5. Telegram From the Embassy in Zaire to the Department of State1

5551. Subject: AIDS in Zaire: CDC–NIH/MOH Collaborate Study. Ref: A) Kinshasa 4242; B) Kinshasa 3994;2 C) 83 Kinshasa 14070.3

1. Summary: A USG medical research team has visited Kinshasa and reached preliminary agreement with GOZ medical authorities on a long-term collaborative study of acquired immuno deficiency syndrome (AIDS) in Zaire. In following up, USG agencies will need to pay close attention to Zairian sensitivities about control of and partici[Page 11]pation in all research ventures. Action requested: Department is requested to follow up with HHS agencies; CDC and NIH, to ensure that USG efforts are properly coordinated and take full account of GOZ concerns.

2. Following up on last October’s investigative visit by US researchers which first uncovered the existence of significant incidence of AIDS in Zaire (Ref C), a combined Centers for Disease Control (CDC)–National Institutes of Health (NIH) team visited Kinshasa from March 9 to 19 to establish a long-term research project on the acquired immuno deficiency syndrome (AIDS) in collaboration with Zairian medical authorities. The three team members were: Dr. Joseph McCormick, CDC, Director, Special Pathogens Branch, Dr. Jonathan Mann, CDC’s nominee for the Zaire AIDS project, and Dr. Andrew Vernon, NIH.

3. The team, accompanied by Embassy Science Officer, met with Dr. Kalisa Ruti, Special Assistant to Minister of Public Health Dr. Tshibasu Mubiay. Kalisa expressed the GOZ’s eagerness to establish U.S. public health authorities. He asked the team to make appropriate contacts within the Kinshasa medical community and to draft a proposal.

On March 19 Dr. Mann and Embassy Science Officer presented proposal to Dr. Kalisa. Mann plans to return to Kinshasa in May to begin an estimated two year tour. A CDC technician will travel to Kinshasa for temporary duty later in the summer to help establish the diagnostic facilities.

4. To set the basis for the proposal, the team spent one week re-establishing contacts at Kinshasa’s five hospitals and found that the two major facilities—University Clinic and Mama Yemo Hospital have continued to document AIDS cases since initial CDCNIH visit in October 1983. The steady rate of cases identified at both facilities confirms that the incidence of AIDS in Zaire is significant. There are indications that the characteristics of the disease in Zaire are somewhat different from the U.S. and there is some suspicion that the evolution of AIDS in the U.S. may follow Zairian patterns.

5. Diagnostic testing for AIDS (T-cell examination) on a limited number of suspected cases is being done at a University of Kinshasa laboratory by doctors from the Institute of Tropical Medicine (ITM) of Antwerp, Belgium. Reagents and material for the tests have been supplied by CDC through the Embassy.

6. The team decided that the collaborative project should center on an epidemiologic investigation with suitable laboratory facilities to support the investigation. The Zairians are willing and able to supply the clinical support necessary for the project. The team proposed that two laboratories be designated to conduct diagnostic testing in Kinshasa. While the first lab will continue to function at the university, [Page 12]Zairian doctors on the university medical faculty are eager to take over responsibility for AIDS research from the Belgian ITM doctors performing part-time diagnostic work as their time permits at the university (their principal task is the study of trypanosomiosis—sleeping sickness). The second laboratory will be established at Mama Yemo Hospital which will also provide office space for the project.

7. This dual effort circumvents the problem of potential rivalry between the University Clinic/Medical School, administered by the Department of Higher Education, and Mama Yemo Hospital, administered by the Department of Public Health.

8. Another potential problem which U.S. researchers must bear in mind concerns the attitude and atmosphere of the project. The Zairians are particularly concerned that the project be a truly collaborative venture using Zairian personnel to their full capabilities with Americans providing specialized knowledge, skills and equipment. Close collaboration with Zairian counterparts by U.S. specialists is critical to the long-term success of the project.

9. Last October’s AIDS mission included several Belgian specialists from the Institute of Tropical Medicine in Antwerp. Embassy understands that NIH is considering funding the ITM to conduct a long-term clinical research project. The Zairians believe that they can conduct the clinical aspects of AIDS research themselves and would prefer to receive direct U.S. support.

10. The GOZ is extremely concerned about AIDS and is eager to work closely with U.S. researchers. However, the Zairian medical community is particularly sensitive about national sovereignty. The GOZ has repeatedly emphasized that all research must be done on a collaborative basis, i.e. with consent and participation by Zairians. Zairian scientists believe that too much previous scientific research has exploited Zaire as little more than a convenient laboratory. For a joint research effort to be successful, it is imperative that USG researchers respect the sensitivities of their Zairian counterparts.

11. Embassy welcomes the beginning of the project. We have arranged to provide full administrative support to USG personnel working on the AIDS research effort and we are following up with MOH.

12. Action requested: Department is requested to follow up with HHS agencies; CDC and NIH, to ensure that USG efforts are properly coordinated and take full account of GOZ concerns.

Constable
  1. Source: Department of State, Subject Files, Health Issues, 1977–1985, Lot 86D184, Africa. Unclassified. Sent for information to NIH, CDC, and Lubumbashi.
  2. In telegram 3994 from Kinshasa, March 9, the Embassy reported that CDC officials had arrived in Zaire. (Department of State, Central Foreign Policy File, D840159–0217) In telegram 4242 from Kinshasa, March 15, the Embassy reported on the status of the AIDS cooperative project. (Department of State, Central Foreign Policy File, D840174–0908)
  3. See Document 4.