HHS DEPUTY SECRETARY TROY VISIT TO JORDAN BOLSTERS MEDICAL

UNCLAS AMMAN 001142 SIPDIS SENSITIVE SIPDIS STATE FOR OES AND NEA/ELA STATE PASS TO USAID HHS FOR JANE COURY (HHS/OGSA) E.O. 12958: N/A TAGS: PREL TBIO ETRD KIPR JO SUBJECT: HHS DEPUTY SECRETARY TROY VISIT TO JORDAN BOLSTERS MEDICAL DIPLOMACY (U) SENSITIVE BUT UNCLASSIFIED. NOT FOR INTERNET DISTRIBUTION Ref: Amman 51 ¶1. (SBU) Summary: Health and Human Services (HHS) Deputy Secretary Tevi Troy's March 30-April 2 visit to Jordan included the high-profile groundbreaking for the King Hussein Institute for Biotechnology and Cancer (KHIBC) with King Abdullah and Queen Rania. In other meetings, Troy discussed Jordan's initiatives in improving youth health and nutrition with the Ministry of Education, and the physical fitness programs undertaken by the Royal Health Awareness Society. At the Wadi Mousa boys' school in the Petra area, Troy joined an athletic demonstration by participants in the King Abdullah Award for Physical Fitness (modeled after the U.S. President's Challenge program). HHS Food and Drug Administration (FDA) Commissioner Dr. Andrew von Eschenbach joined the Deputy Secretary in meetings with Minister of Health Salah Mawajdah, the SIPDIS Jordan Food and Drug Administration (JFDA),and representatives from the food and pharmaceutical sectors to discuss increases in medical and regulatory collaborations, the possibility of pharmaceutical clinical trials in Jordan, and bolstering trade between Jordan and the U.S. The visit garnered positive media coverage and highlighted how U.S. Government investments in scientific and technical collaborations, as well as health diplomacy, can deliver tangible benefits to both Jordanian and U.S. citizens. End Summary. KHIBC'S GOAL OF BECOMING A REGIONAL CENTER FOR CANCER HEALTHCARE -------------- ¶2. (U) Deputy Secretary Troy was invited by King Abdullah to attend the March 31 groundbreaking for the $200 million King Hussein Institute for Biotechnology and Cancer (KHIBC). The high-profile ceremony was attended by King Abdullah, Queen Rania, Prime Minister Nader al-Dahabi, and Faisal El-Fayez, Chairman of the Board of Trustees of KHIBC. Dr. Samir Khleif from the HHS/NIH National Cancer Institute (NCI) serves as the KHIBC Director-General through a July 2006 HHS agreement with the Government of Jordan. Deputy Secretary Troy and Khleif delivered remarks highlighting USG support SIPDIS to strengthen U.S.-Jordanian friendship, and how improved medical care and clinical trials at KHIBC could further establish Jordan as a leading care facility for cancer and other health innovations. ¶3. (U) The KHIBC event garnered wide coverage in newspaper and print media, including a seven-minute lead feature in the evening news on Jordanian television. The media focused on the KHIBC vision of transforming Jordan into a regional leader for cancer healthcare and biotechnology research based on the latest scientific and technological advances. Healthcare Costs Rising in Jordan -------------- ¶4. (SBU) The Deputy Secretary also met with Health Minister Mawajdah and the JFDA Director General Dr. Mohammad Rawashdeh on March 31. After thanking HHS for strong USG support, including prior NCI support for the King Hussein Cancer Center, Mawajdah shared some of the key challenges facing Jordan's healthcare system: 22 percent of Jordanians lack health insurance; the increasing percentage of GDP spent on healthcare; and the growing prevalence of chronic diseases. According to Mawajdah, the impact of Iraqi refugees on the healthcare system is not well understood, but he emphasized that the 650 healthcare centers in Jordan provide services to all patients irrespective of nationality. Jordan is also increasing its revenues through medical tourism, estimated by Mawajdeh at roughly $1 billion annually, with the majority of foreign patients coming from Yemen, Sudan, Algeria, Syria, and the Gulf countries. Other U.S. participants included FDA Commissioner von Eschenbach, FDA Deputy Commissioner Murray Lumpkin, and the Ambassador. Exploring Cooperation in Drug and Food Safety -------------- - ¶6. (U) Deputy Secretary Troy hosted a working breakfast March 31 with Health Minister Mawajdah, JFDA Director General Rawashdeh and other JFDA officials, Royal Court Economic Advisor Maher Matalka, Chairman and Secretary General of the Jordan Association of Pharmaceutical Manufacturers (JAPM),the Regional Representative of the Pharmaceutical Manufacturers of America (PhRMA),the Chairman of the American Chamber of Commerce, the CEO of Jordan Exporters Association, and other private sector representatives from the pharmaceutical and food manufacturing sectors. ¶7. (SBU) Mawajdah noted the strong cooperation between U.S. FDA and JFDA, which is critical to U.S.-Jordan trade in the food and pharmaceutical sectors, and Jordan's desire to benefit from the U.S. FDA experiences through even closer ties. Matalka suggested that such cooperation be formalized through a memorandum of understanding. Commissioner von Eschenbach praised the progress achieved by JFDA, and indicated that the FDA was interested in exploring areas of further cooperation to continue promoting Jordan as a leader within the Middle East. ¶8. (SBU) Rawashdeh noted that through JFDA's transparent and efficient approval process, drugs can sometimes be registered in Jordan within 4-6 months of HHS/FDA approval. Given that the JFDA is highly respected in the region, he said that once drugs are registered in Jordan, it becomes easier to register them in other Middle Eastern countries. The PhRMA representative agreed, saying that JFDA should become a model for the region. Mawajdah noted that Jordan had proposed the idea of using JFDA as an umbrella regulatory organization for countries in the Middle East region, but it was met with a lukewarm reception given the complexities associated with each country's by-laws. He proposed that Jordan and its neighbors might consider harmonizing their regulations as an initial step. ¶9. (U) Regarding trade, Mr. Raja Khouri, Chairman of the American Chamber of Commerce, and JAPM described the Jordanian pharmaceutical industry as a rising star, with 2007 exports worldwide totaling $432 million and expected to rise to $1 billion by 2011. NOTE: Jordanian pharmaceutical exports to the U.S. rose 40 percent to $3.96 million in 2007, but still only represented 2 percent of total exports to the U.S. END NOTE. In order to further increase pharmaceutical exports to the U.S., JAPM requested technical assistance from the HHS/FDA for local generic producers to better understand the HHS/FDA registration process and good clinical practices. HHS/FDA agreed to explore the possibility of conducting such a workshop. JAPM also inquired about the possibility of HHS/FDA conducting pre-inspections of local pharmaceutical companies before submitting a new drug application, which HHS/FDA responded was not normally done. Deputy Commissioner Lumpkin clarified some confusion amongst the participants regarding the difference between U.S. requirements for registration versus approval. He offered future assistance on clarifying U.S. standards and processes. ¶10. (U) Local food manufacturers present noted the difficulty of exporting food containing meat products to the U.S., and indicated a lack of progress after a February 2005 visit from USDA's Food Safety Inspection Service which detailed the necessary upgrades and regulatory improvements that would be needed to export to the U.S. (reftel). JFDA and the Ministry of Agriculture noted that work has been ongoing to amend the food safety law. When asked for assistance with getting HHS/FDA approval, the FDA Commissioner clarified that it does not provide approval for food imports, but the agency could help ensure better understanding of U.S. standards and processes. The role of USDA in food safety was also highlighted. Promoting Children's Health -------------- ¶11. (U) In a meeting with Dr. Fawwaz Jaradat, Secretary General of the Ministry of Education (MOE),and Enaam Barrishi, Executive Director of the Royal Health Awareness Society, the Deputy Secretary discussed Jordan's initiatives in improving child and adolescent health through the physical fitness programs undertaken by the Royal Health Awareness Society. The MOE also has 310,000 public school students from kindergarten through sixth grade participating in nutrition programs. Students receive fortified biscuits, fruits, and dates. The MOE is also increasing its school hygiene program. Physical Fitness at Wadi Mousa Boys School -------------- ¶12. (U) Deputy Secretary Troy visited the Wadi Mousa boys' schools in Petra April 1, accompanied by Samer Al-Kasih, Project Manager for the King Abdullah II Award for Physical Fitness. The Deputy Secretary joined an athletics demonstration by school children SIPDIS participating in the King Abdullah Award for Physical Fitness (modeled after the U.S. President's Challenge program). The program has garnered impressive growth from the 19,000 participating students in its 2006 inception to over 172,000 participating students in 2008. NOTE: In January 2008, 10 students from Jordanian schools visited the U.S. to understand U.S. physical fitness programs. END NOTE. Media coverage for this event was overwhelmingly positive, highlighting the importance of the physical education exchange programs with several pictures of Deputy Secretary Troy doing push-ups along with the students. SIPDIS ¶13. (U) HHS reviewed and cleared this message. 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