HHS SECRETARY SWINGS THROUGH SOUTH INDIA

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SUBJECT: HHS SECRETARY SWINGS THROUGH SOUTH INDIA

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1. (SBU) Summary: The Honorable Michael O. Leavitt, U.S. Secretary
of Health and Human Services (HHS),visited three of South India's
largest cities from January 7-9, 2008. The visit provided the
Secretary an opportunity to promote the importance of assuring

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product safety in an increasingly complex global marketplace. The
visit also promoted HIV/AIDS awareness, discussed trafficking in
persons, and encouraged regulatory reform. The Secretary's visit
was well-received, and both regional and national press gave it
extensive coverage. End Summary.

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DAY ONE: CHENNAI
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Talking Safety with India's Health Minister
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2. (SBU) India's Union Minister of Health and Family Welfare, Dr.
Anbumani Ramadoss, accompanied Secretary Leavitt to all of the
January 7 events in Chennai, and the two held a formal meeting to
discuss cooperation on product safety. Ramadoss explained that the
Secretary's message of promoting systems and standards to assure the

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safety of exports from India to the United States was arriving at an
opportune moment, when the Health Ministry is promoting structural
changes to India's regulatory structure. Various portions of this
reform are currently wending their way through the Indian
parliament. He thanked the U.S. Government (specifically, HHS and
the Embassy's Health Attache) for the support and advice it has
provided, noting that it was extremely helpful as he tried to both
increase the capacity of India's health system and restructure his
Ministry's regulatory role.


3. (SBU) Secretary Leavitt applauded the Minister's reform efforts,
and noted that an increasingly robust global marketplace requires a
readjustment in the way all countries look at product safety.
Emphasizing that he was not just directing his message towards
India, Secretary Leavitt said the country's current efforts at
reform provided an excellent opportunity to work cooperatively with
the United States to develop tools useful not only at a bilateral
level, but also in a global context. The Secretary also proposed
that his Department and India's Health Ministry create a
Ministerial-level Working Group to develop a keener understanding of
the relevant problems and propose solutions. Ramadoss heartily
endorsed this idea, and agreed that the members of this group -- or
groups -- begin meeting within six months.


4. (SBU) Secretary Leavitt and Ramadoss also discussed avian
influenza (AI),and emphasized the importance of international
cooperation. Leavitt thanked Ramadoss for India's continuing
commitment to provide samples from human and avian cases of
influenza, and Ramadoss reiterated his intention to work with the
United States and other partners to monitor the threat posed by the
H5N1 virus.

Promoting Better Health, Fighting HIV/AIDS
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5. (U) Secretary Leavitt focused on health care and life sciences
during his day-long visit to Chennai. At the Government Hospital
for Thoracic Medicine (GHTM),one of India's premiere publicly
operated facilities for treating HIV-positive patients, the
Secretary met with staff and clients, and he learned about the

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facility's capabilities and challenges. Hospital staff showed the
Secretary a copy of the "Follow-Up Counseling Toolkit" -- a

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compilation of charts, videos, and other information newly developed
by the HHS Centers for Disease Control and Prevention for counselors
to use in advising HIV-positive patients. The Secretary also
learned more about the hospital's use of peer counselors and the
importance of providing same-day reporting of test results, an
important factor for patients who travel long distances to reach the
hospital. The Secretary also saw other hospital facilities,
including the pharmacy, laboratory, and pediatric center.


6. (U) Continuing the theme of HIV prevention, the Secretary later
spoke at Chennai's Loyola College at the public release of a new
curriculum developed with U.S. Government technical assistance. The
"Celebrating Life" publication, intended for college-age audiences,
teaches advisors and trainers skills for prevention, including how

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to maintain a healthy lifestyle, and dispel various myths about
HIV/AIDS. The Red Ribbon Club (RRC),an innovative organization for
college students supported by the Tamil Nadu State AIDS Control
Society (TNSACS) and HHS/CDC under the President's Emergency Plan
for AIDS Relief, hosted the curriculum's public launch, and became
the first organization to adopt the new curriculum. The launch
ceremony included a group of RRC students who performed an energetic
skit designed to help youngsters learn techniques for saying "no" to
various unhealthy activities, including smoking, illegal drugs,
alcohol, and promiscuous sex.

Supporting Collaboration in the Life Sciences
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7. (U) The Confederation of Indian Industry (CII) hosted a seminar
in Chennai on Indo-U.S. collaboration in the life sciences, health
sciences, and public health, an event co-sponsored with Apollo
Hospitals, India's first corporate chain of high-quality hospitals.
Secretary Leavitt emphasized the importance of scientific

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collaboration to the 400-member crowd of (mainly) medical
professionals, and noted that hundreds of Indian scientists are
engaged in collaboration and training every year with HHS. He also
spoke in favor of the Indian Government's plans to establish
regulatory institutions modeled on the HHS Food and Drug
Administration as a way of providing more efficient protection for
consumers and building regulatory partnerships between the two
countries.

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DAY TWO: HYDERABAD
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Promoting Pharmaceutical Safety
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8. (U) In a city known for the strength of its pharmaceutical
sector, on January 8, 2008, Secretary Leavitt visited two of
Hyderabad's most prominent companies, Dr. Reddy's Laboratories (DRL)
and Bharat Biotech Indian, Limited (BBIL). At DRL, Secretary
Leavitt toured the pharmaceutical production facility and learned
about the company's product portfolio, which consists largely of
generics and active pharmaceutical ingredients (API),but will soon
include biosimilars (drugs that mimic the design and effect of
branded biotech drugs). Secretary Leavitt also discussed the
company's quality-and safety-assurance programs with Dr. K. Anji
Reddy, the company's Chairman. At BBIL, which produces a wide
variety of vaccines, including an innovative rabies vaccine that it
developed in partnership with HHS/CDC, the Secretary emphasized the
importance of biotech product safety and the protection of
intellectual-property rights.

Encouraging the Chief Minister to Support Pharma Safety
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9. (SBU) Secretary Leavitt reinforced his message to the private
sector during a meeting with Andhra Pradesh's Chief Minister, the
Honorable Y. S. R. Reddy, that also included several other top State
officials. The Secretary emphasized that the quality and safety of
pharmaceutical products is critical for both Indian and American
consumers and producers. He also stressed that a science-based
regulatory environment encourages safety, while creating an
effective platform for trade that benefits India, the United States,
and other trading partners.


10. (SBU) Chief Minister Reddy noted the emphasis his Government
places on health, and noted that 82 percent of his State's
population is poor or low-income and needs government assistance to
obtain health services. He briefed the U.S. Delegation on a
recently launched insurance scheme, the Aarogyasri Health-Care
Trust, which aims to provide health insurance to those who cannot
afford it. Reddy invited U.S. and other foreign investors to
explore opportunities to invest in "super-specialty hospitals,"
especially in the State's second-tier cities.

Combating Trafficking in Persons
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10. (SBU) The Secretary met representatives of four different

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non-governmental organizations (NGOs) based in and around Hyderabad
that help combat trafficking in persons (TIP). Secretary Leavitt
thanked the representatives for their work on this issue, and
emphasized that combating TIP is an important policy of the
President and his entire Administration. The NGO representatives
told the Secretary that the problem appears to be growing, but that
it is difficult to obtain precise metrics. Traffickers are often
family members, community leaders, politicians, or even school
teachers, but linkages between traffickers are usually informal, and
not in the nature of organized crime. When asked about the Indian
Government's efforts to combat TIP, the consensus of the NGO
representatives was that the Government has improved significantly
in this area over the past few years, but that much more needs to be
done.

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DAY THREE: KERALA
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Emphasizing port security
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11. (SBU) On January 9, 2008, Secretary Leavitt visited Cochin, an
international spice-exporting hub in the State of Kerala, to promote
HHS's efforts to ensure the safety of food imported into the United
States. The Secretary inspected the port of Cochin, one of India's
12 "national ports," through which flows a substantial amount of
spices and seafood bound for the United States. The port's Chairman
told Secretary Leavitt that he is "extremely conscious" of the
importance of security, and noted that he recently chaired a
Government of India committee on port security. As Secretary
Leavitt toured the port by boat, the Chairman also explained plans
for expansion of the port in an arrangement with Dubai Ports World,
which manages the port's container facility.

Promoting Food Safety
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12. (U) Secretary Leavitt later visited two major players in
Cochin's spice industry, Synthite Industrial Chemicals and AVT
McCormick. Synthite is one of the world's leading manufacturers of
natural, spice-derived products, including spice oleoresins,
essential oils, and food colorings. AVT McCormick, half-owned by
Baltimore-based McCormick Spices, is a major producer of sterilized
spices, and exports more than forty percent of its production to the
United States. Both Synthite and AVT McCormick place a major
emphasis on traceability from the original raw material (usually
spices or peppers) to the final finished product. At both
manufacturing facilities, Secretary Leavitt saw bar codes or tags
placed on each package to identify the batch, location, and
producers of the spices used to make each product. Synthite
executives told the Secretary that their customers -- the
international flavor companies that then mix Synthite's products and
sell to major food processors -- "demand traceability" for all of
their products. AVT McCormick's executives echoed the comments the
Secretary heard from Synthite, saying "traceability is key" in the

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market.


13. (U) The companies' emphasis on food safety is not limited to
ensuring traceability. Secretary Leavitt watched AVT McCormick
employees load U.S.-bound containers with crates of spices. AVT
McCormick's General Manager told the Secretary that they load the
containers at their own facility to ensure there is no tampering.
She added that they recently began video monitoring of the loading
dock to enhance security. At both Synthite and AVT McCormick,
Secretary Leavitt inspected the companies' onsite labs to test the

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safety of products.

Striving for a new safety paradigm
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14. (U) Throughout his visit to South India, Secretary Leavitt
engaged the press to emphasize the importance of protecting both
American and Indian consumers from unsafe products. In Kerala,
Secretary Leavitt told the press that he was visiting India "because

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it is my responsibility to ensure the people of the United States
have safe and effective food, drugs, and medical products," a
message he emphasized repeatedly throughout his visit. He added

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that "the United States imports more than two trillion dollars worth
of goods every year. These goods come from 800,000 vendors to more
than 300 different ports of entry." Secretary Leavitt explained it
is no longer possible to inspect every container to stop dangerous
products from entering the United States because of the enormous
flow of goods into the country. In this "networked world," he said,
we need new strategies such as "ensuring quality is built into every
step of the production process" no matter where it occurs.

Comment
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15. (SBU) Secretary Leavitt's visit received positive coverage
throughout the duration of his trip, and his willingness to open
much of the visit to press coverage resulted in fairly accurate
reporting, which is not always a given. Government officials,
educational institutions, business organizations, and private
companies all rolled out the red carpet, and participated eagerly in
the visit. The Secretary's message of promoting safer products for
both Indians and Americans appears to resonate with a wide audience.
End Comment.


16. (U). The HHS delegation cleared this cable.

HOPPER