Rear Admiral Burkhard Explores Initiating PACOM HIV/AIDS

UNCLAS SECTION 01 OF 03 VIENTIANE 000519 SIPDIS STATE FOR EAP/MLS (Emery) STATE FOR AIAG (Patterson, Summers) STATE FOR OGAC CDC for GAP (Birx) DOD FOR OSD-POLICY (Stern, Lai) DOD FOR DSCA HHS FOR OGHA (Steiger) PACOM FOR J52 (Miller, Lacy, Ma) PACOM FOR J45 (Schuler, Nicholls) PACOM FOR PACAF/SGZ (Cinco, Oh, Palmer) PACOM FOR POLAD JPAC FOR MUNIPALLI PHNOM PENH ALSO FOR DATT HANOI ALSO FOR DATT BANGKOK FOR CDC (FOX, MALONE) E.O. 12958: N/A TAGS: MARR MASS MOPS EAID PREL TBIO KHIV LA SUBJECT: Rear Admiral Burkhard Explores Initiating PACOM HIV/AIDS Cooperation with Laos REF: A) Vientiane 410 B) Laos Assessment Carson-Monestersky (7-22-08 notel) C) Vientiane 485 ¶1. SUMMARY: Rear Admiral (RADM) Thomas Burkhard, the Pacific Command (PACOM) Surgeon, visited Laos August 26-28 to discuss initiating U.S.-Laos military-to- military HIV/AIDS cooperation via PACOM endorsed PEPFAR (US Presidential Emergency Program for AIDS Relief) funding. Admiral Burkhard's visit was advanced by Commander Roland Fahie, PACOM's blood program officer, who met with various Lao hospitals and the Lao Red Cross to explore ways to improve the security and supply of blood in Laos. As Laos statistics show a low HIV/AIDS prevalence rate, PACOM plans a potential initial investment of $90,000. The Lao Ministry of National Defense indicated it is willing to cooperate on HIV/AIDS issues with PACOM via the Lao Ministry of Health's Center for HIV/AIDS (CHAS),following a recent pattern of cooperation that brings members of the U.S. and Lao military together under the sponsoring aegis of a sector-specific coordinating body (ref A). End Summary. ¶2. COMMENT: RADM Burkhard's trip was another step in advancing U.S.-Lao mil-mil relations, and possible HIV/AIDS cooperation had been identified during the third bilateral defense dialogue earlier in the month in Honolulu as a new area of mil-mil exchange (ref C). With an HIV/AIDS general population prevalence of 0.2%, the focus of future PACOM involvement is likely to be on education to prevent the problem from enlarging. Laos is at risk largely due to its higher prevalence neighbors. Based on initial impressions, PACOM aid will likely focus on blood-banking and "train the trainer" type activities to help spread an AIDS awareness message on military bases throughout Laos. Because the current rate of HIV/AIDS infection in the military is low - estimated at perhaps 10 soldiers (ref B) - using the military or police hospitals as antiretroviral therapy treatment centers may not be cost-effective. An additional challenge will be defining the reach and composition of a program. Hiring a local foreign service national or local physician to provide program oversight would potentially save on overhead costs, and utilizing NGO(s) with specific knowledge and prior work experience with MOD and within Laos to implement programs would likely reduce the management complexity. END COMMENT. ¶3. RADM Thomas K. Burkhard, the outgoing Pacific Command (PACOM) Surgeon (commander of medical programs for the PACOM region) visited Vientiane on August 26-28 to discuss initiating U.S.-Lao HIV/AIDS cooperation via PACOM. Admiral Burkhard was accompanied by Captain Jesse Monestersky, the Director of Public Health in the PACOM Surgeon's Office, and Commander Roland Fahie, PACOM's Joint Blood Program Officer. Captain Monestersky had visited Laos in July to assess the state of HIV/AIDS work in Laos and to evaluate the possible areas of military-to-military cooperation (Ref B). As a result of his earlier visit, the Lao military presented a draft three-year HIV/AIDS prevention and treatment plan for members of the armed forces. Commander Fahie arrived August 24 to advance the RADM's trip and to explore the possibility of expanding PACOM cooperation on blood safety, quality assurance, and supply with the Lao Red Cross and local hospitals. World Health Organization -------------- ¶4. RADM Burkhard's party met with Dr. Dong il Anh, the WHO Country Representative as well as Dr. Michale Hahn, the Country Coordinator for UNAIDS, on August 26 to discuss the prevalence of HIV/AIDS in Laos and consider ways for PACOM to work with the Lao military and VIENTIANE 00000519 002 OF 003 local hospitals responsible for HIV/AIDS. Dr. Hahn suggested a "train the trainer" model as one that could usefully deliver an HIV/AIDS awareness message widely throughout the military at reasonable expense. Ministry of Foreign Affairs -------------- ¶5. On August 27 RADM Burkhard met with Ambassador Khouanta Phalivong, the Director General at the MFA's Europe and America's department. Khouanta welcomed PACOM's assistance in HIV/AIDS, noting the U.S.-Lao relationship was entering a new phase and that the Government of Laos wanted to "open up". He called military-to-military cooperation an important area of the bilateral relationship, and said the MFA would help PACOM try to access areas of interest that remain off limits. Khouanta appeared especially interested in Commander Fahie's ability to assist the Lao National Blood Bank. RADM Burkhard spoke at length of the robust engagement PACOM has with Vietnam, and mentioned that he had visited Vietnam's military hospital 103, for which PACOM built a new blood bank. (Note: Despite repeated attempts, the Embassy has not yet succeeded in taking visitors to military hospital 103 or police hospital 109, both located in Vientiane. End note.) The Ambassador emphasized the importance of PACOM working together with the Ministry of National Defense (MND),the Ministry of Health (MOH),and the Center for HIV/AIDS (CHAS). The Admiral was also very clear in telling Ambassador Khouanta that he understood it would take time for close relationship to develop between PACOM and the Lao military. Ministry of National Defense -------------- ¶6. RADM Burkhard and the Ambassador met with Colonel Dr. Bounteun Bandavong, the Director General of the Medical Department at the Ministry of National Defense (MND) on August 27 to explore exactly what kind of program PACOM could develop in cooperation with MND dealing with HIV/AIDS. Col. Bounteun noted that MND had already received assistance from Australia's Burnet Institute and the Lao Red Cross, and said MND would be interested in cooperating with PACOM on HIV/AIDS, although all work at the moment should go via CHAS. Dr. Bounteun also noted that there is currently no treatment for HIV/AIDS at any of the military hospitals - patients receiving antiretroviral therapy (ART) do so at one of two civilian locations in Laos. ¶7. While Dr. Bounteun outlined HIV/AIDS cooperation with PACOM along familiar lines - U.S. and Lao military members meeting under the aegis of a national coordinating body - he did indicate some future flexibility. He noted that although a visit to military hospital 103 was not possible during this trip, it might happen during the next visit. He also noted that the Lao military had previously had its own blood bank, and appeared interested in possibly creating a new one. Dr. Bounteun also indicated the Lao military would be pleased to attend courses mentioned by RADM Burkhard, such as HIV/AIDS training in San Diego carried out with the Naval Medical Center and local universities. Lao Red Cross -------------- ¶8. RADM Burkhard's final meeting on August 28 was with the leadership of the local Lao Red Cross (LRC). The LRC is charged with managing the Lao National Blood Bank, which dispense blood to VIENTIANE 00000519 003 OF 003 Vientiane-area hospitals, including military hospital 103, and to the 11 provincial hospitals, which also have the ability to transfuse blood. Of the 147 districts (approximately equal to a U.S. county) in Laos, each of which has a hospital, only 12 districts generally keep blood on hand for emergency or surgical purposes. The leadership of the LRC expressed its appreciation for the opportunity to work with Commander Fahie on blood safety, quality assurance training, donor recruitment and blood fractionation and to develop greater capacity for blood component therapy. The Admiral encouraged the LRC to take advantage of Commander Fahie's expertise and indicated PACOM's intention to develop a robust blood safety relationship. ¶9. RADM Burkhard's successor is newly onboard at USPACOM, Rear Admiral Michael Anderson. He shares RADM Burkhard's high enthusiasm to work together with the Lao military medical department and Ministry of Health. RADM Burkhard cleared this cable. HUSO