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Cablegate: Ambassador Reviews Broader Health Cooperation with Vice

VZCZCXRO7791
RR RUEHHM
DE RUEHHI #1293/01 3291041
ZNR UUUUU ZZH
R 241041Z NOV 08
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 8769
INFO RUEHHM/AMCONSUL HO CHI MINH 5321
RUEHBK/AMEMBASSY BANGKOK 6528
RUEHPH/CDC ATLANTA GA
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUEAUSA/DEPT OF HHS WASHINGTON DC

UNCLAS SECTION 01 OF 02 HANOI 001293

SENSITIVE
SIPDIS

STATE FOR AMBASSADOR MARK DYBUL
STATE FOR EAP/MLS, EAP/EP, INR, OES/STC, OES/IHA, OGAC
STATE PASS TO USAID FOR ANE AND GH
HHS/OSSI/DSI PASS TO OGHA (WSTIEGER/LVALDEZ/MABDOO), FIC/NIH
(RGLASS), AND FDA (MLUMPKIN/WBATTS)
CDC FOR COGH (SBLOUNT/KMCALL)
BANGKOK FOR RDM/A (CBOWES/MACARTHUR/MBRADY)

E.O. 12958: N/A
TAGS: TBIO PREL PGOV SOCI KHIV KFLU VM
SUBJECT: AMBASSADOR REVIEWS BROADER HEALTH COOPERATION WITH VICE
MINISTER OF HEALTH

1. (SBU) Summary. Ambassador Michalak and Vice Minister of Health
Nguyen Thi Kim Tien met to discuss their vision for the future of
U.S.-Vietnam health cooperation. Tien spoke highly of her recent
trip to the United States, during which she met with professionals
from U.S. government agencies, universities, and the private sector
to discuss health care capacity building and the development of the
health sector in Vietnam. Tien acknowledged substantial obstacles
to that development, notably in human resources, infrastructure, and
regulatory reform. Ambassador Michalak noted that growing U.S.
educational initiative could boost Vietnamese capacity. Both cited
the need to increase the focus on holistic, sector-wide cooperation,
relative to disease-specific assistance. The upcoming negotiation
on a "compact" under the re-authorization of the President's Plan
for Emergency AIDS Relief (PEPFAR) represents the most probable
avenue to contribute more broadly to health systems strengthening.
Vice Minister Tien pledged to work with Ambassador Michalak and the
Embassy health team to organize more detailed discussions on the way
forward. End Summary.

2. (SBU) Vice Minister Tien, whose portfolio includes international
cooperation, research, and human resource development, expressed
pleasure with her recent trip to the United States. In addition to
meeting with Deputy Secretary of Health, Dr. Troy, she met with
staff from National Institutes of Health and the Food and Drug
Administration. She highlighted her visit to Johnson and Johnson,
Inc., during which she discussed the establishment of training
project and other collaborative work, including in the medical
device industry, in Vietnam, similar to cooperation with Russia,
China, and India. Tien also called on Johns Hopkins University,
where she attended meetings at the Hospital and School of Public
Health to discuss projects to build epidemiological capacity and
academic exchange and training.

3. (SBU) Vice Minister Tien asked for U.S. assistance to help
Vietnam develop a regulatory framework for the medical device
industry. Currently, Vietnam must import 90 percent of this
equipment. Unlike pharmaceuticals, Vietnam has yet to develop the
necessary regulatory infrastructure for medical devices and needs
help from top to bottom. Tien noted that the U.S. ASEAN Business
Council planned to host a seminar in Hanoi in January 2009 on the
medical device industry and asked that the Ambassador participate.
The Health Attache is working with agencies in the Department of
Health and Human Services (HHS) to identify possible assistance.

4. (SBU) The Vice Minister emphasized three primary obstacles to the
development of the Vietnamese health sector: 1) lack of human
resources, 2) poor infrastructure, and 3) an inadequate legal and
regulatory system. Tien listed human resource development as her
top priority, particularly in the fields of medical research and
hospital management. She also wanted Vietnam to increase the number
of private hospitals and facilities competent to conduct medical
training by international standards. Tien acknowledged that lack of
English language skills limited training opportunities for
Vietnamese health professionals and urged initiatives that could
help remedy this deficiency. The Ministry of Planning and
Information chaired the inter-Ministerial committee on human
resource development, but, as a member, MOH, primarily Tien herself,
played an important role. Ambassador Michalak noted that the
Embassy Education Task Force might be able to address some of
Vietnam's health care human resource needs, though this was a
long-term issue.

5. (SBU) The Ambassador and the Vice Minister agreed that the two
nations needed to take a more holistic view towards public health
cooperation. First, they acknowledged that preventive medicine and
public health are not the same thing. While helping Vietnam build
the former, a focused discipline, was worthwhile, it did not
substitute for overall needed development of the health sector,
grounded in a public health framework. Second, both noted that that
the United States and most other donors currently align support by
disease. In Vietnam, the United States has strong programs for
HIV/AIDS, influenza, and disabilities. Indeed, she quoted one
official on the trip to the United States as saying that U.S.
assistance remained overly focused on HIV/AIDS, instead of building
overall capacity. However, as Vietnam's health care system
develops, assistance should focus on improvements that contribute to
health systems strengthening, rather than solely focusing on
specific diseases. The two nations need to prioritize this
assistance and Ambassador Michalak and Vice Minister Tien reviewed

HANOI 00001293 002 OF 002


how to expand and improve bilateral health cooperation, building on
the bilateral 2006 Agreement on Health and Medical Science
Cooperation, with an eye to developing sustainable initiatives not
completely dependent on ongoing U.S. assistance.

6. (SBU) In light of the re-authorization of the President's Plan
for Emergency AIDS Relief (PEPFAR), the Ambassador described the
process of re-negotiation and our intention to establish a 5-year
"compact." While funding is not assured, the added emphasis on a
broader approach to human resource development and health systems
strengthening addresses GVN's more pressing needs. As the two
nations begin to discuss the nature of ongoing assistance, Tien
agreed to meet with her Minister to select a single point of contact
to coordinate Government of Vietnam (GVN) input. Though the
Ministry of Health (MOH) may take the lead, three other ministries
also play important roles: Public Security; Education and Training;
and Labor, Invalids, and Social Affairs.

7. (SBU) The Ambassador and Vice Minister exchanged information on
the ongoing development of the letter of intent (LOI) on health
between the GVN and donors. The LOI is being led by the MOH under
Tien with assistance from the World Health Organization. The
planned non-binding LOI is a "sub-statement" on health development
that follows from the Hanoi Core Statement on overall aid
effectiveness, which in turn is modeled after the Paris Declaration.
The goal of the process is to strengthen needed advocacy in health,
boost needed dialog on health systems strengthening (which,
practical terms, will assist the sustainability of our HIV and
influenza investments), and leverage better multilateral
coordination. As economic development usually trumps interest at
higher levels, Tien noted the increasing role of the 40-member
Social Affairs Committee within the National Assembly in debating
health care policy. She suggested that Ambassador Michalak meet
with that body to review ongoing cooperation and discuss plans for
the future of Vietnamese health care.

Michalak

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