ambassador Marquardt's speeches

U.S. Ambassador Niels Marquardt
United States-Cameroon Health Cooperation
Signing Ceremony

Thursday, June 14, 2007 – 12 noon
Ministry of Public Health Conference Room

Thank you, Minister Olanguena Awono, for hosting this important occasion today.

It is a singular pleasure to sign this agreement today, because its lengthy gestation has spanned my three years in Cameroon.  I would like to thank Minister Urbain Olanguena Awono and his colleagues at the Ministry of Public Health -- in particular, Professor Sinata Koulla, Dr. Pierre Ongolo Zogo, Professor Assumpta Bella, Dr. Maurice Fezeu, and Mr. Emmanuel Maina -- for their diligence and patience throughout this process.  We can all take pride in the successful outcome today. 

Today’s agreement is important as an example of U.S commitment to global health.  We live in an increasingly interconnected and interdependent world, and infectious pathogens respect no national borders. 

From the struggle against HIV, we have learned that international collaboration is essential to generate effective and affordable tools for treatment and prevention.  The global HIV pandemic has also taught us that international partnerships can effectively mobilize resources, and direct them to needy countries with a high burden of HIV infections. 

Following the re-emergence of H5N1 avian influenza in 2003, in Asia, and last year in Africa, we have observed wildlife and poultry affected in Nigeria, Niger, Burkina Faso, and Cameroon. In Egypt, human cases have been confirmed. From avian influenza we have learned that we must cooperate internationally to detect and respond appropriately to animal and human health threats. 

From the Ebola virus to extensively drug-resistant (NB:  this is the technical name for TB resistant to first- and second-line drugs) tuberculosis, , we have seen new infectious pathogens emerge and old ones evolve. The global health community must be prepared to investigate and respond whenever and wherever disease strikes. 

The salient lesson from experiences with these various emerging infections has been the critical importance of international cooperation.   For this reason, my country seeks partnerships with countries like Cameroon.  Here in Cameroon the government faces, among other sobering health concerns, a generalized HIV epidemic, endemic malaria transmission, and the potential threat to human health posed by avian influenza.  The United States recognizes that international partnership and collaboration greatly reinforces our abilities to combat infectious diseases and improve global health. 

Permit me to describe some recent examples of U.S. cooperation on health in Cameroon and explain how this agreement will affect future health collaborations with Cameroon.
Currently, the United States funds directly or indirectly three categories of activities related to health promotion and infectious diseases in Cameroon: health research, disease prevention, and treatment.

The U.S. government funds health research in Cameroon, most notably in HIV and malaria, with the purpose of generating new knowledge and improved understanding for the prevention of these diseases.  Two U.S. government agencies – the U.S. National Institutes of Health and the U.S. Department of Defense – provide grants to American universities that develop collaborations with Cameroonian institutions.  The Walter Reed Johns Hopkins project is one excellent example of this type of university-based health research project.  Another U.S. government agency, the U.S. Centers for Disease Control and Prevention, directly supports U.S. and Cameroonian scientific staff here in Cameroon. The Centers for Disease Control and Prevention in Cameroon operates under the auspices of the U.S. Embassy. Its focus is to conduct HIV prevention research.

In addition, the Government of the United States directly funds disease-prevention programs in Cameroon.  This type of health cooperation is traditionally the purview of USAID, the U.S. Agency for International Development. Although Cameroon lacks its own resident USAID mission, Cameroonian organizations are eligible for U.S. funding through the West Africa Regional USAID office.  To cite one example, regional USAID funding supports the Cameroon Baptist Convention’s Program to Prevent Mother-to-Child HIV Transmission.  This organization has justly earned international kudos for its model HIV prevention program.  Since 2000 this organization has counseled and tested about 185,000 pregnant women for HIV in Cameroon, and provided lifesaving medication to HIV-infected mothers to prevent HIV transmission to their infants. 

Through substantial contributions to the Global Fund to Fight AIDS, Tuberculosis and Malaria, the United States indirectly supports HIV treatment programs operated by the Cameroon Ministry of Public Health.  Minister Urbain Olanguena Awono has been extraordinarily successful in obtaining competitive Global Fund grants totaling over US $50 million. In 2006 and 2007, the U.S. government donated approximately 25% of the total contributions pledged by all countries to the Global Fund.  Through prudent use of Global Fund financing, the government of Cameroon has made antiretroviral treatment free for all HIV/AIDS patients in Cameroon, a truly historic achievement.  According to recent figures from the Ministry of Public Health, 31,000 AIDS patients in the country are receiving antiretroviral treatment in 2007. This represents a doubling of the number of patients on treatment since 2005.  Cameroon should be commended for these laudable public health achievements.

So how does the present agreement relate to these ongoing examples of direct and indirect United States-Cameroon health cooperation? 

All of these activities – in health research, disease prevention, and treatment will continue unimpeded.  What is different now is that this government-to-government agreement establishes the official framework for future cooperation between the United States and Cameroon in the areas of HIV/AIDS, avian influenza, and other infectious diseases.  The agreement provides a legal platform for expanding and strengthening that relationship.  It paves the way for additional future U.S. investment in Cameroon, including technical assistance to address global health issues and disease prevention.

Specifically, in the area of technical assistance, the agreement makes possible the placement in Cameroon of resident technical advisors, experts from the United States and elsewhere who can assist Cameroon with the control and prevention of infectious diseases. Similarly, it paves the way for the expansion of training opportunities for health personnel in Cameroon.

For the Centers for Disease Control and Prevention, or CDC as the government public health agency is known, this agreement marks a special milestone.  Until today, CDC has been collaborating with the Ministry of Public Health to prepare to conduct HIV prevention research within at-risk communities in Cameroon.  The signing of the agreement today culminates a lengthy process to obtain formal recognition and endorsement for CDC’s long-term presence in Cameroon.  Ultimately, CDC aims to test new ways to prevent HIV/AIDS in Cameroon.  With the agreement in place, CDC will be able to strengthen, on a larger scale, local capacity for collaborative HIV research in Cameroon.  They will expand local research capacity by training scientific staff and health personnel in Cameroon in internationally accepted clinical research practices.  In addition, CDC will renovate laboratories and other physical infrastructure needed for clinical research.  At the same time, CDC will engage at-risk communities and other stakeholders to promote open dialogue about research.   

The accord today signals Cameroon’s wish to invite the Government of the United States to carry out open and transparent research in the country in accordance with the highest ethical standards, and in mutually agreed-upon priority areas.   Minister Olanguena Awono himself has exhorted Cameroonians to make their personal contributions to the global fight against HIV/AIDS. This continued and expanded collaboration is a visible commitment from both our governments to seek solutions to the pandemic. 

I would like to close with my own exhortation.  We live in an era of unprecedented attention and resources devoted to global health, both through multilateral cooperation, such as the Global Fund, and through bilateral cooperation.  A few weeks ago, President Bush announced his proposal for extending the President’s Emergency Plan for AIDS Relief, or PEPFAR – which I understand has been dubbed “PEPFAR-THER”.  PEPFAR already has provided US $15 billion to over 25 countries heavily affected by the AIDS epidemic between 2003 and 2008.  The President now proposes to double overall funding to an additional US $30 billion during the next 5 years, from 2008 to 2013.   Furthermore, the President has also launched the President’s Malaria Initiative, a USD $1.2 Billion program that has spent US $135 million this year on malaria control in 15 African countries. 

Currently, while benefiting as I said from significant indirect U.S. support through the Global Fund, Cameroon does not feature in either of these major global health initiatives.  As we sign this landmark agreement, I believe, however, that the Government of Cameroon now has a new opportunity to demonstrate effective and transparent use of support and funding made available for health cooperation.  With ever better governance and the improving demonstration of effective disease control strategies, the promise of additional United States investment in health cooperation with Cameroon may be realized, to the lasting benefit of the Cameroonian people. 

As I prepare to sign this agreement, and as I prepare to leave Cameroon at the end of my assignment here, I am full of hope for an even brighter future for health cooperation between my country and yours.  Thank you for your attention, and thank you all for what you are doing to help address the shared challenges of global disease prevention, eradication, and treatment.