sector.  One weak area of the local process is that 
NGOs do not coordinate well, and CCM reps wondered if Global 
Fund money could be used to improve NGO cooperation.  Allen 
responded that capacity-building funds may be available, and 
he would look into it upon his return to Washington. 
 
Lunch with Health and Faith-Based Organizations 
--------------------------------------------- -- 
8. D/S Allen lunched January 19 with representatives of MOH, 
Ghana Health Service, faith-based organizations (Papal 
Nuncio, Christian Council, CRS), technical advisors (WHO 
Country Rep, Ghana AIDS Commission), and USAID.  The 
discussion focused on HIV/AIDS, with participants explaining 
that they fight the stigma of AIDS in Ghana through 
dissemination of information, encouraging public discussions 
of HIV/AIDS, and making drugs and support services widely 
available.  The discussion also touched on social change 
interventions targeting cultural practices, and the &a, b, 
c8 approach ("abstinence, be faithful, condom use"). 
 
9. The role of faith-based organizations in addressing 
individual practices is important, and participants noted 
that this is a difficult area given deep cultural traditions 
that transcend religious principles.  Much has been learned 
from Africa's experience in combating HIV/AIDS to date, 
particularly the significant contribution of abstinence and 
being faithful, alongside appropriate condom use.  HIV/AIDS 
interventions largely target women's empowerment, but men are 
a major contributor if not driver of the epidemic.  More 
needs to be done to instill male responsibility, and there is 
an important role for prevention education among the youth to 
begin instilling a change in behavior.  All agreed that more 
work is need to strengthen institutional capabilities of 
on-the-ground organizations working with the infected (or 
affected). 
 
10. Ghanaian representatives asked what insights U.S. 
institutions could provide on Buruli ulcer, an infectious 
disease involving the skin, which has reached epidemic levels 
in Ghana.  D/S Allen indicated he would pursue this with NIH. 
 
January 19 HIV/AIDS Site Visits 
------------------------------- 
11. D/S Allen traveled to the Coca-Cola (CC) bottling plant 
in Accra to learn about its workplace HIV/AIDS policy.  CC 
views HIV/AIDS as a business issue, affecting consumers and 
employees, and feels its corporate responsibility is to enact 
workplace policies to halt the spread and effects of the 
virus and ensure a healthy and safe work environment for 
maximum productivity.  CC,s strategy involves awareness 
programs, using employee training courses, promotions and 
peer educators.  CC also runs an on-site clinic and pays all 
but 10 percent of HIV treatments. D/S Allen also traveled 
just outside Accra to see a site where Living Water 
International (LWI), a U.S. faith-based NGO, provides safe 
drinking water to a facility for disabled children and 
adults, many with cerebral palsy.  LWI is drilling boreholes 
with OPIC-financed equipment. 
 
ADF Programs in Ghana 
--------------------- 
12. ADF is supporting 17 projects in Ghana in its effort to 
support grass-roots economic development to help alleviate 
poverty.  It recently designed and funded four new projects: 
tomato processing and canning, maize grits production, 
organic citrus peel and juice processing, and bamboo 
furniture manufacturing.  ADF officials and Ambassador Yates 
participated on January 20 in a high profile, public signing 
ceremony for the tomato processing company.  Finance Minister 
Osafo-Maafo, Energy Minister Nduom, and Private Sector 
Development Minister Bartels participated for the GoG 
(Comment:  Such high-level engagement is unusual, and is a 
sign of GoG support for ADF's work in Ghana.  End Comment). 
ADF President emphasized that ADF is committed to increasing 
its funded-projects in Ghana over the next ten years, with a 
maximum grant support of approximately USD 20 million. 
Including the four recent projects, ADF hopes to invest in 
eight to ten new projects in Ghana by summer 2004. 
 
ADF Focus on HIV/AIDS 
--------------------- 
13. On January 21 D/S Allen and ADF reps visited a community 
in Accra where the ADF-funded group YPEP (Youngsters Peer 
Education Project) promotes adolescent reproductive health 
and development through peer education and youth-friendly 
integrated services.  YPEP is a youth AIDS education project 
where educators provide information on health issues and 
HIV/AIDS.  The goal is to promote responsible sexual behavior 
and control the incidence and spread of HIV among youths. 
 
Comment 
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14. With the extensive media coverage of the HHS/ADF visit, 
especially during D/S Allen's meeting with President Kufuor, 
the trip served to raise awareness in Ghana of health issues, 
specifically those related to HIV/AIDS, and highlighted USG 
efforts to assist Ghana in the health sector.  The GoG showed 
itself an enthusiastic partner in the ADF programs in Ghana, 
and appears eager to support efforts to increase ADF 
investment into the country.  Also useful was D/S Allen's 
message to President Kufuor that Ghana needs to move past the 
rhetoric of "The Golden Age of Business" and take concrete 
steps to improve its investment climate if it is to compete 
for MCA funds and attract greater foreign investment.  End 
Comment 
 
Lanier