KAZAKHSTAN: NEW MINISTER OF HEALTH PLEDGES CONTINUED

UNCLAS SECTION 01 OF 02 ASTANA 000267

SENSITIVE
SIPDIS

STATE FOR SCA/CEN, EUR/ACE, F
STATE PLEASE PASS TO USAID

E.O. 12958: N/A
TAGS: PGOV PREL EAID EINV SOCI KNNP KZ
SUBJECT: KAZAKHSTAN: NEW MINISTER OF HEALTH PLEDGES CONTINUED
PARTNERSHIP WITH UNITED STATES

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1. (U) Sensitive but unclassified. Not for public Internet.


2. (SBU) SUMMARY: On February 12, the Ambassador met for the first
time with new Minister of Health Zhaksylyk Doskaliyev, and further
reinforced the strong partnership that exists between the United
States and Kazakhstan in the area of health-care reform. Minister
Doskaliyev praised the achievements of the past, particularly the
training programs for primary care and family health practitioners,
and looked forward to formalizing our bilateral partnership in
health-care reform through a Memorandum of Understanding (MOU)
between the Ministry and USAID. The Minister invited the
contributions of U.S. technical experts in the development of the
Ministry's new multi-year health strategy, as well as assistance in
the implementation of grant funds from the Global Fund to Fight
AIDS, TB, and Malaria. He welcomed further U.S. assistance provided
through the Cooperative Threat Reduction program to establish a
Central Reference Laboratory and expand the Electronic Integrated
Disease Surveillance System. The Minister also provided some advice
that he believed would facilitate General Electric's plans to
further market its high-tech medical equipment in Kazakhstan. END
SUMMARY.

NEW DOSKALIYEV LIKE THE OLD DOSKALIYEV, OR NOT?


3. (SBU) The Ambassador met with Minister of Health Zhaksylyk
Doskaliyev on February 12 to discuss several ongoing initiatives of
the U.S. government in health care reform. The Minister, although
just recently appointed to his post in November, is hardly a
newcomer. He previously served in the same position 2000-2004. He
recently served as the Rector of the Kazakh State Medical Academy in
Astana (2004-07),and as a member of Parliament (2007-08). During
his first tenure as Health Minister, he was viewed as one rather set
in his ways and not particularly forward thinking. Shortly after he
took office in 2001, in fact, the Government of Kazakhstan cancelled
a loan from the World Bank on health-care restructuring. He was
viewed as unsupportive of programs that promoted primary health
care, and that utilized international technical assistance and
training programs.


4. (SBU) However, based on his statements during his meeting with
the Ambassador, Minister Doskaliyev is much more amenable to
international technical assistance the second time around. He had
high praise for USAID assistance, particularly training programs for
family doctors in primary health care. He also welcomed each
initiative that the Ambassador proposed on strengthening the
partnership of the Ministry of Health with U.S. government
assistance programs. Moreover, Minister Doskaliyev welcomed a
recent agreement with the World Bank on a comprehensive health-care
loan and assistance program.

MINISTER SUPPORTS MOU WITH USAID


5. (SBU) The Ambassador stressed the need to continue the
collaborative relationship in the future, particularly through a
Memorandum of Understanding (MOU) between USAID and the Ministry
formalizing the bilateral partnership in the area of health care
reform. He offered U.S. technical assistance on the development of
Kazakhstan's new health strategy, and with the implementation of
grant funds received by Kazakhstan from the Global Fund to Fight
AIDS, TB, and Malaria. The Ambassador proposed the support and
assistance of the U.S. Centers for Disease Control and Prevention
(CDC) and the U.S. Defense Threat Reduction Agency (DTRA) in the
development of a long-term plan for the proposed Central Reference
Library and U.S.-funded zonal diagnostics laboratories, as well as
in adapting Kazakhstan's Electronic Integrated Disease Surveillance
System to cover all reportable diseases.


6. (SBU) The Minister endorsed formalizing the partnership between
the Ministry and USAID with an MOU. He stated that, "USAID can
submit its draft MOU at any time, and I am sure we will sign it."

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He suggested the organization of a public event for the signing of
the agreement to better recognize the ongoing partnership in
health-care reform between the two countries. (NOTE: USAID health
officers are working on a draft of this MOU, which we expect to
submit to the Ministry by the end of February. END NOTE.)

WE LIKE TECHNICAL ASSISTANCE NOW


7. (SBU) Minister Doskaliyev also welcomed USAID's contributions and
technical assistance on the Ministry's new long-term strategy on
health care, and invited USAID specialists to an event taking place
later that same day. He further stated that, "the opinions of U.S.
experts are very important to Kazakhstan," and he welcomed their
recommendations. He also approved of any additional technical
assistance USAID might be able to provide on programs implemented in
Kazakhstan with grants received from the Global Fund to Fight AIDS,
TB, and Malaria. (NOTE: To date, Kazakhstan has received two
HIV/AIDS grants that total $57 Million, as well as two TB grants
that total $75 Million. END NOTE.)


8. (SBU) Concerning the Cooperative Threat Reduction program's four
completed zonal diagnostic laboratories and the planned Central
Reference Laboratory, the Minister stated that these laboratories
are badly needed given the challenges facing the country, including
emerging health threats such as avian influenza and non-typical
pneumonia. The Minister then meandered through a confusing,
pseudoscientific discussion about border-crossing rivers, the water
temperature at which cholera is active (at this point vigorously
prompting a bewildered staff member to nod confirmation to his guess
of 12 degrees centigrade),and the underestimated insidiousness of
camel pox and how it is dealt with in Kazakhstan, finally making the
point that Kazakhstan is a transit zone for many exotic diseases
that have to be studied together with international partners in a
collaborative setting. He concluded that he saw the Central
Reference Laboratory as the perfect solution.

GE -- WE BRING GOOD THINGS TO KAZAKHSTAN


9. (SBU) Minister Doskaliyev viewed General Electric's (GE) interest
in expanding its sales of high-tech medical equipment in Kazakhstan
very positively. He advised that, "to intensify cooperation
(between the Government of Kazakhstan and GE),the company needs to
open a factory in Kazakhstan to produce medical equipment so that GE
can conquer the market. Kazakhstan would invest in such a project
also, and this fits with the President's plan of 100 hospitals." He
further stressed that Kazakhstan will have 300 medical laboratories
that will need modern high-tech medical equipment. He said that
with a total population of 55 million in Central Asia, the potential
market for GE stretches beyond Kazakhstan. Now is the "golden time"
for investment in Kazakhstan, so "let's get started."


10. (SBU) COMMENT: Minister of Health Doskaliyev, at least at this
early stage of his second time around in this post, seems much more
disposed towards international assistance in health-care reform. He
supported each initiative the Ambassador raised, and expressed his
appreciation for past assistance and pledged continued cooperation.
While it may be too soon to reopen discussions with the Ministry on
opportunities for cost-sharing arrangements between the Government
of Kazakhstan and U.S. foreign assistance agencies (similar to
Kazakhstan's agreement with USAID on the Program for Economic
Development),such opportunities should be explored again in the
future. END COMMENT.

HOAGLAND