US embassy cable - 05MASERU418

UNCLAS SECTION 01 OF 02 MASERU 000418 
 
SIPDIS 
 
AIDAC 
 
STATE FOR OGAC AND AF/S 
 
E.O. 12958: N/A 
TAGS: SENV, SOCI, TBIO, PREL, LT, HIV 
SUBJECT: GLOBAL AIDS COORDINATOR VISITS LESOTHO; WANTS INCREASED USG 
EFFORT TO FIGHT AIDS 
 
MASERU 00000418  001.2 OF 002 
 
 
1. SUMMARY. Chief of the Office of the U.S. Global AIDS 
Coordinator, Ambassador Randall Tobias, visited Maseru on July 
22 to observe HIV/AIDS programs supported by the President's 
Emergency Plan for AIDS Relief (PEPFAR) and managed by the U.S. 
Agency for International Development, the Centers for Disease 
Control and by the U.S. Embassy, followed by a visit on July 23 
to Swaziland. Ambassador Tobias was accompanied by his advisors, 
as well as by staff from the USAID Regional HIV/AIDS Program 
(RHAP) and CDC Regional teams.  Lesotho suffers from the third 
highest HIV prevalence rates in the world and faces multiple and 
urgent challenges. While support from the United States for 
HIV/AIDS has increased nearly five-fold in the last two years, 
Lesotho remains one of the poorest countries in Southern Africa 
with extremely limited capacity to mitigate the impact of 
HIV/AIDS.  Ambassador Tobias met with senior government 
officials and visited U.S.-supported HIV/AIDS programs in the 
central government referral hospital and several community-based 
NGO's.  He was impressed by efforts underway, but raised serious 
concerns about the magnitude of the HIV/AIDS problem in Lesotho. 
 Ambassador Tobias invited the USG team to strategize bold and 
creative approaches to further assist the Government of Lesotho 
to strengthen their HIV/AIDS prevention, treatment, and care and 
support response.  END SUMMARY 
 
2.  Ambassador Tobias met with a wide range of prominent 
government and non-government officials including the First 
Lady, Minister of Health,  the Principal Secretary of Finance 
and Development Planning, Principal Secretary 
of Health, CEO of the National AIDS Secretariat, Ambassador of 
Lesotho to the United States, and Prince Seeiso.  He was briefed 
by Ambassador Perry and the USG team and held a lunch meeting 
with key health sector and other government officials, 
multilateral donors, international organizations and civil 
society leaders involved in the fight against HIV/AIDS. 
 
3.    To gain a first-hand view of the health care system, 
Ambassador Tobias was guided by the Minister of Health Phooko 
through a tour of Queen Elizabeth II Hospital, the country's 
central referral hospital,  where he observed  activities and 
met with program staff from the Prevention of Mother to Child 
Transmission (PMTCT) program and the pediatric ward; the 
Anti-Retroviral Therapy clinic; and services  for TB/HIV 
co-infection, supported by PEPFAR. In addition, he visited a 
mobile voluntary HIV counseling and testing unit (VCT) managed 
by a USG implementing partner. The Ambassador and his team 
visited a neighborhood NGO that receives assistance from the 
First Lady of Lesotho, a popular champion for HIV/AIDS in her 
country. The volunteer group works with community members to 
raise funds and provide care and support for families affected 
by HIV.  The Ambassador and his team also visited the Lesotho 
Child Counseling Unit (LCCU), a NGO working with victimized 
children and orphans supported by the Ambassador's Special 
Self-Help fund and the Peace Corps. During his site visits, 
Ambassador Tobias spent time talking with local Basotho people, 
orphans, caregivers and people living with HIV/AIDS. 
 
4. The briefings with the USG Team, government officials and 
other donor partners revealed a number of critical issues facing 
the country. Lesotho suffers from serious human resource 
deficits, including a health work force that is understaffed, 
often attracted to employment outside of the country , and which 
is equally affected by HIV infection like the general population 
they serve. The magnitude of the country's epidemic poses a 
tremendous economic burden on the public health sector in 
particular. Basic drugs, equipment, other material resources and 
infrastructural support are in desperately short supply and/or 
disrepair. In addition, the needs of women and children who are 
suffering most from the impact of HIV/AIDS in Lesotho tend to be 
overlooked. The USG response to these and other critical 
challenges to-date includes USG-funded programs, as well as 
leadership from Ambassador Perry.  Ambassador Perry co-chairs 
the United Nations Expanded Theme Group on HIV/AIDS, chairs the 
USG Task Force Steering Committee and convenes regular HIV/AIDS 
Task Force meetings with the USG, Lesotho government, and other 
implementing partners to strengthen and coordinate the further 
development of USG support and response. 
 
 5.  Ambassador Tobias and his staff were seriously concerned by 
the gravity of the HIV problem in Lesotho and troubled by  the 
devastating current and future consequences for every single 
sector; from health, to social, to economic, and political. 
Before his departure for the U.S., Ambassador Tobias discussed 
his impressions with the USG Southern Africa team, stating his 
visits to both Lesotho and Swaziland were among the most 
eye-opening and well-organized of his field visits to-date. 
Recognizing the crisis situation in both countries, Ambassador 
Tobias expressed that 'business as usual' would not be 
sufficient to address the severe prevention, treatment and care 
and support challenges in both countries.  He asked the USG 
Southern Africa team to 'think out of the box' and to strategize 
 
MASERU 00000418  002.2 OF 002 
 
 
bold and creative approaches for building and expanding the 
national HIV/AIDS response with USG support. Finally, Ambassador 
Tobias designated his Senior Advisor, Nazanin Samari-Kermani, as 
the focal person from the Office of the U.S. Global AIDS 
Coordinator who will ensure follow-up and continued commitment 
from the President's Emergency Plan for AIDS Relief for Lesotho 
and Swaziland. 
 
6. Media coverage of the visit was extensive.  Post sent press 
releases to media organizations prior to the visit.  Television, 
radio and print covered Ambassador Tobias' visit at a press 
event at LCCU.  LTV, the only domestic 
television station broadcast the visit of Ambassador Tobias on 
the evening news.  Radio stations, Radio Lesotho, Catholic 
radio, and Joy FM repeated the story over a three-day period. 
Public Eye, the most widely read domestic 
newspaper, and the Mirror , also with a high readership, 
published columns quoting from Ambassador Tobias' speech and 
information provided in Embassy press kits. 
. 
7. Comment:  Ambassador Tobias' visit to Lesotho emphasized the 
US commitment to the fight against HIV/AIDS and reinforced 
mission activities with key factors in the fight against 
HIV/AIDS.  The visit highlighted the collaborative work of the 
USG and the Ministry of Health and Social Welfare. The Minister 
of Health stated that having such senior-level US government 
visitors to Lesotho to discuss the issue of HIV/AIDS has 
highlighted the work of his Ministry and reinforced his 
Ministry's work at the health facilities, in the communities and 
with other government departments. End  Comment. 
 
8. This cable was cleared by OGAC, RHAP-Pretoria, and 
CDC-Pretoria. 
 
 
 
 
 
 
 
 
 
 
ALBRECHT