US embassy cable - 04ABUJA984

UNCLAS SECTION 01 OF 02 ABUJA 000984 
 
SIPDIS 
 
SENSITIVE 
 
DEPT FOR AF/W DEPSTEIN 
 
E.O. 12958: N/A 
TAGS: AORC, EAID, KHIV, NI, TBIO, AID 
SUBJECT: OBASANJO ASKS FOR PEPFAR COORDINATION 
 
 1.  (SBU)  Summary:  Global AIDS Coordinator Randall Tobias 
met with Nigerian President Obasanjo and key members of the 
Nigerian HIV/AIDS community and public health sector.  Pres. 
Obasanjo acknowledged that the US retains control of funding 
but urged coordination during the implementation of PEPFAR in 
Nigeria.  Amb. Tobias confirmed that the US policy regarding 
PEPFAR is to empower Nigeria and build on the strategic 
foundation it laid.   In response to Nigerian concerns, the 
Ambassador also clarified that PEPFAR allows for the use of 
FDA approved generic drugs.  End Summary. 
 
2.  (SBU)  Nigerian President Obasanjo received Global AIDS 
Coordinator Amb. Randall Tobias at the Presidency June 4.  In 
addition to Amb. Tobias, the American side consisted of DCM 
Rick Roberts, USAID Mission Director Dawn Liberi, S/GAC Press 
Officer Amy Black and Special Assistant Alex Hammond. 
Accompanying President Obasanjo were Vice President Abubakar, 
National Action Committee against AIDS (NACA) Chairman Prof. 
Babatunde Osotimehin, Director of Public Health Dr. Edugie 
Abebe, and other officials from NACA and the President,s 
Office. 
 
3.  (SBU)  The DCM opened the meeting by thanking the 
President for taking time out of a busy schedule to meet with 
the delegation.  He then lauded the President,s leadership 
role on combating HIV/AIDS within Nigeria and the broader 
regional context.  Noting the commitment to help in the fight 
against HIV/AIDS that President Bush made during his visit to 
Nigeria in July 2003, the DCM introduced Amb. Tobias. 
 
4.  (SBU)  Amb. Tobias began his remarks by complementing 
President Obasanjo on his leadership role.  He then stressed 
President Bush,s strong personal commitment to the fight 
against HIV/AIDS as manifested in PEPFAR.  The Ambassador 
informed the President that in the first year of PEPFAR, 
nearly 59 million USD will be spent in Nigeria to assist in 
the effort.  Amb. Tobias told the President that he was in 
Nigeria to listen to our Nigerian partners and look for ways 
to support the indigenous efforts.  He concluded saying he 
looked forward to working with the Government of Nigeria in 
confronting HIV/AIDS in the country. 
 
5.  (SBU)  President Obasanjo thanked the Ambassador for his 
remarks.  He pointed out that he had brought his Vice 
President to the meeting as an indication of the importance 
his administration attaches to the fight against AIDS. Then 
he recounted the history of efforts against AIDS under his 
leadership.  The President noted that national health issues 
had been at the forefront of his administration since his 
first term.  He had convened a summit on malaria in 2000 
followed by an AIDS summit in 2001.  President Obasanjo noted 
that he was present at the launch of the Global Fund at the 
White House 2002, when President Bush and UN Secretary 
General Annan made the announcement.  President Obasanjo then 
thanked President Bush for launching PEPFAR in Nigeria. 
 
6.  (SBU)  Obasanjo went on to note the biannual Sentinel 
Survey, which Nigeria conducts that recorded a drop in 
HIV/AIDS prevalence from 5.8 percent in 2001 to 5.0 percent 
in 2003.  The President stated that this most recent survey 
identified two states, Cross River and Akwa Ibom, which were 
significantly under performing.  He said that he planned to 
call in the governors, legislators and public health 
officials from those two states and ask for a plan of action 
from them to fight HIV/AIDS. 
 
7.  (SBU)  The President next turned his attention to what he 
termed a critical issue, coordination.  Obasanjo stated that 
the US should control PEPFAR funds but their expenditure 
should be within the Nigerian national program's priorities. 
By implementing a plan of action that would adhere to 
Nigerian priorities the President said four things would be 
accomplished: 
-     The US would demonstrate support for Nigeria and its 
efforts. 
-     Results will be excellent and all can claim credit 
-     The US would be empowering Nigeria 
-     The US would learn lessons replicable in the rest of 
Africa and the world 
 
8.  (SBU)  Amb. Tobias responded that the President made an 
excellent case and stressed that the US approach was to build 
an &edifice on the Nigerian foundation.8  The Ambassador 
noted that Pres. Bush through PEPFAR is focusing on 
prevention, treatment and care and recognizes that the US 
cannot do everything.  Sustainability of PEPFAR in the long 
run was actually predicated on empowering Nigeria. 
 
9.  (SBU)  The NACA Chairman in his remarks continued to 
stress the need for coordination but noted that Nigeria must 
have the lead.  Prof. Babatunde stated that Nigeria is 
already treating 14,000 persons afflicted with AIDS.  He 
pointed out that by using generic drugs Nigeria can treat 
three to four times the number of people that can be reached 
if expensive brand name drugs are used. 
 
10.  (SBU)  Dr. Abebe followed the NACA Chairman and 
addressed concerns about sustainability.  Echoing the 
Chairman,s remarks about generic drugs, Dr. Abebe stressed 
the desire for universal access to ARVs.  She noted the need 
for Nigeria to begin producing its own ARVs if the program 
were to succeed.  Citing Brazil as a model, Dr. Abebe spoke 
of Nigeria,s desire to produce generic drugs for its own 
needs and the region and how manufacturing could avoid 
developing &resistance8 problems.  The Doctor continued 
saying that Nigeria,s infrastructure issues must be 
addressed in order to develop the health system.  She 
concluded saying that she hoped PEPFAR would help Nigeria 
scale up its own program to treat 300,000. 
 
11.  (SBU)  Amb. Tobias responded that the USG was in general 
agreement with the points made.  He noted that Pres. Bush 
anticipated the potential use of generic drugs in PEPFAR and 
the process is in place for any drug company to apply to have 
its products reviewed rapidly by the FDA and if approved 
become eligible for PEPFAR funding.  The Ambassador added 
that he hoped Nigeria would develop a drug manufacturing 
capability and seek approval for PEPFAR funding through the 
FDA process. 
 
12.  (SBU)  Pres. Obasanjo concluded the meeting by saying he 
appreciated Pres. Bush,s position on the use of generic 
drugs and hoped that Nigeria would be able to produce them. 
He then thanked the Ambassador again for his efforts to 
assist Nigeria.  He indicated he would see President Bush 
next week at the G-8 meeting at Sea Island and would report 
his meeting with Amb. Tobias. 
 
13.  (SBU)  Comment:  Obasanjo was up beat and clearly 
informed about HIV/AIDS.  Although he ceded that the US will 
control PEPFAR funds, he and his lieutenants made clear that 
they expect PEPFAR to conform to Nigeria,s strategy and 
priorities.  It is likely that there will be a push in the 
months and years ahead from the Nigerian side to use PEPFAR 
funds to institute generic drug production in the country. 
End Comment 
 
14.  Amb. Tobias cleared this cable before leaving Abuja. 
CAMPBELL