NEW EGYPTIAN MINISTER OF HEALTH BRINGS

UNCLAS SECTION 01 OF 02 CAIRO 000448

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TAGS: EAGR ETRD PGOV PINR EG KFLU
SUBJECT: NEW EGYPTIAN MINISTER OF HEALTH BRINGS
BUSINESSMAN'S APPROACH TO GOVERNMENT


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Introduction/Summary
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1. (SBU) In a January 23 meeting with the Ambassador and key
country team members in health and science affairs, newly
installed Minister of Health and Population Hatem El Gabaly
demonstrated that he will be a valuable addition to Egypt's
reformer camp. Displaying a "can do," business-like attitude
that contrasted starkly with the style of his predecessor,
the Minister discussed the GOE's avian influenza (AI)
efforts, offered a possible way to exempt U.S. products from
Egypt's blanket ban on poultry-related imports, and affirmed
that Egypt would have to honor its intellectual property
rights (IPR) obligations but also do everything within the
law to support Egypt's pharmaceutical industry. See para 6
for biographical information. End introduction/summary.

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Cooperation with NAMRU
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2. (SBU) Minister El Gabaly expressed strong interest in
cooperating with the USG on public health issues, including
with the Cairo-based U.S. Naval Medical Research Unit
(NAMRU-3). The Ambassador called the Minister's attention to
the GOE's AI-related ban on the importation of tissue
samples, which are essential to NAMRU's work. The Minister
provided the Ambassador with its recently drafted general
policy for bringing biological samples into Egypt. El Gabaly
said that the conditions listed in the policy were based on
the World Health Organization (WHO) and Center for Disease
Control (CDC) guidelines for transporting biological
materials across international borders and would apply to all
organizations and individuals seeking to import any
biological samples. Suggesting that he was interested in
having NAMRU-3 resume its testing program, the Minister asked
NAMRU to review these conditions and flag any that might
prevent it from doing its work. (Note: NAMRU subsequently
reviewed the policy, identified only minor concerns with it,
and expects to restart importation of tissue samples within
days. End note.) El Gabaly also requested that NAMRU-3
inform the Minister or his senior-most staff, on a
confidential basis, of positive AI test results of samples

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brought into Egypt.

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Avian Influenza
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3. (SBU) El Gabaly noted that his ministry maintained daily
contact with the WHO and would soon conduct a AI crisis
simulation. Moreover, the Minister informed his staff that
failure to report any suspected case of AI directly to his
office within 30 minutes of detection would result in the
negligent official being fired. The Minister said that the
GOE was also working closely with the Arab League to develop
a fund to compensate farmers whose poultry has to be
destroyed to prevent the spread of AI. Drawing on the
lessons of Turkey, El Gabaly said the fund would have to
compensate farmers for both live poultry and eggs to ensure
their full cooperation in AI eradication efforts. El Gabaly
said that his ministry was attempting to increase its stock
of Tamiflu to 100,000 doses by year's end, but noted that
Roche, the U.S. pharmaceutical producer, was unable to meet
Egypt's demand, let alone demand for the entire region.


4. (SBU) The Ambassador noted that the GOE's blanket ban on
imported poultry products imposed in response to AI concerns
had adversely affected U.S. firms. U.S. poultry products, he
said, were processed in ways that ensured they were safe, and
risk of contamination should not be a concern, as there have
been no AI cases in the United States. Minister El Gabaly
replied that his ministry is reviewing the egg powder issue,
but more broadly offered to exempt all U.S. products from the
ban if they were certified as safe by any internationally
recognized food-safety or health organization, including the
U.S. FDA. The Ambassador responded that such a certification
was unnecessary because WHO guidance clearly indicated which
products from which countries were safe. Moreover, he argued
that banning everything that is not explicitly approved was
exactly the outdated kind of approach that keeps Egypt
lagging behind other countries. El Gabaly insisted that he
had to take this approach because ministry staff would not
necessarily be able to act correctly on the WHO guidance, and
because he needed something concrete to defend himself
against charges of corruption or incompetence if a pandemic
broke out in Egypt.

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IPR Protection for Pharmaceuticals
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5. (SBU) The Ambassador raised the issue of IPR protection,
and specifically the ministry's December approval for a
generic copy of Ely Lilly's innovator drug Zyprexa. The
Minister was unfamiliar with the Ely Lilly case, saying that
he was just beginning to delve into pharmaceutical issues.
Noting industry complaints about the ministry's
pharmaceutical marketing approval system, El Gabaly stated
his intention to fully automate the system to make it more
efficient, transparent, and capable of protecting
confidential information submitted by applicants. He said he

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would be seeking U.S. assistance for this and other reform
efforts in the ministry. Turning to the larger IPR issue, he
noted the need to strike a balance between guaranteeing the
viability of Egypt's pharmaceutical industry and protecting
foreign investors rights. El Gabaly stated several times
that Egypt had to honor its IPR obligations, but cautioned
that he would protect only what the government was legally
obligated to protect. As for Ely Lilly, the Minister
promised to revoke the approval for the local generic copy if
Lilly wins its appeal.

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BIOGRAPHICAL NOTE
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6. (SBU) Hatem Mustafa El Gabaly was appointed Minister of
Health and Population on December 31 2005. He was born on
December 20, 1951, and attended English-language primary and
secondary schools in Alexandria and Cairo. El Gabaly
received his medical training at Cairo University (B.S.
degree in Medicine and Surgery in 1975; M.Sc. in Diagnostic
Radiology in 1979; and M.D. in Diagnostic Radiology in 1983),
and also trained in London and Paris. Dr. El Gabaly drew on
his medical background to establish a number of medical
businesses in Egypt, including a 104-branch polyclinic (the
largest in the Middle East),the largest private laboratory
in Egypt, five private medical practices/centers, and a
specialized surgical hospital in collaboration with the
Cleveland Clinic Foundation. Dr. El Gabaly is a member of
the National Democratic Party's health committee. Prior to
becoming Minister of Health and Population, he was Managing
Director and General Manager of Cairo Radiology Center,
Deputy Chairman and Managing Director of 6th of October
Hospital for Cardiac, Thoracic, Vascular and Nervous
Diseases, and Professor of Diagnostic Radiology at Cairo
University Medical School. Dr. El Gabaly speaks excellent
English. His operating style is business-like and
results-oriented, combined with an air of affability that
makes him an easy interlocutor. Like other economic reform
ministers in the Nazif cabinet, Dr. El Gabaly seems
determined to bring a private-sector sensibility to his
ministry's operations. Noting that the Ministry of Health
and Population employs some 760,000 people ("enough to
populate Benin"),he hopes to start the transformation of the
ministry by seeking USAID funding for management training for
key members of his 4,000-person staff. Dr. El Gabaly is
married and has three children.

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