HHS SECRETARY LEAVITT'S MEETINGS WITH HAIPHONG

UNCLAS SECTION 01 OF 05 HANOI 002823

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E.O. 12958: N/A
TAGS: AMED AMGT CASC EAGR PINR SOCI PGOV TBIO VM HIV AIDS AFLU
SUBJECT: HHS SECRETARY LEAVITT'S MEETINGS WITH HAIPHONG
OFFICIALS


1. (SBU) Summary: On his second full day in Vietnam, U.S.
Secretary of Health and Human Services (HHS) Michael Leavitt

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traveled to the port city of Haiphong to survey the avian
influenza (AI) and HIV/AIDS situations there. He met with
local Haiphong Provincial Health Department officials on
October 15 at the Provincial People's Committee Hall to
discuss HIV/AIDs and AI. The Director of the Provincial
Health Department gave a presentation providing data on
HIV/AIDS and AI cases in Haiphong, and underscored the
strong commitment by local officials to combat HIV/AIDs and
AI in the province, 100 kilometers outside the capital of
Hanoi. HHS Secretary Leavitt also paid courtesy calls up on
Haiphong People's Committee Vice Chairman Hoang Van Ke, and
visited a local hospital and clinic as well as the home of
recent AI survivors to raise community awareness of AI and
emphasize U.S. support for the Vietnamese and the GVN in its
efforts to combat it. End Summary.

LOCAL CAPACITY NEEDS HELP
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2. (U) Haiphong People's Committee Vice Chairman Hoang Van
Ke welcomed the Secretary's delegation to Haiphong, and
expressed gratitude to the United States for its cooperation
in combating HIV/AIDS and avian influenza (AI) in the region
and around the world. Noting that Haiphong is the third-
largest city in Vietnam and an important port gateway with
economic growth of over ten percent in the past decade, Ke
emphasized the critical role international partners play in
helping to properly administer and manage health projects in
Vietnam. Ke remarked that the country had made considerable
advancements, and that local officials are committed to the
timely treatment of those infected with H5N1, but Vietnam is
still a poor country and needs the help of the international
community.


3. (U) Vice Chairman Ke also told the Secretary that
Haiphong is following the Central Government's direction on
AI prevention, and is focusing on vaccinating poultry,
monitoring for a possible outbreak, and implementing a
public awareness and education campaign. The Secretary
thanked the Vice Chairman for receiving him, and said the
main purpose of his visit to Hai Phong Province was to see
how the partnership on HIV/AIDS is progressing, and to
better understand the challenges of preventing another AI
outbreak at the provincial level.

HIV/AIDS AND PREVENTION INTERVENTION
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4. (U) Provincial Health Department (PHD) Director Nguyen
Van Vy profiled the HIV/AIDS and avian influenza situations
in Haiphong (copies of his presentation were distributed to
the delegation). (Comment: With a population of 1.7 million
people, Haiphong has one of the highest prevalence rates of
HIV/AIDS in the nation, around .33 percent according to HHS
Centers for Disease Control and Prevention (CDC) estimates.
HHS/CDC began its Global AIDS Program (GAP) in Haiphong in
2002 in cooperation with the Vietnamese Ministry of Health,
by creating the LIFE-GAP project and establishing a
voluntary counseling and testing center and an adult
outpatient clinic and a pediatrics outpatient clinic, among
others, which now come under the funding and administrative
umbrella of the President's Emergency Plan for AIDS Relief.
End Comment).


5. (SBU) Dr. Vy pointed to Haiphong's geographic situation
as one reason for the rate of disease in the province.
Haiphong shares a border with "HIV epidemic hot spots" Quang
Ninh, Hanoi and Hai Duong. The tourism and shipping sectors
also contribute to the easy transmission of HIV/AIDS, and
the city now has over 5000 intravenous drug users. Vy
expressed concern that the HIV/AIDS pandemic in Haiphong is
very complex and at high risk for a potentially exponential
increase in infection rates. In a chart that detailed HIV
and AIDS cases and deaths from 1993 through September 2005,
Dr. Vy acknowledged that the number of total HIV infections
had decreased 35-36 percent since January 2003. By
September 2005, he said, the cumulative number of HIV cases
in Haiphong totaled 7,134 and cumulative AIDS cases totaled
2,803. So far, Haiphong has had an estimated 1,902 deaths
from HIV/AIDS, according to the chart.


6. (U) Resolution Number 21/NQ BTV for AIDS prevention is
an indication of the strong commitment from the highest
levels of local leadership to combat AIDS, Dr. Vy remarked.
The Haiphong People's Committee approved an AIDS Prevention
Strategy for 2005-2010 to prevent and control the pandemic
in Haiphong. The province has also implemented an
Information-Education-Communication (IEC) Strategy,
including a syringe- and needle-exchange program and condom
distribution, as "indirect vaccines" to AIDS prevention.
(NOTE: The President's Emergency Plan in Vietnam follows
U.S. Government policy and does not provide financial or
technical support to syringe- or needle-exchange programs.
END NOTE.) Television, radio, internet and personal
communication methods are increasing awareness about the
risks and prevention of HIV/AIDS, and have resulted in
information outreach to 90 percent of urban residents and 70
percent of the suburban residents in Haiphong Province, Dr.
Vy said.


7. (U) According to Dr. Vy, Haiphong has tested 25,000-
40,000 blood samples in the past ten years, and provided for
pre- and post-test counseling, as well as established self-
help groups and clubs to promote awareness about HIV/AIDS.
The Provincial Health Department is also entrusted with
sterilization of equipment and other materials, safe blood
transfusions, preventing mother-to-child transmission, and
treatment of AIDS patients. Furthermore, since AIDS
prevention is a community responsibility, the Provincial
Health Department has joined forces with the Provincial
Department of Labor and War Invalids-Social Affairs, the
police, the women's union, the youth union and the National
Fatherland Front. International partners include Family
Health International; HHS/CDC; SCF from the United Kingdom
(UK); NAV from Norway; the Global Fund to Fight AIDS,
Tuberculosis and Malaria; the Department of International
Development of the UK Government; the United Nations (UN)
Educational, Scientific and Cultural Organization (UNESCO);
and the UN Children's Fund (UNICEF).


8. (U) Since October 2002, the Provincial Health Department
has worked with HHS/CDC to establish a voluntary counseling
and testing center, the first of its kind in Vietnam.
Currently, there are two centers in Haiphong. The
Outpatient Clinic (OPC) for adults in Viet Tiep Hospital
(the other center is in Ho Chi Minh City) provides anti-
retroviral (ARV) drugs for patients. Another OPC for
children is located in the Haiphong Pediatrics Hospital, and
the Obstetrics Hospital works to prevent mother to child
transmissions.

THE AVIAN FLU SITUATION IN HAIPHONG
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9. (SBU) According to Dr. Vy, since the beginning of 2004,
the Provincial Health Department, under the guidance of the
Ministry of Health and the People's Committee, has actively
worked to collaborate with the agricultural sector to
prevent AI and its transmission to humans. The Committee
has issued relevant documents for distribution at the
commune level, promoted hygiene in poultry farms and
equipped Viet-Tiep hospital to treat H5N1 patients.
Haiphong has successfully treated seven patients with H5N1
in March and April of this year. The patients included a
twelve-year-old girl in the Niem Nghia Ward, a nine-year-old
girl and five persons in one family in Kien Thuy District,
whom Secretary Leavitt visited that afternoon. Dr. Vy
concluded his remarks by noting that Haiphong appreciates
the assistance it receives from HHS, including vaccines,
medical facilities and training materials.


10. (SBU) Secretary Leavitt thanked Chairman Ke and Dr. Vy
for their presentations, which, he said, helped the
delegation understand the health situation at the provincial
level. The Secretary and others in the delegation asked for
clarification on how the seven patients with H5N1 were
treated and the length of time between the first indications
of symptoms to the beginning of treatment with Tamiflu. Dr.
Vy responded that local officials reported the outbreak to
the national Ministry of Health and its National Institute
of Health and Epidemiology (NIHE),and sent the patients'
specimens to NIHE, which provided Tamiflu to the patients
one day after hospitalization. The patients were probably
hospitalized four or five days after first feeling ill, he
added. Diagnosis was made after the Tamiflu treatment
began, and the patients gradually improved in health. The
Secretary thanked the Vietnamese delegation, and said that

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he looks forward to continued cooperation between Haiphong
institutions and HHS and other U.S. agencies.

OUTREACH AND DIALOGUE
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11. (U) In addition to his two main meetings with Chairman
Ke and Dr. Vy, Secretary Leavitt attended a luncheon hosted
by Chairman Ke at the Provincial People's Committee Guest
House. He also visited an HIV/AIDS Voluntary Counseling and
Testing Center and HIV/AIDS Outpatient Clinic, both funded
by the President's Emergency Plan for AIDS Relief. At the
end of his trip, he stopped by a rural Commune Health
Station and met with the family that contracted and
recovered from AI in March 2005.

PARTICIPANTS
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12. (U) U.S. Participants:
HHS Secretary Michael Leavitt
U.S. Ambassador Michael Marine
Kerry Weems, HHS Deputy Chief of Staff
Dr. Kent Hill, Acting Assistant Administrator for Global
Health, U.S. Agency for International Development (USAID)
Dr. James Butler,
Under Secretary for Farm and Foreign Agricultural Services,
U.S. Department of Agriculture (USDA) Dr. Julie Gerberding,
Director, HHS/CDC Dr. Anthony Fauci, Director, HHS/NIH/NIAID
Suzy De Francis, Assistant Secretary for Public Affairs,
HHSDr. William Steiger, Special Assistant for International
Affairs, HHSDr. Vaughan Turekian, Special Assistant to Under
Secretary Dobriansky Allyson Bell, Director of Scheduling

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and Advance, HHS
HHS Hanoi Health Attache Marie Sweeney
HHS/CDC Chief of Party Mitchell Wolfe
USDA/FAS Hanoi Attache John Wade
USAID Program Manager Dan Levitt


13. (U) Vietnamese Participants:
Haiphong People's Committee Chairman Hoang Van Ke
Vice Minister of Health Trinh Quan Huan
Provincial Health Department (PHD) Director Nguyen Van Vy
PHD Deputy Director Tran Thi Thanh Thuy
LIFE-GAP Director Luu Thi Minh Chau
LIFE-GAP Subproject Director Do Thi Minh Nguyet
Director of International Cooperation Department of Ministry
of Health Tran Trong Hai
Director of Haiphong Foreign Affairs Department Pham Huu Thu
Director of Haiphong Agriculture and Rural Development
Department Do Trung Thoai
Deputy Director of Haiphong Health Department Phan Trong
Khanh


14. (U) Secretary Leavitt's party has cleared this cable.

BOARDMAN