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"

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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