IRAQ MINISTRY OF HEALTH INVESTMENT CONFERENCE:

UNCLAS STATE 021371

SENSITIVE
SIPDIS

E.O. 12958: N/A
TAGS: CMGT CVIS VO PA PGOV PREL SOCI ECON IZ
SUBJECT: IRAQ MINISTRY OF HEALTH INVESTMENT CONFERENCE:
STRATEGIC PLAN, VISAS AND EDUCATION PARTNERSHIPS

REF: BAGHDAD 317


1. (U) Summary: At the Iraq Health Investment Summit, held
on February 19 and 20 in Istanbul, the Minister of Health,
Dr. Salih al-Hasnawi, showcased Iraq's 2009-2013 health plan
and solicited partnerships with private companies. Potential
investors believed there were opportunities in the new
healthcare market. Despite assurances from the Minister of
Health that security in Iraq has improved and has been stable
for over a year, some investors expressed caution. The
&cumbersome8 U.S. visa process was noted by Iraqis and
American investors alike, with American investors
highlighting lost business opportunities due to long delays
before Iraqis could obtain U.S. visas. Academics and medical
professionals noted that despite years of distance in the
U.S.-Iraq healthcare relationship, partnerships and exchanges
could help rebuild this relationship and improve the average
Iraqi's outlook towards America. This is a potential area
for cooperation under the Strategic Framework Agreement.

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Iraq Health Investment Conference
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2. (U) The investment summit in Istanbul was well attended,
with approximately 100 medical company representatives
participating. The conference addressed the ministry's
strategic plan, acknowledged shortfalls, cited mechanisms
being put in place to reform some archaic systems, such as
Kimadia, the drug procurement system. The U.S.-Iraq Chamber
of Commerce addressed practical investment guidelines for
companies seeking business with Iraq. The Iraqi delegation
was comprised of the Ministry of Health's most knowledgeable
and articulate directors generals, two representatives from
Prime Minister Maliki's office, 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 of themselves and of the companies.

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Focus on Primary Healthcare and Nursing
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3. (SBU) The Ministry of Health laid out an ambitious
strategic plan covering 26 areas, many of which are aimed at
achieving U.N. Millennium Development Goals as well as
meeting international healthcare standards. The MOH
presented in great detail its plans to expand the primary
healthcare center (PHC) network as well as construct new
hospitals across Iraq. In the coming years, the MOH
infrastructure expansion plan includes construction of an
additional 1,500 PHCs (estimates of the number of existing
PHCs range from 1,200-1,900) and increasing the number of
hospital beds available for secondary and tertiary care. The
GOI has developed plans to construct seven &turn-key8
hospitals in 2009 and has already awarded more than $1.5
billion in hospital contracts to Turkish, Australian and
German companies.


4. (SBU) The Minister of Health also announced that 2009 was
the &Year of Nursing.8 Follow-up discussions with the
World Health Organization country lead indicated that the MOH
needs to better address the nursing sector to make this year
more than an empty phrase. The steps that need to be taken,
however, will not be grand in nature such as those associated
with a strategic plan for nursing, but rather actions that
increase positive publicity about nurses and the nursing
profession. The WHO has been working closely with the
Ministries of Health and Higher Education on key projects to
improve nursing education and services as well as addressing
the stigma associated with the nursing profession in Iraq.

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Security concerns
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5. (U) The improvement in security was noted several times by
Dr. Salih and members of his delegation. Despite their
reassurances, many participants remained cautious about
making any concrete commitments despite the potential of a
growing health market. Several companies already active in
Iraq's health sector, 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 partners8 to improve the
healthcare system and service delivery as they developed
business contracts.

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U.S. Visa Policy
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6. (U) While security was identified as a hindrance to doing
business in Iraq, no other issue raised more difficulties
than obtaining U.S. visas. Both American businesses
representatives and Iraqis spoke at length about the negative
impact the visa process was having on investment and
educational exchanges. One of many examples shared by Iraqi
professionals included a prominent 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.


7. (U) Embassy Baghdad Health Attache and NEA/I Desk Officer
were asked to participate in an impromptu meeting on this
issue with representatives from several American companies.
The Health Attache explained that for an Iraqi a visa
currently takes about 90-120 days to process, and advised
businesses to allow at least a four-month window for Iraqi
participation in events in the U.S. 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 Iraq8 and noted
that European countries, which issue visas to Iraqis in
approximately two weeks, were &running over8 American
businesses. The group of businesses was currently in the
process of mobilizing support from Congressional leaders to
ask the USG to reexamine Iraqi visa processes and
regulations. The business representatives contended that
improving the visa process has the potential of saving many
small American businesses, which lose business to foreign
competitors who are able to host Iraqis in their countries.

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Partnerships and Medical Exchanges
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8. (SBU) The Health Attache and NEA/I Desk Officer met with a
prominent Iraqi cardiologist, Dr. Hillal Shawiki, responsible
for overseeing a physician exchange partnership funded by the
United Kingdom's Department of Health. Dr. Shawki detailed
the process of this successful exchange program, which in two
years has trained 400 Iraqi medical professionals in the
United Kingdom at a cost of nine million dollars. This
program includes rigorous selection criteria and strong
monitoring and evaluation carried out by Dr. Shawki and a
group of volunteers from Iraq's medical and higher education
professionals. As part of the eight-week observerships,
participation includes courses on Change Management and
Clinical Observation. After nearly an hour of exchanging
information on this successful model, which can be replicated
by the United States as it seeks to carry out commitments
made in the Strategic Framework Agreement with Iraq, Dr.
Shawki shared his thoughts on the most important lesson the
United States could learn from this process. Surprisingly it
was not about how to best implement or model the program, but
rather how to &win the battle of trust8 by regaining the
&hearts and minds8 of the Iraqi educated middle class which
can influence younger generations.


9. (SBU) Comment: Participants reached consensus 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 that market. As Iraq rebuilds
its healthcare infrastructure, huge investments by the MOH
will be directed toward businesses, which can meet the needs
of this rapidly expanding system. In addition, health
diplomacy through increased medical exchanges is an effective
tool at improving attitudes towards the U.S. among educated,
middle-class Iraqis. This conference, initiated and funded
by the MOH, is reflective of an Iraqi ministry that is
seeking partners willing to advance its strategic goals,
focused mainly on primary healthcare. Complaints about visa
issuance delays mirror those Embassy Baghdad hears routinely
from Iraqi officials, educators, and business leaders at all
levels.
CLINTON