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Cablegate: Rear Admiral Burkhard Explores Initiating Pacom Hiv/Aids

VZCZCXRO7909
RR RUEHCHI RUEHDT RUEHHM RUEHNH
DE RUEHVN #0519/01 2660602
ZNR UUUUU ZZH
R 220602Z SEP 08
FM AMEMBASSY VIENTIANE
TO RUEHC/SECSTATE WASHDC 2220
INFO RUCNASE/ASEAN MEMBER COLLECTIVE
RUEHBK/AMEMBASSY BANGKOK 7811
RUEKJCS/SECDEF WASHINGTON DC
RUEKJCS/JOINT STAFF WASHINGTON DC
RUEKDIA/DIA WASHINGTON DC
RHHMUNA/CDR USPACOM HONOLULU HI
RHMFIUU/CDR JPAC HICKAM AFB HI
RHHMUND/COMMARFORPAC
RUEHBK/USDAO BANGKOK TH
RUEHBK/CHJUSMAGTHAI BANGKOK TH
RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHINGTON DC

UNCLAS SECTION 01 OF 03 VIENTIANE 000519

SIPDIS

STATE FOR EAP/MLS (Emery)
STATE FOR AIAG (Patterson, Summers)
STATE FOR OGAC
CDC for GAP (Birx)
DOD FOR OSD-POLICY (Stern, Lai)
DOD FOR DSCA
HHS FOR OGHA (Steiger)
PACOM FOR J52 (Miller, Lacy, Ma)
PACOM FOR J45 (Schuler, Nicholls)
PACOM FOR PACAF/SGZ (Cinco, Oh, Palmer)
PACOM FOR POLAD
JPAC FOR MUNIPALLI
PHNOM PENH ALSO FOR DATT
HANOI ALSO FOR DATT
BANGKOK FOR CDC (FOX, MALONE)

E.O. 12958: N/A
TAGS: MARR MASS MOPS EAID PREL TBIO KHIV LA
SUBJECT: Rear Admiral Burkhard Explores Initiating PACOM HIV/AIDS
Cooperation with Laos

REF: A) Vientiane 410
B) Laos Assessment Carson-Monestersky (7-22-08 notel)
C) Vientiane 485

1. SUMMARY: Rear Admiral (RADM) Thomas Burkhard, the Pacific Command
(PACOM) Surgeon, visited Laos August 26-28 to discuss initiating
U.S.-Laos military-to- military HIV/AIDS cooperation via PACOM
endorsed PEPFAR (US Presidential Emergency Program for AIDS Relief)
funding. Admiral Burkhard's visit was advanced by Commander Roland
Fahie, PACOM's blood program officer, who met with various Lao
hospitals and the Lao Red Cross to explore ways to improve the
security and supply of blood in Laos. As Laos statistics show a low
HIV/AIDS prevalence rate, PACOM plans a potential initial investment
of $90,000. The Lao Ministry of National Defense indicated it is
willing to cooperate on HIV/AIDS issues with PACOM via the Lao
Ministry of Health's Center for HIV/AIDS (CHAS), following a recent
pattern of cooperation that brings members of the U.S. and Lao
military together under the sponsoring aegis of a sector-specific
coordinating body (ref A). End Summary.

2. COMMENT: RADM Burkhard's trip was another step in advancing
U.S.-Lao mil-mil relations, and possible HIV/AIDS cooperation had
been identified during the third bilateral defense dialogue earlier
in the month in Honolulu as a new area of mil-mil exchange (ref C).
With an HIV/AIDS general population prevalence of 0.2%, the focus of
future PACOM involvement is likely to be on education to prevent the
problem from enlarging. Laos is at risk largely due to its higher
prevalence neighbors. Based on initial impressions, PACOM aid will
likely focus on blood-banking and "train the trainer" type
activities to help spread an AIDS awareness message on military
bases throughout Laos. Because the current rate of HIV/AIDS
infection in the military is low - estimated at perhaps 10 soldiers
(ref B) - using the military or police hospitals as antiretroviral
therapy treatment centers may not be cost-effective. An additional
challenge will be defining the reach and composition of a program.
Hiring a local foreign service national or local physician to
provide program oversight would potentially save on overhead costs,
and utilizing NGO(s) with specific knowledge and prior work
experience with MOD and within Laos to implement programs would
likely reduce the management complexity. END COMMENT.

3. RADM Thomas K. Burkhard, the outgoing Pacific Command (PACOM)
Surgeon (commander of medical programs for the PACOM region) visited
Vientiane on August 26-28 to discuss initiating U.S.-Lao HIV/AIDS
cooperation via PACOM. Admiral Burkhard was accompanied by Captain
Jesse Monestersky, the Director of Public Health in the PACOM
Surgeon's Office, and Commander Roland Fahie, PACOM's Joint Blood
Program Officer. Captain Monestersky had visited Laos in July to
assess the state of HIV/AIDS work in Laos and to evaluate the
possible areas of military-to-military cooperation (Ref B). As a
result of his earlier visit, the Lao military presented a draft
three-year HIV/AIDS prevention and treatment plan for members of the
armed forces. Commander Fahie arrived August 24 to advance the
RADM's trip and to explore the possibility of expanding PACOM
cooperation on blood safety, quality assurance, and supply with the
Lao Red Cross and local hospitals.

World Health Organization
-------------------------

4. RADM Burkhard's party met with Dr. Dong il Anh, the WHO Country
Representative as well as Dr. Michale Hahn, the Country Coordinator
for UNAIDS, on August 26 to discuss the prevalence of HIV/AIDS in
Laos and consider ways for PACOM to work with the Lao military and

VIENTIANE 00000519 002 OF 003


local hospitals responsible for HIV/AIDS. Dr. Hahn suggested a
"train the trainer" model as one that could usefully deliver an
HIV/AIDS awareness message widely throughout the military at
reasonable expense.

Ministry of Foreign Affairs
---------------------------

5. On August 27 RADM Burkhard met with Ambassador Khouanta
Phalivong, the Director General at the MFA's Europe and America's
department. Khouanta welcomed PACOM's assistance in HIV/AIDS,
noting the U.S.-Lao relationship was entering a new phase and that
the Government of Laos wanted to "open up". He called
military-to-military cooperation an important area of the bilateral
relationship, and said the MFA would help PACOM try to access areas
of interest that remain off limits. Khouanta appeared especially
interested in Commander Fahie's ability to assist the Lao National
Blood Bank. RADM Burkhard spoke at length of the robust engagement
PACOM has with Vietnam, and mentioned that he had visited Vietnam's
military hospital 103, for which PACOM built a new blood bank.
(Note: Despite repeated attempts, the Embassy has not yet succeeded
in taking visitors to military hospital 103 or police hospital 109,
both located in Vientiane. End note.) The Ambassador emphasized
the importance of PACOM working together with the Ministry of
National Defense (MND), the Ministry of Health (MOH), and the Center
for HIV/AIDS (CHAS). The Admiral was also very clear in telling
Ambassador Khouanta
that he understood it would take time for close relationship to
develop between PACOM and the Lao military.

Ministry of National Defense
----------------------------

6. RADM Burkhard and the Ambassador met with Colonel Dr. Bounteun
Bandavong, the Director General of the Medical Department at the
Ministry of National Defense (MND) on August 27 to explore exactly
what kind of program PACOM could develop in cooperation with MND
dealing with HIV/AIDS. Col. Bounteun noted that MND had already
received assistance from Australia's Burnet Institute and the Lao
Red Cross, and said MND would be interested in cooperating with
PACOM on HIV/AIDS, although all work at the moment should go via
CHAS. Dr. Bounteun also noted that there is currently no treatment
for HIV/AIDS at any of the military hospitals - patients receiving
antiretroviral therapy (ART) do so at one of two civilian locations
in Laos.

7. While Dr. Bounteun outlined HIV/AIDS cooperation with PACOM
along familiar lines - U.S. and Lao military members meeting under
the aegis of a national coordinating body - he did indicate some
future flexibility. He noted that although a visit to military
hospital 103 was not possible during this trip, it might happen
during the next visit. He also noted that the Lao military had
previously had its own blood bank, and appeared interested in
possibly creating a new one. Dr. Bounteun also indicated the Lao
military would be pleased to attend courses mentioned by RADM
Burkhard, such as HIV/AIDS training in San Diego carried out with
the Naval Medical Center and local universities.

Lao Red Cross
-------------

8. RADM Burkhard's final meeting on August 28 was with the
leadership of the local Lao Red Cross (LRC). The LRC is charged
with managing the Lao National Blood Bank, which dispense blood to

VIENTIANE 00000519 003 OF 003


Vientiane-area hospitals, including military hospital 103, and to
the 11 provincial hospitals, which also have the ability to
transfuse blood. Of the 147 districts (approximately equal to a
U.S. county) in Laos, each of which has a hospital, only 12
districts generally keep blood on hand for emergency or surgical
purposes. The leadership of the LRC expressed its appreciation for
the opportunity to work with Commander Fahie on blood safety,
quality assurance training, donor recruitment and blood
fractionation and to develop greater capacity for blood component
therapy. The Admiral encouraged the LRC to take advantage of
Commander Fahie's expertise and indicated PACOM's intention to
develop a robust blood safety relationship.

9. RADM Burkhard's successor is newly onboard at USPACOM, Rear
Admiral Michael Anderson. He shares RADM Burkhard's high enthusiasm
to work together with the Lao military medical department and
Ministry of Health. RADM Burkhard cleared this cable.
HUSO

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