HHS SECRETARY LEAVITT'S MEETING WITH THE MINISTER OF HEALTH

UNCLAS SECTION 01 OF 02 ISLAMABAD 002970 DEPT OF HHS WASHINGTON DC SENSITIVE AIDAC SIPDIS E.O. 12958: N/A TAGS: TBIO EAID PGOV PK SOCI KOCI SUBJECT: HHS SECRETARY LEAVITT'S MEETING WITH THE MINISTER OF HEALTH ¶1. (SBU) Summary: On August 19, Health and Human Services Secretary Michael Leavitt and the Minister of Health Sherry Rehman met at the Ministry of Health (MOH). The Minister and the MOH Director General identified the lack of health services and state presence in parts of Pakistan as contributing to anti-government political trends in some regions. They summarized the current government's priority areas for the health sector: improving maternal and child health and meeting the Millennium Development Goals; training health workers; upgrading infrastructure; building a regulatory framework for pharmaceuticals; and developing capacity to produce and export quality medicines and vaccines. Secretary Leavitt said that the U.S. would like to continue to work with the Minister and her staff to identify areas for exchange and assistance. End summary. ¶2. (SBU) On August 19, the Secretary of the U.S. Department of Health and Human Services (HHS) Michael Leavitt and Pakistan Minister of Health Sherry Rehman met at the Ministry of Health in Islamabad. Minister of Health Sherry Rehman (who is also the Minister of Information and Broadcasting) thanked Secretary Leavitt for responding quickly to the invitation she had extended during their recent meeting in Washington, D.C. She expressed her hope that, going forward, Pakistan would benefit from U.S. expertise and best practices in the health sector. Secretary Leavitt called his visit "health diplomacy" and stated that his purpose was to learn more about health issues in Pakistan. ¶3. (SBU) MOH Director General Dr. Rashid Jooma declared that the current government, unlike the previous one, would do more than give lip service to improving primary health care in Pakistan. He stated that the GOP plans to augment health services, especially where the state has been weak or absent in the past. Dr. Jooma and Minister Rehman ascribed the political "reorientation" of segments of Pakistan's population to the government's inadequate delivery of services in certain parts of the country. ¶4. (SBU) Dr. Jooma said that although Pakistan's resource limitations make it difficult to fill the significant gaps in the health sector, reforms are underway. The MOH's 3-fold approach to improving the health sector focuses on (1) infrastructure; (2) training; and, (3) well-designed and monitored services. The MOH plans to continue to expand the Lady Health Workers cadre (that implements a successful rural health care program); increase births in health care facilities to reduce maternal and infant mortality (which remain high in Pakistan); increase childhood vaccination rates; and increase access to safe drinking water. Pakistan would welcome assistance from the U.S. in all of these areas, Dr. Jooma added. ¶5. (SBU) The Minister and DG requested assistance from the U.S. to boost the quality and competitiveness of its fledgling pharmaceutical industry, which cannot export to the U.S. now because products do not conform to U.S. standards. The Minister stated that the GOP's drug regulatory authority will most likely be placed outside of the MOH. She requested assistance to develop an FDA-like agency, with statutory and regulatory authority that would in turn strengthen the country's pharmaceutical sector. She also would like help with pricing of pharmaceuticals, and making Pakistan eligible for participation in drug trials. ¶6. (SBU) Secretary Leavitt observed that the U.S.G is highly concerned with the safety and quality of imported products. In the face of increasing import volume, there has been a major shift in U.S. policy away from direct inspection. Instead, the U.S.G will assume the role of accreditor of independent certification bodies that will conduct inspections of production facilities. He cited discussions now underway among the U.S., Canada, Japan, Australia, the UK and others to begin harmonizing pharmaceutical standards. ¶7. (SBU) The Secretary recommended that Pakistan align itself with these global trends in order to build a pharmaceutical industry with global credibility. He and his team also stressed the importance of intellectual property rights (IPR) and data exclusivity. Leavitt said that the HHS would make production rights available to Pakistan for Hepatitis E vaccine. ¶8. (SBU) The Minister and DG also requested help in the areas of health insurance and training and retention of nurses. The Secretary noted that these are difficult issues facing the U.S. as well. He suggested that there may be areas for collaboration in setting standards for training of nurses and other health workers. ¶9. (SBU) The Minister said one of the most daunting problems facing the MOH is how to reach women in the tribal areas and parts of Balochistan. She explained that there is a "cultural resistance" ISLAMABAD 00002970 002 OF 002 that has worsened in the last 5-7 years. Even Lady Health Workers "meet with lots of opprobrium." She recounted that there have been attacks on mobile health units and on health workers. At the same time, remote communities want curative care services. ¶10. (SBU) Leavitt inquired about the use of telemedicine in Pakistan, and suggested that it could be helpful for dispersed rural populations. The DG said that there are two telemedicine hubs now operating from teaching hospitals: one in Karachi and one in Rawalpindi. ¶11. (SBU) The principals agreed to work together over the next six months to define potential areas of cooperation. ¶12. (SBU) Comment: USAID is currently providing assistance exceeding $100 million in FY08 to the health care sector in Pakistan in maternal and child health, family planning, water and sanitation, and control of infectious diseases. USAID and CDC collaborate closely on public health training and infectious diseases programs. End comment. ¶13. (U) This cable has not been cleared by Secretary Leavitt. PATTERSON