HHS DEPUTY SECRETARY AZAR'S MEETING WITH MOFA ECONOMIC

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SUBJECT: HHS DEPUTY SECRETARY AZAR'S MEETING WITH MOFA ECONOMIC
BUREAU DG ISHIKAWA ON DECEMBER 6

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1. (U) Summary: On December 6, Department of Health and Human
Services Deputy Secretary Alex M. Azar II met in Tokyo with
Ambassador Kaoru Ishikawa, Director General of the Ministry of
Foreign Affairs (MOFA) Economic Affairs Bureau. They discussed a
range of global and bilateral health issues, including regional
health priorities and the U.S. beef importation issue. End summary.


Common Approaches; China as Example
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2. (SBU) Department of Health and Human Services (HHS) Deputy
Secretary Alex M. Azar II and Ambassador Kaoru Ishikawa, Director

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General of the Ministry of Foreign Affairs (MOFA) Economic Affairs
Bureau began their December 6 discussion by noting the increasing
role of health issues in foreign policy. D/S Azar thanked Ishikawa
for his instrumental role in establishing The Global Fund to Fight
AIDS, Tuberculosis, and Malaria in his prior position as Director
General of MOFA's Global Issues Division. Ishikawa noted that the
U.S and Japan share a common approach to global health issues,
focused on increasing transparency and meeting the needs of real
people with demonstrable results. As an example, Ishikawa mentioned
Japan's efforts in China's southern provinces to push for greater
transparency on outbreaks on avian influenza and other infectious
diseases. D/S Azar noted that China has lately been increasingly
cooperative and transparent on health issues. Ishikawa agreed, and
added that progress with China is best achieved through a
multilateral approach, where calls for greater transparency do not
single out one particular country, and thus enable the Chinese to
"save face".

Global Health Priorities
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3. (SBU) D/S Azar inquired about Japan's future global health
priorities and mentioned the importance of Japan's investments in
delivering health care and education in the Middle East,
particularly in Iraq and Afghanistan. Ishikawa responded that Japan
was proud of its efforts, particularly its school reconstruction
projects in Iraq, but that the GOJ is making decisions on future
contributions in a domestic environment of budget and salary cuts.
D/S Azar emphasized that Japan is a key partner in The Global Fund,
and that the U.S. Administration has a strong desire for Japan to
remain on the Global Fund Board as a leading donor country.
(Comment: Two years ago, the GOJ was embarrassed at the prospect of
losing or being forced to share its seat on the Global Fund Board.
Ishikawa hinted that further contributions to the Global Fund were
part of discussions within the government on a possible "emergency"
budget request, and that former PM Mori continued to make Japan's
leadership against infectious diseases worldwide one of his top
priorities. End comment.)

Polio Eradication; Africa Poses Particular Challenges
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4. (SBU) On polio eradication, D/S Azar added that Japan's help is
needed for a final push toward complete eradication of the disease,
particularly in countries such as Nigeria, where Muslim communities
are suspicious of vaccination programs. Ishikawa acknowledged that
health challenges in Africa are immense, but was non-committal on
future GOJ funding for polio eradication, instead mentioning
initiatives to increase Japan's diplomatic presence in Africa and
efforts by private donor groups in Japan to support Global Fund
objectives. Turning again to China for an example of Japan's
international health cooperation, Ishikawa noted Japan's successful
eight-year effort to help eradicate polio from China after the 1989
outbreak of the disease.

Beef Issue
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5. (SBU) D/S Azar thanked Ishikawa for Japan's reopening its beef
market to U.S. imports and underscored that the U.S. employs a
science-based process to ensure a safe beef supply. He mentioned
the recent Harvard risk assessment that confirmed the negligible
risk of Bovine Spongiform Encephalopathy (BSE) in U.S. beef, and
informed Ishikawa that the HHS Food and Drug Administration (FDA)
would publish by year-end 2006 a new regulation concerning the use

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of animal materials in medical products. He added that a final FDA
regulation on specified risk material in animal feed is likely in
2007, but emphasized that under U.S. law, regulation on such matters
must be evidence-based and cost-justified. D/S Azar offered to keep
MOFA and Japan's Food Safety Commission informed during this
process.


6. (SBU) Ishikawa acknowledged this, but advised a cautious
approach in advocating for full access to the Japanese beef market.
Ishikawa noted that while the scientific evidence and his own
personal tastes made him a supporter of U.S. beef in Japan, he
alluded that public opinion holds more sway on the issue than do
policymakers, stating that "Japanese housewives are more powerful
that I am." Ishikawa noted that Japan now imports most of its beef
from Australia, and that the USG and U.S. industry would be wise to
note that Australia's marketing campaign has emphasized the safety
of its beef supply, in particular its full traceability, and has
succeeded in winning over Japanese public opinion. Ishikawa went on
to note the mutual importance of agricultural trade to both
countries.


7. (U) This message has been cleared by HHS.

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