IRAQ HEALTH INVESTMENT SUMMIT HIGHLIGHTS PROGRESS,

UNCLAS BAGHDAD 000605


E.O. 12958: N/A
TAGS: AORC ECIN BEXP CVIS IZ ECON PGOV PREL
SUBJECT: IRAQ HEALTH INVESTMENT SUMMIT HIGHLIGHTS PROGRESS,
CHALLENGES

REF: Baghdad 317


1. SUMMARY. The Iraq Health Investment Summit, held on February
19-20 in Istanbul, Turkey, was a key opportunity for the Minister of
Health (MOH),Dr. Salih al-Hasnawi, to showcase Iraq's 2009-2013
strategic health plan and to solicit partnerships with private
companies for Iraq's healthcare system. Potential investors said
they believed there were opportunities to be tapped in this new
healthcare market. Despite repeated assurances from the Minister of
Health that security in Iraq has improved and has been stable for
over a year, the optimism was tempered by concerns over the
fragility of the security situation and weak MOH infrastructure
capacity. Iraqi and American investors complained about the
"cumbersome" U.S. visa process hampering business opportunities in
Iraq. Academics and medical professionals expressed optimism that
after years of difficulty in the US-Iraq healthcare relationship,
partnerships and exchanges with the influential medical cadre can
help rebuild Iraqis' confidence in America. END SUMMARY.

FIRST EVER IRAQ HEALTH INVESTMENT
CONFERENCE A SUCCESS
--------------

2. The MOH hosted over 100 medical company representatives and the
World Health Organization to its February 19-20 Iraq Health
Investment Summit in Istanbul. The conference outlined the
ministry's strategic plan for 2009-2013 and acknowledged shortfalls
and mechanisms being put in place to reform some archaic systems,
such as Kimadia, the state-owned and operated medical
equipment/pharmaceutical procurement and distribution organization
for the MOH. The U.S.-Iraq Chamber of Commerce also provided
practical investment guidelines to companies looking to do business
in Iraq. The GOI delegation was comprised of the Minister of Health
and his most knowledgeable and articulate Director Generals, as well
as two of the Prime Minister's representatives, a member of the
Council of Representatives Health and Environment Committee, and
leaders in Iraqi medicine and education. Members of the Iraqi
delegation challenged each other during the general sessions, asking
tough questions, including discussion on decision making processes
and the length of time to turn contracts around.

PRIORITIES FOCUS ON PRIMARY HEALTHCARE AND NURSING
-------------- --------------

3. The MOH presented an ambitious strategic plan covering 26 areas,
many aimed at achieving the Millennium Development Goals as well as
international standards of improved healthcare. The MOH presented
in great detail its construction plans to expand the primary
healthcare center (PHC) network as well as the construction of new
hospitals across Iraq. In the coming years, the MOH infrastructure
expansion plan includes construction of an additional 1,500 PHCs
(estimates for existing PHCs range from 1,200-1,900 depending on how
clinics and satellites are defined) and increasing the number of
hospital beds available for secondary and tertiary care. The GOI
has developed plans to construct seven "turn-key" hospitals in 2009
and has already awarded over $1.5 billion in hospital contracts to
Turkish, Australian and German companies. The Minister of Health
also announced that 2009 was the "Year of Nursing." Follow-up
discussions with the World Health Organization (WHO) country lead
indicated that further commitment from the MOH was needed in
addressing the nursing sector. The MOH will focus on actions to
garner positive publicity about nurses and the nursing profession to
combat years of neglect and lack of training. The WHO has already
Qcombat years of neglect and lack of training. The WHO has already
been working closely with the Ministries of Health and Higher
Education on key projects aimed at improving education of and
services provided by nurses and addressing the stigma associated
with the nursing profession.

SECURITY AND MOH CAPACITY A LINGERING CONCERN
--------------

4. The improvement in security was noted several times throughout
the conference, both by Dr. Salih and members of his delegation.
Despite repeated reassurances, conference participants remained
cautious about making any concrete commitments despite the potential
of a growing health market. Several company representatives already
active in Iraq's health sector, with some employing hundreds of
individuals across the country, noted to other potential investors
that the security situation had improved, yet reforms in MOH
procurement and contracting were still needed. Dr. Salih urged
companies to "become partners" with Iraq to improve the healthcare
system and service delivery as they developed business contracts.

AMERICAN BUSINESSES AND IRAQIS CALL FOR
REVISED U.S. VISA POLICY
--------------

5. While security was identified as a hindrance to doing business
in Iraq, no other issue was raised more vehemently than the
difficulty in obtaining U.S. visas. Both American businesses and
Iraqis spoke at length about the negative impact the cumbersome visa
process was having on investment and educational exchanges. One
Iraqi complained of a rising cardiologist having to turn down a
fully-sponsored invitation to the American Cardiologist Association
meeting in Florida because he was invited with less than a four
month window.


6. The Health Attach explained the visa process and encouraged
attendees to plan their travel to the U.S. well in advance. While
the group appreciated the various checks built into the visa
processing system, they were "sad to see that U.S. policies are
preventing U.S. businesses from investing in Iraq" and noted that
European countries, which issue visas to Iraqis in approximately two
weeks, were "running over" American businesses. A group of
conference participants are currently in the process of mobilizing
support from Congressional leaders to ask the Department to
reexamine Iraqi visa regulations. The business representatives
contended that improving the visa process has the potential of
saving many small American businesses, which lose from foreign
competitors who are able to host Iraqis in their countries.

WAY AHEAD THROUGH U.S.-IRAQI PARTNERSHIPS
--------------

7. The Health Attach and NEA/I Desk Officer met with a prominent
Iraqi cardiologist who has been responsible for overseeing a
physician exchange partnership funded by the United Kingdom's
Department of Health. Dr. Hillal Shawki shared in great detail the
implementation process of this successful exchange program, which in
two years has trained 400 Iraqi medical professionals in the United
Kingdom for $9 million. This program includes rigorous selection
criteria and a strong monitoring and evaluation component carried
out by Dr. Shawki and a group of volunteers from Iraq's medical and
higher education professional cadre. As part of the eight week
observerships, participation includes courses on Change Management
and Clinical Observation. Dr. Shawki believed this successful UK
model could be replicated by the U.S. as a joint commitment under
the Strategic Framework Agreement. Dr. Shawki encouraged the U.S.
to implement programs that would help "win the battle of trust" by
regaining the "hearts and minds" of the educated middle class which
can influence younger generations.


8. COMMENT. Despite security concerns, conference participants
agreed that Iraq provides an excellent medical business market worth
several hundred million dollars each year, and this is a critical
time for businesses to enter the market. As Iraq rebuilds its
healthcare infrastructure, the MOH will need to make significant
investments in businesses and systems to meet its public health
needs. In addition, health diplomacy through increased medical
exchanges will become an effective tool at "winning the heart and
minds" of the educated middle-class Iraqis. This conference,
initiated and funded by the MOH, is reflective of an Iraqi Ministry
actively seeking willing partners to advance its strategic goals.
In recent months, we have increasingly registered louder
frustrations by Iraqis and American investors on the visa process in
this and other fora; this will continue to be a thorny issue as Iraq
opens up for business throughout all its sectors, and travel to the
U.S. becomes a key component of bilateral exchanges. As Iraq's
health sector continues to develop its investments and reforms, we
will remain engaged in our programs and foreign assistance in
healthcare programs with a focus on maintaining stability and
further improving service delivery. END COMMENT.

BUTENIS