AMBASSADOR'S INTRODUCTORY MEETING WITH MINISTER OF

C O N F I D E N T I A L VILNIUS 000615 SIPDIS E.O. 12958: DECL: 11/18/2019 TAGS: PGOV KFLU SOCI TBIO LH SUBJECT: AMBASSADOR'S INTRODUCTORY MEETING WITH MINISTER OF HEALTH CAPLIKAS Classified By: Ambassador Anne E. Derse for reasons 1.4 (b) and (d). ¶1. (C) SUMMARY: During her initial meeting with Minister of Health Algis Caplikas, Ambassador Derse heard that the budget crisis was forcing the ministry to speed up its reforms in the health-care sector, that the GOL believes it is prepared for the worsening flu pandemic, and that the ministry will decide within two months whether it can take advantage of a program that offers lower drug prices to fight tuberculosis. The Minister, who also is a member of the Seimas (parliament),said at the moment everything is taking a back seat to the effort to pass the 2010 budget. End summary. ¶2. (U) Ambassador Derse on November 16 paid her first call on Minister of Health Algis Caplikas, who is a member of the Seimas from the Liberal and Center Union party and in an earlier government served as Minister of Construction and Urban Development and as Minister of Environment. Caplikas told the Ambassador that the biggest issues facing his ministry were health-care reform, budgetary constraints and pandemic flu. Health-care reform -------------- ¶3. (C) Caplikas said Lithuania had too wide a hospital network, with too many doctors and too many beds. "Such a huge network is patient friendly, but we'd have to have two times the budget we have" to operate it, he said. Because of the GOL's current fiscal crisis, he said, budget cuts are forcing the ministry to implement reforms more quickly than it would like to. Neighboring countries have already implemented such reforms and can provide models for Lithuania he said, particularly in areas such as controlling public procurement and safeguarding public money. Reforms will also lead to better patient care in some areas, such as allowing for more effective and efficient use of expensive medical equipment that is currently underutilized, the Minister said. Savings on tuberculosis drugs -------------- ¶4. (C) The Ambassador told the Minister that she was concerned that the GOL has yet to take advantage of the Green Light Program of the World Health Organization (WHO),which allows member countries to purchase reduced-cost medicines to fight multi-drug-resistant tuberculosis (MDR-TB). Lithuania has one of the world's highest MDR-TB rates, and became a Green Light member with significant USG assistance earlier this decade. The Ambassador pointed out that the GOL could save significant amounts of money in these difficult times simply by utilizing a program it already has access to. Caplikas said Lithuanian law made it "difficult or sometimes impossible" for the government to buy drugs from a centralized source rather than holding a public tender. The Ambassador reminded the Minister that WHO had expressed willingness to participate in such tenders, but had received no response from the GOL. Caplikas said, "What I can promise is more clarity in terms of the Green Light program. In the next two months, we will have clarity in how to go forward with the program or to end our involvement in the program. But the savings are obvious, and I think it will be possible. We'll try to find the way forward." Pandemic flu -------------- ¶5. (C) The Minister told the Ambassador that the number of people infected with flu or similar respiratory illnesses "has increased dramatically" in recent days, and that 10 municipalities were at epidemic levels of more than 100 cases per 10,000 inhabitants. Because there is no doubt that an epidemic exists, he said, the GOL has stopped routine testing for H1N1 virus. There have been no reported flu-related deaths so far this year, he said. (NOTE: Two days after the meeting, Lithuanian media reported the country's first flu death: a 14-year-old boy in Kaunas without any reported underlying health conditions. Embassy intends to provide more information septel. End note.) Caplikas said he was concerned that parents were starting to panic and keeping their children home from school without reason, which only made it seem as if more children were sick and alarmed even more parents. ¶6. (C) Caplikas said that GOL officials were in constant contact with WHO and European health officials to exchange information and track flu trends. He also said Lithuania was doing well compared to neighboring countries in terms of the financial resources dedicated to fighting the flu. He said Lithuania has stockpiled antiviral drugs and hoped to purchase H1N1 vaccine by the end of the year to protect medical workers and people in high-risk groups. (NOTE: After leaving the Minister's office, the Ambassador had a chance hallway meeting with Audrius Sceponavicius, director of the Public Health Department and the ministry's point person on flu issues. He told her that the GOL had acquired 120,000 courses of Tamiflu and Relenza, and hoped to buy 20,000 doses of the H1N1 vaccine from other countries in December. End note.) ¶7. (C) Ministry officials also told the Ambassador that Sweden, as holder of the EU Presidency, would host a meeting of all countries in the Schengen visa zone in early December to discuss the flu pandemic and hear reports on the situation in each country. Lithuania will participate in that meeting, as well as in a December 1 meeting in Brussels at which health ministers of EU countries will discuss pandemic flu. Budget trumps all -------------- ¶8. (C) Caplikas, who appeared tired and distracted during the meeting, said he looked forward to speaking with the Ambassador more fully in the future, but that at present all of his time and attention were taken by the need for the GOL to get a 2010 budget passed by the Seimas. DERSE