HHS SECRETARY LEAVITT'S MEETINGS AT PAKISTAN NATIONAL

UNCLAS SECTION 01 OF 02 ISLAMABAD 002971

DEPT OF HHS WASHINGTON DC

SIPDIS
AIDAC

E.O. 12958: N/A
TAGS: TBIO EAID PGOV PK SOCI KOCI
SUBJECT: HHS SECRETARY LEAVITT'S MEETINGS AT PAKISTAN NATIONAL
INSTITUTE OF HEALTH (PNIH)


1. (U) Summary: U.S. Secretary of Health and Human Services (HHS)
Michael Leavitt visited Pakistan's National Institute of Health
Institute (PNIH) on August 19, during his two-day trip to Pakistan.
At PNIH, Secretary Leavitt met with senior officials from the
Pakistani Ministry of Health (MOH) to discuss on-going and potential
HHS programs in Pakistan. He also spoke informally with fellows of
Pakistan's Field Epidemiology Laboratory Training Program (FELTP),
and toured facility reference laboratories for avian influenza at
the PNIH. End summary.

Field Epidemiology Laboratory Training Program (FELTP):


2. (U) Dr. Iftikhar Ahmed, PNIH Executive Director, and Dr. Rana
Jawad Asghar, FELTP Resident Advisor from the HHS Centers for
Disease Control and Prevention (CDC),introduced Secretary Leavitt
to the group of 19 FELTP fellows who comprise Pakistan's first two
FELTP classes. The fellows, all physicians, are working in and
represent all provinces of Pakistan, Azad Kashmir and the Federally
Administered Tribal Areas (FATA). The fellows described their work
in disease surveillance and response. Highlights included
investigating Pakistan's first human outbreak of highly pathogenic
avian influenza in Northwest Frontier Province in November 2007, and
performing polio surveillance sequencing that has tracked movements
of the virus in Balochistan and Sindh. Fellows spoke informally
with Secretary Leavitt about their individual backgrounds,
motivations for joining FELTP and aspirations for the future.
Secretary Leavitt answered questions on topics that included health
care challenges, financing and reform in the U.S. (Note:
Pakistan's FELTP program began in July 2007, under the auspices of
HHS/CDC and with funding from USAID. End note.)

Roundtable with PNIH National Program Managers


3. (U) Secretary Leavitt discussed potential interaction and support
that HHS could provide Pakistan with key MOH officials, including
Dr. Ahmed and Dr. Asghar, as well as Dr. Rashid Jooma, MOH Director
General. Principal participants from the HHS delegation included
Secretary Leavitt and William Steiger, Director, Office of Global
Health Affairs (OGHA); Mark Abdoo, Acting Director for Asia and the
Pacific at HHS/OGHA; and Dr. Altaf Lal, HHS Regional Health Attache
for South Asia, based at the U.S. Embassy in New Delhi.

Requests for Assistance with Legislation and Regulation


4. (U) In follow-up to the Secretary's morning discussion with
Minister of Health Sherry Rehman (septel),MOH director General Dr.
Rashid Jooma asked specifically if HHS could provide assistance in
writing legislation, statutes and regulations to create an
autonomous drug-regulatory authority in Pakistan. Dr. Jooma pointed
out that revised regulations are needed to guarantee safety and
quality standards, as well as intellectual property protections, for
Pakistan's pharmaceutical and vaccine industries so they can
compete, not only domestically, but also in world markets.


5. (U) Secretary Leavitt observed that the U.S. vaccine industry was
declining a few years ago, and the U.S. Government had serious
concerns at the time that the industry could not produce enough to
meet the potential domestic need during an influenza pandemic. The
Secretary pointed out, however, that U.S. industry recovered because
of a series of innovations and legal protections that stimulated new
production. He said HHS could provide technical and scientific
assistance to the Pakistani Ministry of Health as it drafts basic
statutes on drug safety to make them compatible with international
norms, and in the formulation of intellectual-property laws that
could add to the viability of investment in the vaccine and
pharmaceutical industries in Pakistan. Secretary Leavitt also
reiterated his offer to Minister Sherry Rehman to provide licensing
rights for a vaccine against Hepatitis E.


6. (U) With regard to producing vaccines, Dr. Lal noted that India
now makes 80 per cent of the world's supply of measles vaccine and
that India's hepatitis vaccine is now "cheaper than bottled water"
because of India's very low labor costs and large production
volumes. Secretary Leavitt noted that many Indian companies now use
publicly available U.S. technologies, and that many vaccine
production opportunities exist now in the public domain, provided
the industry can maintain production standards and safety
guarantees.

Highly pathogenic Avian influenza (AI)


7. (U) Dr. Jawad shifted the discussion to Avian Influenza and noted
that the lab-based AI surveillance system marked the first-ever
HHS/CDC program in Pakistan. He said the program had established
two important linkages: first, operational research through five
sentinel sites, in Islamabad and in each of Pakistan's four

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provinces; and second, developing an effective interaction between
Pakistan's Ministry of Health and the Ministry of Food and
Agricultural.


8. (U) This cable has been cleared by Secretary Leavitt's staff.



PATTERSON