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Cablegate: (U) Sample Sharing and Vaccine Access in Vietnam

VZCZCXRO8878
RR RUEHHM
DE RUEHHI #0890/01 1351037
ZNR UUUUU ZZH
R 151037Z MAY 07 ZDK
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 5356
INFO RUEHHM/AMCONSUL HO CHI MINH 3026
RUEHGV/USMISSION GENEVA 1181
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHPH/CDC ATLANTA GA
RUEHSUN/USUN ROME IT
RUEHIN/AIT TAIPEI 1487
RUEAIIA/CIA WASHINGTON DC

UNCLAS SECTION 01 OF 02 HANOI 000890

SIPDIS

STATE FOR EAP/MLS, IO, G/AIAG AND ISN
STATE PASS TO HHS/OGHA (STIEGER, BHAT, D. BELL)
STATE PASS TO CDC (COX, MOHEN, and BLOUNT)
USDA PASS TO APHIS
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (LSTERN)
ROME FOR FAO

SENSITIVE
SIPDIS

E.O. 12958: N/A
TAGS: TBIO AORC PREL PNIR KFLU WHO OTRA VM
SUBJECT: (U) SAMPLE SHARING AND VACCINE ACCESS IN VIETNAM
(C-TNT-00406)

HANOI 00000890 001.2 OF 002


SENSITIVE BUT UNCLASSIFIED

REF: STATE 62177, 62181, and 62185 (all the same cable)

1. (U) As requested (reftel), below is the Mission's assessment of
the position of the Government of Vietnam (GVN) with regard to
sharing H5N1 avian influenza (AI) samples.

2. (SBU) The GVN supports the World Health Organization (WHO) policy
on sharing of (AI) viral samples and readily shares animal and human
material. The GVN has not evoked restrictive agreements, such as
material transfer agreements when sharing with FAO or WHO networks.
We do not think the GVN believes that countries contributing samples
of virus are entitled to more than analysis, technical assistance,
and recommendations. The GVN has not alluded to compensation
related to sample sharing.

3. (SBU) The GVN seeks to promote approaches to sample sharing that
are equitable and fair, especially with regard to getting credit as
further information and knowledge are generated from research and
development. GVN officials have suggested that Ministry of Health
(MOH) staff and scientists could be involved and consulted in
processes after samples leave the country. The GVN is considering a
position that explains the value of sample sharing to Vietnam --
beneficial reputation, stronger international cooperation and
support, capacity building for domestic vaccine manufacture, and
direct benefits to the people of Vietnam. This point seems to be
absent from international level dialogue and may be helpful in
finding a constructive way forward with less cooperative nations.
According to the International Cooperation Department of the MOH,
the GVN will not/not take a stance that allies itself with other
countries against a country with a different position, such as that
of Indonesia.

4. (SBU) Equitable access to influenza vaccines in Vietnam would
start with an analysis of sustainability and domestic production.
Based on its experience with the WHO's Expanded Program on
Immunization (EPI), the GVN recognizes the balance -- both in terms
of cost and quality -- between domestic manufacture and the
importation of vaccines. It has a tradition of long-term vaccine
planning, which aims at eventual domestic production. Human and
animal AI vaccines are primary targets for domestic production.
Substantial overseas direct assistance, including from the United
States, has supported this effort. International cooperation in
terms of technical assistance and financial support is valued in
this light. Mission does not know the GVN's view on tiered pricing
of vaccines. However, the GVN is a regional manufacturer of
vaccines (e.g., exporting some EPI vaccines to Laos and Cambodia)
and thus would be subject to both advantages and disadvantages of
tiered pricing.

5. (SBU) The GVN probably does not support regional production
facilities of commonly needed, larger volume vaccines. With the
support of a HHS-CDC cooperative agreement project to build a
sustainable human influenza (not just to detect AI, but all
influenza) national sentinel surveillance network, combining both a
syndromic and laboratory-confirmation approach, the GVN now has a
greater appreciation for the public health and advocacy value in
addressing seasonal and routine influenza in AI and pandemic
influenza prevention efforts. The GVN is not ready for large scale
purchase and importation of vaccine products for seasonal influenza
(due to costs). Human influenza vaccine commonly available in
market economies is available in Vietnam in the private sector
driven by market demand; consumption is very limited.

6. (SBU) The GVN understands the influenza vaccine production
process but does not yet have the capacity to follow it. Ownership
of Vietnam's pharmaceutical industry is mixed with both private
equity companies and government institutes and companies. There is
one company and two institutes, all government owned, producing
vaccines. There are limited examples of international
pharmaceutical industry partnerships and a moderate degree of
international academic collaboration. Substantial progress in the
research and development of human and animal AI vaccines has been
made (including two-way sample sharing through the WHO Influenza
Collaborating Center Network). The GVN's main concern about vaccine
production is cost and efficacy; the GVN has a supportive position

HANOI 00000890 002.2 OF 002


that research and development must be staged (small scale followed
by large scale in-country field evaluation). There is insufficient
drug and vaccine regulatory and oversight capacity (including in
good clinical practice and good manufacturing practice) to evaluate
new products by international standards. The MOH is working with
the U.S. Food and Drug Administration to build a sustainable
training program to address this need.

7. (SBU) The GVN established the Partnership for Avian and Human
Influenza (PAHI) on November 1, 2006, a maturation of ongoing
multilateral and bilateral collaborative efforts to combat first
SARS and then AI. The United Nations Development Programme (UNDP)
is the international lead, but works closely with WHO, Food and
Agriculture Organization (FAO), World Bank and the bilateral
development agencies to ensure the success of this medium-term
response to build capacity in the public health sector. The first
task was to broadly coordinate donor funding and technical
assistance. A PAHI secretariat will be established in a few weeks.
The Mission expects that issues pertaining to sample sharing and
vaccine access will be addressed in this forum.

MARINE

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