BRAZIL: AMBASSADOR FINDS OPPORTUNTIES FOR PUBLIC HEALTH

UNCLAS SECTION 01 OF 03 BRASILIA 000012 SIPDIS DEPT FOR WHA/BSC, WHS/EPSC DEPT PASS TO USAID HENRIETTA FORE PLEASE PASS TO HHS/OGA -W.STEIGER AND R.CORREA-DE-ARUAJO PLEASE PASS TO NIH/FIC - K.BIALY SIPDIS E.O. 12958: N/A TAGS: SOCI EAID KHIV BR SUBJECT: BRAZIL: AMBASSADOR FINDS OPPORTUNTIES FOR PUBLIC HEALTH COOPERATION IN MEETING WITH HEALTH MINISTER REF: SAO PAULO 726 BRASILIA 00000012 001.2 OF 003 ¶1. SUMMARY. Ambassador Clifford Sobel met with Brazilian Health Minister Jose Gomes Temporao on December 12 to advance the public health cooperation agenda. The Ambassador said the USG would work with the Health Ministry, the NGO "Malaria No More," and the State of Amazonas to develop a program to fight malaria in the Amazon; the Minister looked forward to seeing this proposal. Further, the Minister invited a team of U.S. and Panamanian specialists to come to Brazil January 7-8 in order to develop a proposal on how to incorporate the benefits of the regional training center located in Panama in to the Health Ministry's efforts to help its Mercosul neighbors and Portuguese-speaking Africa with training of medical personnel. The Minister offered, and the Ambassador said he would work to set it up, to meet with representatives of pharmaceutical companies of the American Chamber of Commerce and the pharmaceutical community in Sao Paulo for a dialogue, including on intellectual property rights (IPR) issues and the Ministry's priorities for the next four years. Finally, the Minister said he would like to invite the new USAID Administrator to meet with him in the Amazon and discuss the health challenges that confront Brazil today. END SUMMARY ¶2. On December 12, Ambassador Clifford Sobel met with the Brazilian Minister of Health, Jose Gomes Temporao, to advance bilateral and trilateral (U.S.-Brazil-South) cooperation. The Minister was accompanied by his new International Affairs Advisor, Eduardo Botelho Barbosa. USAID Brazil Director Jennifer Adams and Counselor for Environment, Science, Technology and Health Richard Driscoll. The Ambassador highlighted the possibilities for new cooperation since their meeting in July (REFTEL),the advances made with ongoing cooperation, and pressed for greater use of the bilateral Public Health Working Group to support the cooperation relationship. INVITATION FOR USAID ADMINISTRATOR TO VISIT AMAZON ¶3. The Ambassador noted that now would be a good time for the Ministry of Health to send a signal to Washington about its interest in cooperating with the United States on health matters. Given the significant public health challenges in the northern part of Brazil, the Health Minister indicated his intent to send an invitation to the new USAID Administrator to meet with him in the northern part of Brazil. MALARIA COOPERATION ¶4. The Minister was concerned by the serious problem with malaria in Brazil, especially in the north. There are 600,000 cases, he reported. He looked forward to seeing the USG, together with the NGO "Malaria No More," supporting the Health Ministry and the State of Amazonas to develop a cooperative program there. The Ambassador reported that he had spoken the day before with Ray Chambers, the founder of Malaria No More, and Chambers was very interested in his organization becoming more active in Brazil. (Note. On the same day that this meeting was taking place in Brasilia, representatives of the Health Ministry, the State of Amazonas, and USAID were meeting in Manaus to discuss the possibilities of a cooperative program. End Note.) ¶5. The Minister added that he would like to see USG help with the threat of malaria to the estimated 40,000 workers coming in to Porto Velho, State of Rondonia, to work on construction of hydroelectric plants in the next few years. The Ambassador informed the Minister of the interest of the Governor of the State of Maranhao in having assistance with malaria similar to that being discussed for the State of Amazonas. Also, he told the Minister of his concern over the very high rate of Hepatitis B in the north. He had heard that while the global average was very low (something around one percent of the population),the rate in northern Brazil very high (reportedly about 27 percent). PANAMA REGIONAL TRAINING CENTER ¶6. Following up on the successful visit in November of a delegation from the Health Ministry to the Regional Health-Care Training Center in Panama City, the Minister agreed to have a team from the U.S. Department of Health and Human Services (HHS) and from the training center come to Brazil to meet with counterparts on January 7-8. The point of contact would be Assistant Secretary Francisco Campos, who led the Brazilian delegation to Panama. The goal of the visit to Brazil would be to learn about Brazil's experience with PROFAE, an ambitious program that already has trained nearly 400,000 medical technicians, and develop a proposal for future trilateral BRASILIA 00000012 002.3 OF 003 cooperation. The Minister emphasized that Brazil itself did not assistance with training. ¶7. The Minister saw opportunities for cooperation with the USG and the training center. He stated that in the 2008-2011 Long-Term Plan (called "Mais Saude" or "More Health"),which he recently released, it calls for the Health Ministry to provide assistance especially with the members of Mercosul and Lusophone countries in Africa. In addition, the Long-Term Plan sets a goal of assisting these countries with "the large scale training in the area of health . . . drawing on Brazil's experience with [PROFAE]". The Minister regretted that he would not be in Brasilia during this period and so would be unable to meet with the visiting U.S.-Panamanian team. ¶8. Subsequent to the meeting, Dr. Rosaly Correa-de-Araujo, HHS's Director of the Office of the Americas and spoke with Dr. Campos to arrange for the January 7-8 visit. Dr. Campos had already heard from the Minister about the visit and was ready to help. Dr. Nestor Mattos, the International Affairs Director of the training center, has agreed to participate in the visit. ¶9. The Minister indicated interest in the possibility of sending Brazilian specialists to teach at the training center in Panama. REACHING OUT TO THE PRIVATE SECTOR ¶10. The Minister offered to meet with representatives of the pharmaceutical industry and others in the private sector to brief them on the role he sees they could play in Brazil's health sector, which would include the topic of intellectual property rights. The Ambassador said he would work with the American Chamber of Commerce in Sao Paulo to arrange for an invitation to speak on this subject early in 2008. The Minister pointed out that the "Mais Saude" has a significant component regarding working with the private sector. For the first time there was a line item in the four-year plan for industry. Moreover, he was pleased to announce that Novartis had just decided to build a US$ 500 million facility in the northern state of Pernambuco, turning down Singapore and Italy. ¶11. The Ambassador commented that having a dialogue with the private sector, which included discussing intellectual property, would be a great message and would resound well with the pharmaceutical firms. The Minister noted he had just had a good meeting with Merck. ¶12. The Ambassador mentioned that he had learned of an intellectual property rights issues involving ANVISA (the Brazilian equivalent of the Food and Drug Administration). The Minister suggested that the Embassy contact the Health Ministry Secretary for Science, Technology and Strategic Inputs, Reinaldo Felippe Nery Guimares, to discuss the matter; the Ambassador agreed with that course of action. LEVEL IV LABORATORY ¶13. The Ambassador asked about the Health Ministry's interest in setting up a biosafety level IV laboratory and, offered to assist where the USG can. The Minister said they had thirteen level III laboratories and were studying the construction and maintenance costs associated with a level IV lab. They were familiar with the CDC Level IV lab in Atlanta and they are planning to visit a similar lab in London. He said they hadn't finished their analysis, though such a laboratory would be costly to build and to maintain. ¶14. If they were to set up a level IV laboratory, he commented, it would be available for other countries too. USAID Brazil Director said this could be a real benefit to Brazil because it would help strengthen ties between Brazilian health officials and counterparts in the Americas. PUBLIC HEALTH WORKING GROUP ¶15. In June, both sides held the first meeting of the Public Health Working Group to address policy issues and to seek ways to improve and expedite the regulatory review process for medical research. The Ambassador pointed out that the cooperation had fizzled since the initial burst of activity in June. The Minister took note of the matter. HEALTH ATTACHE ¶16. The Ambassador reported that an HHS commission selected one of Secretary Leavitt's key staff members to become the Health Attache SIPDIS BRASILIA 00000012 003.2 OF 003 in Brazil. He would be the first Health Attache in the Western Hemisphere. The Ambassador predicted the attache would arrive shortly after completing his Portuguese language training in March. TRILATERAL COOPERATION ¶17. The Ambassador stated that joint cooperation activities in Lusophone Africa, or trilateral aid, attracted a great deal of interest from the White House and apparently also from Brazilian President Lula. The Minister concurred and reported that his Mais Saude four-year plan included an emphasis on aiding Portuguese-speaking African countries. He reported that FIOCRUZ, the prestigious Brazilian vaccine research institute, was planning to open an office in Mozambique. COMMENT ¶18. The meeting was a useful follow on to the July meeting among HHS Secretary Leavitt, Minister Temporao, and Ambassador Sobel, where the areas of possible cooperation were identified. (REFTEL) Here, the focus was on very concrete steps: what can be done with malaria in the Amazon; looking at how to incorporate the best aspects of the Panama regional training center into Brazil's efforts to assist Lusophone Africa and the Mercosul countries, etc. The aura of goodwill and cooperation extended even to areas where the Minister and the Ambassador and their spouses could jointly work to support breast cancer initiatives in Brazil. SOBEL