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Cablegate: Brazil: Ambassador Finds Opportunties for Public Health

VZCZCXRO4583
RR RUEHRG
DE RUEHBR #0012/01 0031933
ZNR UUUUU ZZH
R 031933Z JAN 08 VOL ZDK
FM AMEMBASSY BRASILIA
TO RUEHC/SECSTATE WASHDC 0767
INFO RUEAUSA/DEPT OF HHS WASHDC
RUEHPH/CDC ATLANTA GA
RUEHSO/AMCONSUL SAO PAULO 1406
RUEHRI/AMCONSUL RIO DE JANEIRO 5635
RUEHRG/AMCONSUL RECIFE 7554

UNCLAS SECTION 01 OF 03 BRASILIA 000012

SIPDIS

DEPT FOR WHA/BSC, WHS/EPSC
DEPT PASS TO USAID HENRIETTA FORE
PLEASE PASS TO HHS/OGA -W.STEIGER AND R.CORREA-DE-ARUAJO
PLEASE PASS TO NIH/FIC - K.BIALY

SIPDIS

E.O. 12958: N/A
TAGS: SOCI EAID KHIV BR
SUBJECT: BRAZIL: AMBASSADOR FINDS OPPORTUNTIES FOR PUBLIC HEALTH
COOPERATION IN MEETING WITH HEALTH MINISTER

REF: SAO PAULO 726

BRASILIA 00000012 001.2 OF 003


1. SUMMARY. Ambassador Clifford Sobel met with Brazilian Health
Minister Jose Gomes Temporao on December 12 to advance the public
health cooperation agenda. The Ambassador said the USG would work
with the Health Ministry, the NGO "Malaria No More," and the State
of Amazonas to develop a program to fight malaria in the Amazon; the
Minister looked forward to seeing this proposal. Further, the
Minister invited a team of U.S. and Panamanian specialists to come
to Brazil January 7-8 in order to develop a proposal on how to
incorporate the benefits of the regional training center located in
Panama in to the Health Ministry's efforts to help its Mercosul
neighbors and Portuguese-speaking Africa with training of medical
personnel. The Minister offered, and the Ambassador said he would
work to set it up, to meet with representatives of pharmaceutical
companies of the American Chamber of Commerce and the pharmaceutical
community in Sao Paulo for a dialogue, including on intellectual
property rights (IPR) issues and the Ministry's priorities for the
next four years. Finally, the Minister said he would like to invite
the new USAID Administrator to meet with him in the Amazon and
discuss the health challenges that confront Brazil today. END
SUMMARY

2. On December 12, Ambassador Clifford Sobel met with the Brazilian
Minister of Health, Jose Gomes Temporao, to advance bilateral and
trilateral (U.S.-Brazil-South) cooperation. The Minister was
accompanied by his new International Affairs Advisor, Eduardo
Botelho Barbosa. USAID Brazil Director Jennifer Adams and Counselor
for Environment, Science, Technology and Health Richard Driscoll.
The Ambassador highlighted the possibilities for new cooperation
since their meeting in July (REFTEL), the advances made with ongoing
cooperation, and pressed for greater use of the bilateral Public
Health Working Group to support the cooperation relationship.

INVITATION FOR USAID ADMINISTRATOR TO VISIT AMAZON

3. The Ambassador noted that now would be a good time for the
Ministry of Health to send a signal to Washington about its interest
in cooperating with the United States on health matters. Given the
significant public health challenges in the northern part of Brazil,
the Health Minister indicated his intent to send an invitation to
the new USAID Administrator to meet with him in the northern part of
Brazil.

MALARIA COOPERATION

4. The Minister was concerned by the serious problem with malaria
in Brazil, especially in the north. There are 600,000 cases, he
reported. He looked forward to seeing the USG, together with the
NGO "Malaria No More," supporting the Health Ministry and the State
of Amazonas to develop a cooperative program there. The Ambassador
reported that he had spoken the day before with Ray Chambers, the
founder of Malaria No More, and Chambers was very interested in his
organization becoming more active in Brazil. (Note. On the same
day that this meeting was taking place in Brasilia, representatives
of the Health Ministry, the State of Amazonas, and USAID were
meeting in Manaus to discuss the possibilities of a cooperative
program. End Note.)

5. The Minister added that he would like to see USG help with the
threat of malaria to the estimated 40,000 workers coming in to Porto
Velho, State of Rondonia, to work on construction of hydroelectric
plants in the next few years. The Ambassador informed the Minister
of the interest of the Governor of the State of Maranhao in having
assistance with malaria similar to that being discussed for the
State of Amazonas. Also, he told the Minister of his concern over
the very high rate of Hepatitis B in the north. He had heard that
while the global average was very low (something around one percent
of the population), the rate in northern Brazil very high
(reportedly about 27 percent).

PANAMA REGIONAL TRAINING CENTER

6. Following up on the successful visit in November of a delegation
from the Health Ministry to the Regional Health-Care Training Center
in Panama City, the Minister agreed to have a team from the U.S.
Department of Health and Human Services (HHS) and from the training
center come to Brazil to meet with counterparts on January 7-8. The
point of contact would be Assistant Secretary Francisco Campos, who
led the Brazilian delegation to Panama. The goal of the visit to
Brazil would be to learn about Brazil's experience with PROFAE, an
ambitious program that already has trained nearly 400,000 medical
technicians, and develop a proposal for future trilateral

BRASILIA 00000012 002.3 OF 003


cooperation. The Minister emphasized that Brazil itself did not
assistance with training.

7. The Minister saw opportunities for cooperation with the USG and
the training center. He stated that in the 2008-2011 Long-Term Plan
(called "Mais Saude" or "More Health"), which he recently released,
it calls for the Health Ministry to provide assistance especially
with the members of Mercosul and Lusophone countries in Africa. In
addition, the Long-Term Plan sets a goal of assisting these
countries with "the large scale training in the area of health . . .
drawing on Brazil's experience with [PROFAE]". The Minister
regretted that he would not be in Brasilia during this period and so
would be unable to meet with the visiting U.S.-Panamanian team.

8. Subsequent to the meeting, Dr. Rosaly Correa-de-Araujo, HHS's
Director of the Office of the Americas and spoke with Dr. Campos to
arrange for the January 7-8 visit. Dr. Campos had already heard
from the Minister about the visit and was ready to help. Dr. Nestor
Mattos, the International Affairs Director of the training center,
has agreed to participate in the visit.

9. The Minister indicated interest in the possibility of sending
Brazilian specialists to teach at the training center in Panama.

REACHING OUT TO THE PRIVATE SECTOR

10. The Minister offered to meet with representatives of the
pharmaceutical industry and others in the private sector to brief
them on the role he sees they could play in Brazil's health sector,
which would include the topic of intellectual property rights. The
Ambassador said he would work with the American Chamber of Commerce
in Sao Paulo to arrange for an invitation to speak on this subject
early in 2008. The Minister pointed out that the "Mais Saude" has a
significant component regarding working with the private sector.
For the first time there was a line item in the four-year plan for
industry. Moreover, he was pleased to announce that Novartis had
just decided to build a US$ 500 million facility in the northern
state of Pernambuco, turning down Singapore and Italy.

11. The Ambassador commented that having a dialogue with the
private sector, which included discussing intellectual property,
would be a great message and would resound well with the
pharmaceutical firms. The Minister noted he had just had a good
meeting with Merck.

12. The Ambassador mentioned that he had learned of an intellectual
property rights issues involving ANVISA (the Brazilian equivalent of
the Food and Drug Administration). The Minister suggested that the
Embassy contact the Health Ministry Secretary for Science,
Technology and Strategic Inputs, Reinaldo Felippe Nery Guimares, to
discuss the matter; the Ambassador agreed with that course of
action.

LEVEL IV LABORATORY

13. The Ambassador asked about the Health Ministry's interest in
setting up a biosafety level IV laboratory and, offered to assist
where the USG can. The Minister said they had thirteen level III
laboratories and were studying the construction and maintenance
costs associated with a level IV lab. They were familiar with the
CDC Level IV lab in Atlanta and they are planning to visit a similar
lab in London. He said they hadn't finished their analysis, though
such a laboratory would be costly to build and to maintain.

14. If they were to set up a level IV laboratory, he commented, it
would be available for other countries too. USAID Brazil Director
said this could be a real benefit to Brazil because it would help
strengthen ties between Brazilian health officials and counterparts
in the Americas.

PUBLIC HEALTH WORKING GROUP

15. In June, both sides held the first meeting of the Public Health
Working Group to address policy issues and to seek ways to improve
and expedite the regulatory review process for medical research.
The Ambassador pointed out that the cooperation had fizzled since
the initial burst of activity in June. The Minister took note of
the matter.

HEALTH ATTACHE

16. The Ambassador reported that an HHS commission selected one of
Secretary Leavitt's key staff members to become the Health Attache

SIPDIS

BRASILIA 00000012 003.2 OF 003


in Brazil. He would be the first Health Attache in the Western
Hemisphere. The Ambassador predicted the attache would arrive
shortly after completing his Portuguese language training in March.

TRILATERAL COOPERATION

17. The Ambassador stated that joint cooperation activities in
Lusophone Africa, or trilateral aid, attracted a great deal of
interest from the White House and apparently also from Brazilian
President Lula. The Minister concurred and reported that his Mais
Saude four-year plan included an emphasis on aiding
Portuguese-speaking African countries. He reported that FIOCRUZ,
the prestigious Brazilian vaccine research institute, was planning
to open an office in Mozambique.

COMMENT

18. The meeting was a useful follow on to the July meeting among
HHS Secretary Leavitt, Minister Temporao, and Ambassador Sobel,
where the areas of possible cooperation were identified. (REFTEL)
Here, the focus was on very concrete steps: what can be done with
malaria in the Amazon; looking at how to incorporate the best
aspects of the Panama regional training center into Brazil's efforts
to assist Lusophone Africa and the Mercosul countries, etc. The
aura of goodwill and cooperation extended even to areas where the
Minister and the Ambassador and their spouses could jointly work to
support breast cancer initiatives in Brazil.

SOBEL

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