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 ASTANA 00000267 001.2 OF 002 ¶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." ASTANA 00000267 002.2 OF 002 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