JAPANESE CONCERNS ON IPAPI AND REGIONAL STOCKPILES

UNCLAS SECTION 01 OF 03 TOKYO 004369 SIPDIS DEPT FOR AIAG AMBASSADOR LANGE DEPT FOR G DEPT FOR OES/IHA SINGER AND FENDRICK DEPT FOR EAP/J HHS PASS TO CDC AND NIH HHS FOR A/S AGWUNOBI HHS FOR OGHA STEIGER, BHAT AND ELVANDER DEPT PASS TO AID/GH/HIDN DENNIS CARROLL SIPDIS SENSITIVE E.O. 12958: N/A TAGS: TBIO KFLU KSTH ECON PREL SOCI JA SUBJECT: JAPANESE CONCERNS ON IPAPI AND REGIONAL STOCKPILES OF ANTIVIRAL DRUGS REF: A. TOKYO 4368 ¶B. 05 TOKYO 4012 ¶C. TOKYO 1613 TOKYO 00004369 001.2 OF 003 ¶1. (U) This cable contains sensitive but unclassified information and is intended for internal USG use only. ¶2. (SBU) Summary. Japanese officials are concerned about management issues surrounding the International Partnership on Avian and Pandemic Influenza (IPAPI) and see the need for setting a clear strategy on the Partnership's future development. IPAPI needs leadership and its meetings should cover substantive issues. Tokyo is asking for the United States' strong leadership in this respect. The Japanese would also like to see communication between the United States, Japan and other core members improved. The Partnership needs to urgently address how to implement committed monies, as only a small part of the Beijing funds have been used to date. ¶3. (SBU) Most of the guidelines for the deployment of Japan's ASEAN stockpile of antiviral drugs have been established. Japan is not planning to allocate a specific amount of Tamiflu to individual countries prior to a pandemic. Japanese officials are not clear why it is necessary to remain silent on the physical location of the U.S. strategic stockpile in Asia, but they agreed to keep the details close hold. The more "sensitive" issue for Tokyo is to make clear which countries will be eligible to receive drugs from the stockpile. End summary. ¶4. (U) On July 25, Department of Health and Human Services (HHS) Assistant Secretary for Health John Agwunobi met with Ministry of Foreign Affairs (MOFA) Global Issues Department Director-General Takahiro Shinyo and others to discuss bilateral coordination on avian influenza preparedness efforts and other regional health issues. HHS International Affairs Officer Erika Elvander and ESToff also attended the meetings. ¶5. (U) Dr. Agwunobi began the meeting by thanking Japan for its leadership in polio eradication efforts. He urged strong continued cooperation in the future. Agwunobi also thanked Tokyo for its work on HIV/AIDS and said that the United States stands firmly behind Japan's position on the Board of the Global Fund to Fight AIDS, Tuberculosis and Malaria. A/S Aqwunobi reiterated U.S. appreciation of Japanese support for Afghanistan and Iraq health and humanitarian efforts. He noted his intention to visit the International Medical Center of Japan and the National Institute of Infectious Diseases, two of Japan's premier institutions. Finally, he noted MHLW Minister Kawasaki's letter to Secretary Leavitt that he would personally deliver. Director-General Shinyo responded that Japan-U.S. cooperation on global health issues has been very fruitful to date. He explained that Japan previously announced it would donate USD 500 million for AIDS related projects and an additional USD five billion to fight other infectious diseases over a five-year period (see ref B). The GOJ wants these efforts to be complemented and is now asking Japanese private companies to become more involved in the fight against AIDS. ¶6. (SBU) Turning to the topic of avian influenza and the International Partnership on Avian and Pandemic Influenza (IPAPI),Shinyo noted that Japan was an original member of the core group when IPAPI was announced at the UN in September 2005. He expressed concern about the nature of the leadership of the Partnership and that the Partnership is evolving into a much larger worldwide organization than perhaps was originally intended. He explained that there are differences of opinion on how to manage IPAPI. Shinyo TOKYO 00004369 002.2 OF 003 said that convening IPAPI related meetings every six months was useful, but that it was important to set a clear strategy on how to move the Partnership forward. IPAPI needs leadership and the discussions at the conferences need to be more substantive. He asked for the United States to take strong leadership in this respect. In addition, Shinyo said that communication between the United States, Japan and other original members must be improved and maintained. Tokyo is concerned that the U.S. and EU are making bilateral deals and then presenting the results to the remaining partners as a "take it or leave it" option. Shinyo mentioned that he has discussed this briefly with Under Secretary for Global Affairs Paula Dobriansky. ¶7. (SBU) The Partnership needs to urgently address how to implement committed monies, as only a small part of the Beijing funds have been used to date. Shinyo argued that it was important to speed this process up. Coordination between the Partners and the World Bank is necessary. In addition, closer information sharing between the members of IPAPI is needed -- Shinyo argued that the Partnership should not just be a fund raising effort. The Southeast Asia experience with containment should be shared with other regions. Because IPAPI meetings are growing to include a very large number of participants, there is a limited exchange of detailed information during the conferences. To help solve this problem, Shinyo suggested that it would be useful to hold regular experts' meetings or breakout sessions to cover issues in depth. ¶8. (SBU) The discussion then turned to the ASEAN stockpile. DG Shinyo said that most of the guidelines for deployment and usage have been established. He asked how the U.S. plans to use its strategic stockpile in relation to others around the globe. For Japan, Tokyo's stockpile donation will be considered as the "local" stockpile and will be used first. Next, the WHO stockpile will be used and finally Japan would turn to the U.S. one. Dr. Agwunobi explained the U.S. concept and underscored that it would be important to have a strategy that would work in any situation. Shinyo said that some of the ASEAN members are seeking a pre-allocation of Tamiflu, but Japan does not feel this would be useful. A portion of the personal protective equipment (PPE),however, may be allocated in advance to individual countries. Agwunobi responded that it is important to coordinate Japan's PPE stockpile with what USAID is planning and mobilizing. In addition, the A/S stressed that it was necessary to start conducting exercises on the movement of the stockpiles to help identify weaknesses in the system prior to an actual pandemic. ¶9. (SBU) Concerning the public release of information on the U.S. stockpile's physical location, Agwunobi underscored that it is Washington's preference to keep that information close hold. Shinyo responded that Japan has approached it from the perspective of the U.S.-Japan security relationship, and that he did not really see why it was necessary to "hide" the stockpile. He did not feel that divulging the actual location was a sensitive issue. (Note: Global Issues Department Deputy Director Kyoko Hokugo later admitted that Japan was not eager to disclose the actual location due to the bilateral security pact. Shinyo also agreed to keep the location quiet.) The DG argued that a more sensitive issue for Tokyo was to make clear which countries will be eligible to receive drugs from the U.S. stockpile -- will they be solely for the use of ASEAN members or will they be available to China and other countries that may request it. Tokyo has specified in its agreement that Japan's stockpile is for ASEAN members. Japan, however, would also consider making the TOKYO 00004369 003.2 OF 003 antiviral drugs available to neighboring countries, if an avian influenza outbreak there would present the threat of impacting ASEAN member states. ¶10. (SBU) Shinyo next raised communication as an important part of pandemic preparations. Japan is one of only a few countries that have donated funds to UNICEF's risk communications program (see ref C). The DG argued that it was important to have others assist UNICEF and the WHO in those efforts in order to reach as much of the public as possible. Agwunobi agreed that it was necessary to quickly start using a central body to disseminate information in local languages at the community level. Agwunobi noted the human cases in Indonesia as an example of the importance of strong cross agency, multilateral and bilateral strategies for communication. He offered to link the appropriate MOFA officials with Bill Hall, in the office of the Assistant Secretary for Public Affairs at HHS. SIPDIS ¶11. (SBU) Shinyo concluded the meeting by stressing the importance of human security as it relates to infectious diseases and natural disasters. The fight against infectious diseases is central to Japan's strategy of human security. He expressed appreciation for the USG's understanding of the concept. Shinyo said that while some have criticized Japan's concept as being "too broad", there are many concrete examples such as the work being done on AI pandemic preparedness to validate the approach. Agwunobi concluded that Japan was developing a "brand" around the world that embodied "benevolence" and used the examples of Japan's assistance during the tsunami and to Iraq and Afghanistan. He thanked the DG for Japan's close cooperation with the United States on a broad range of global health issues. ¶12. (SBU) Comment. The meeting between Shinyo and Agwunobi was followed by dinner. It was clear from the conversation that the GOJ considers WPRO Director General Shigeru Omi's nomination for Director-General of the WHO as a key political goal and is hoping that the U.S.-Japan bilateral relationship will be used in support of achieving this goal. End comment. ¶13. (U) Note: Taiwan was also discussed during the meeting. A report will follow septel. ¶14. (U) HHS's Office of Global Health Affairs cleared this cable. SCHIEFFER