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Cablegate: Joint Research On Health/Environmental Effects Of

This record is a partial extract of the original cable. The full text of the original cable is not available.

UNCLAS SECTION 01 OF 08 HANOI 000923

SIPDIS

SENSITIVE BUT UNCLASSIFIED

DEPT FOR EAP/BCLTV (EDUNLAP), OES/STC (BPERRY),
STAS (GATKINSON), EAP/RSP, EAP/PD, AND OES/PCI
DEPT PASS HHS FOR OGHA/STEIGER; NIH/FIC/GKEUSCH;
NIH/NIEHS/KOLDEN, ASASSAMAN; CDC/OGH/BLOUNT;
CDC/CEH/SINKS, BARRETT, NEEDHAM; FDA/OIA/WBATTS
DEPT PASS USAID FOR G/ENV, G/H
DEPT PASS EPA FOR ORD/WFARLAND
DEPT PASS OSTP FOR WGAINES
BANGKOK FOR REO
SECDEF ALSO FOR ISA/AP/LSTERN AND ES/WVAN HOUTEN
USDA FOR FAA/AO/SSAP/HEUTE, ITP/ODA/SHEIKH
NSC FOR BEARDSWORTH

E.O. 12958: N/A
TAGS: SENV PREL TBIO VM
SUBJECT: JOINT RESEARCH ON HEALTH/ENVIRONMENTAL EFFECTS OF
AGENT ORANGE/DIOXIN - UPDATED STATUS REPORT

SENSITIVE BUT UNCLASSIFIED - PLEASE PROTECT ACCORDINGLY

REF: USDAO U-066-04, dated 01 March 2004

1. (U) This is an action cable. Embassy recommends that
the USG Agent Orange/Dioxin Interagency Working Group meet
to review and discuss the contents of this cable.

2. (SBU) SUMMARY: More than two years after the March 2002
signing of a Memorandum of Understanding (MOU) to address
joint research on health, environmental and ecological
effects of dioxin and Agent Orange in Vietnam, U.S. and
Vietnamese researchers have made some tangible progress in
the one environmental research project being conducted at a
dioxin "hot spot" in Da Nang Airbase. The only progress in
health research, however, has been to budge the Vietnamese
bureaucracy to review, but not yet approve, the one small
pilot case control study to evaluate some birth defects.
Highlights of activities and events over the past 12 months
include the following.

--Environment: Since October 2001, the U.S.
Environmental Protection Agency (USEPA) and the Vietnam
Academy of Science and Technology (VAST) (formerly, the
National Center for Natural Sciences and Technology - NCST)
have been engaged in a collaborative program. The program
is designed to characterize the nature of dioxin
contamination in soil and to select remediation methods
suitable to the task as well as to GVN budget constraints
and the target 2,3,7,8-tetrachlorodibenzo-p-dioxin (2,3,7,8-
TCDD) concentrations in soil established by the GVN. To
date, the collaboration is moving forward with the
installation of the Gas Chromatograph/Mass Spectrometer
(GC/MS) at VAST planned for spring 2004 and development of
the site characterization plan for the dioxin "hot spot" in
Da Nang.

--Health: In January 2003, NIEHS approved funding for
the State University of New York at Albany (Albany
University) in collaboration with Vietnam's Ministry of
Health (MOH) to conduct a small pilot case control study to
evaluate some birth defects with respect to maternal and
paternal serum 2,3,7,8-TCDD concentrations. As of March
2004, the research proposal had undergone "expert" review by
the MOH, but had not yet reached Vietnam's National Steering
Committee 33, the interagency entity that controls/approves
all activities related to Agent Orange. Post expects a long
delay in receiving the approval from Committee 33. In fact,
we would not be surprised if the Vietnamese make substantive
changes to the proposal that will be unacceptable to NIEHS.
In January 2004, NIEHS conveyed to MOH and to Minister of
Natural Resources and Environment Mai Ai Truc, who serves as
Chairman of Committee 33, that NIEHS may not be able to hold
the funds targeted for this project much longer. The
funding, approximately USD 3,000,000, has been set aside but
not released to the vendors. (COMMENT: In March 2003,
Embassy's assessment was that the GVN would attempt to
control, disrupt, or block any research project that could
potentially produce scientific evidence that refuted the
GVN's allegations of broad, catastrophic damage to the
health of Vietnamese citizens, especially birth defects.
One year later, this assessment has not been proven wrong.
Committee 33's response/comments on the health research
project will provide valuable insights into Vietnamese
attitudes and intentions. END COMMENT.)

-- Lawsuit and Intensified Media Campaign: In
conjunction with a lawsuit filed in a New York City court in
January 2004 by the newly created "Vietnam Association for
Agent Orange Victims" (VAAOV), the state-run media has been
running a series of reports about Agent Orange "victims" and
showing pictures of children and adults with obvious mental
and physical disabilities attributing the disabilities to
Agent Orange. These and other articles directly state or
imply that the USG should provide "compensation" or "take
responsibility" for actions taken during the war, including
supporting disabled children deemed victims of the war. The
media also now is reporting on an online petition sponsored
by the Britain-Vietnam Friendship Association calling upon
the U.S. President, government and responsible chemical
companies to compensate Vietnamese victims of Agent Orange.
(COMMENT: The GVN continuously publicly calls upon for the
U.S. to provide support for alleged Agent Orange victims,
which it identifies without the backing of scientific
evidence. These scientifically disingenuous comments may
make it difficult for the GVN to support results of studies
which may show these repeated statements false, the GVN's
health system seriously flawed, and its use of the disabled
for propaganda cynical. END COMMENT.)

--Ministry of Defense (MOD) Proposal to U.S. DOD:
Reftel describes Vietnam MOD's proposal for U.S. DOD
cooperation to "clean up and decontaminate toxins" -
AO/dioxin and CS - used during the Vietnam War. Embassy
recommends that, if DOD decides to offer any assistance with
AO/dioxin "hot spots," this assistance should be coordinated
with USEPA and NIEHS and be focused on supplementing the
ongoing program at the Da Nang site. MOD has been a
participant in that activity, and must continue to
participate since the site is located on military property.
MOD's proposal for cooperation on disposal of CS is not
within the scope of ongoing programs related to AO/Dioxin
and should be considered as a separate issue. END SUMMARY

3. (U) Provided below is a detailed review of the status
of the joint research initiatives and programs conducted by
USEPA and NIEHS with Vietnamese counterparts, as well as
opinions/attitudes expressed by key Vietnamese players.

--------------------------------------------- --------------
U.S.-Vietnam Scientific Workshop on Methodologies of Dioxin
Screening, Remediation and Site Characterization
--------------------------------------------- --------------

4. (U) From November 3-5, 2003, a workshop titled "U.S.-
Vietnam Scientific Workshop on Methodologies of Dioxin
Screening, Remediation and Site Characterization" was held
in Hanoi. The meeting was sponsored by the VAST (formerly
(NCST) and NIEHS, USEPA, University of California at Davis
(UC-Davis), Department of Civil and Environmental
Engineering, Michigan State University (MSU), Office of
International Studies and Programs, Michigan State
University and the Ford Foundation. Its purpose was to
focus on three avenues of research: (1) development of
bioanalytical and analytical methods to detect and/or
estimate the relative biological and toxicological potency
of samples containing dioxins and related chemicals; (2)
examination of remediation methods to degrade and/or
detoxify soil containing dioxins and related chemicals; (3)
characterization of sites contaminated with dioxins and
related chemicals; (4) and, development of safety and health
guidelines to protect individuals working at contaminated
sites. Attendance was limited to U.S. and VN participants
and invited guests. Participants from VN included
individuals from VAST, Hanoi National University, Ministry
of Defense (MOD), Ministry of Health (MOH), Office 33,
Vietnam Veterans Association, and Ministry of Science and
Technology. Participants from the U.S. included individuals
from USG agencies, universities and private industry.
5. (U) During the workshop participants described analytic
methods suitable for detection or measurement of dioxin in
soil or other media including immunoassays, cell-based
assays and chemical methods. These methods may be used for
screening for the presence of dioxin, measuring dioxin
concentration in environmental and biologic media, and
assessing conger-specific profiles. All may be applied to
characterize the concentration and location of soil
contamination. Remediation approaches appropriate to
reducing the concentration of contaminants include thermal,
chemical, or biological degradation or containment and may
involve one or a combination of methods. The Government of
Vietnam expressed more interest in remediation methods that
are less costly and somewhat less effective versus methods
known to more completely clean up. They are also willing to
apply less well tested/studied methods, e.g., biodegradation
and isolation (less well studied and thought to be less
costly) versus incineration (which has been determined to be
effective and well-studied).

6. (U) The workshop recommendations noted that to identify
the location(s) and concentration of dioxin in soil of the
contaminated sites, the Vietnamese scientific and laboratory
infrastructure must be augmented. The necessary
improvements include acquisition of appropriate instruments,
identification of suitable and cost effective analytical
methods and training in these methods. In addition, some
needs could be met by using existing programs that train
individuals at the graduate level, e.g., U.S. AID programs
and the Fogarty International Center. Development of an
academic consortium to aid in this process was thought to be
instrumental in this process. Recommended members of the
consortium include UC-Davis, MSU, VAST, Institute of
Biotechnology, universities and other organizations based in
Vietnam. This group would be structured to collaborate on
research projects, the results of which would be published
as joint publications in the international peer reviewed
literature.

7. (U) Noteworthy recommendations and comments relevant to
analytic methods and site characterization included the
following. USEPA would provide guidance on geostatistics
and the selection and purchase of publicly available
software for site characterization. USEPA would also assist
VAST in the development of the experimental design for
logical bench/pilot testing. Development of a good
bioassay, validated by well known analytic methods, is
critical to be able to analyze larger numbers of samples at
lower cost. Selection of remediation technologies should
take into account both cost and effectiveness and that
multiple treatment regimens could be utilized to obtain the
desired treatment effect. The types of treatment technology
may differ based on the concentration and dispersal of
contamination, e.g., concentrated (localized) contamination
versus dispersed contamination. An international conference
to describe and discuss the array of the most appropriate
remediation technologies is necessary for the planning
process. The areas targeted for remediation are Da Nang
airport, Bien Hoa Airport and Phu Cat. USEPA and others
would provide to Vietnamese partners occupational safety and
health technology and information from publicly available
websites, e.g., NIOSH, OSHA, ILO, WHO, and others; evaluate
the possibility of translating suitable information and
training materials into Vietnamese; and develop training and
evaluation programs for researchers and site workers. This
will require working with partners in Vietnam - these
individuals have not yet been identified. Share existing
technology for protecting workers employed to clean up
contaminated waste sites.

8. (U) The remediation cleanup standard accepted by GVN is
1000 ppt (parts per trillion) for non-agricultural use
(military or industrial) and is 100 ppt for agricultural or
residential use. The GVN has agreed that the targeted goal
for "cleanup" for Da Nang is 1000 ppt, 2378-TCDD, and that
the target for completion of the clean up/remediation of Da
Nang is 2005.

--------------------------------------------- ----------
USEPA Collaboration with Vietnam Academy of Science and
Technology (VAST)
--------------------------------------------- -----------

9. (U) Since October 2001, the USEPA has collaborated with
VAST to transfer analytical technologies and training and to
build laboratory capacity at VAST. These activities
included assistance in the selection of appropriate
analytical techniques to detect concentration of dioxin in
soil, provision of training to VAST scientists in Hawaii on
the selected analytic techniques, and the transfer of a
functioning high resolution GC/MS from the United States,
glassware and reagents to Vietnam at no cost to VAST or the
Government of Vietnam.

10. (U) In a follow-up meeting on November 7, 2003, with
Dr. Dang Vu Minh, President of the Vietnam Academy of
Science and Technology, Dr. William Farland, Acting Deputy
Assistant Administrator for Science, Office of Research and
Development, USEPA, described the status of the USEPA-VAST
collaboration. He reported that USEPA is installing the
CALUX Assay at VAST and that USEPA is providing VAST
capacity (financial support) to purchase 1500 CALUX tests
over the next 2 years and the necessary training and
consultations. USEPA is purchasing a license for the CALUX
Assay. The CALUX assay is a short-term test that can
identify the presence of 2,3,7,8-TCDD in soil. Once
obtained, the license will be transferred to VAST. There is
precedence for a U.S. agency to award such a contract for
the benefit of another country. The license will also
include training of Vietnamese scientists on the CALUX and
expert consultation for two years. Although the USEPA will
provide 2 years of support and sufficient capacity to
analyze 1500 soil samples with CALUX, they will not act as
mediator once the license is obtained for VAST. In January
2004, USEPA awarded the contract for the installation and
calibration of the GCMS. If all goes according to plan, the
GCMS should be operational by the middle of April 2004.

11. (U) USEPA is also working with VAST to design the site
characterization plan for sampling at the Da Nang Airport
site. The following activities are to be completed prior to
finalization of the plan: complete analysis and preparation
of the report on ten soil samples for dioxin levels analyzed
in Vietnam and U.S.; develop Da Nang Site Characterization
Plan; obtain site Access and permission to sample; obtain
site Map with GPS coordinates; develop sampling design and
sampling grid; develop plans for sampling and analysis
(phased design), quality assurance/quality control, health
and safety program (heat, chemical, UXO hazards); develop
plans for sample preparation/archiving, sample analysis,
data analysis, evaluation and interpretation of results.
Currently, the tasks listed above are being developed but
have not been completed or vetted by all collaborating
parties. The next steps in the process include:
identification of mechanisms for further training/experience
with analytical techniques; transfer of CALUX Assay
capability including further training and sampling capacity
and training of VAST staff on the GC/MS.

12. (U) Discussions about how and where to take samples at
the Da Nang site identified the following issues: USEPA
volunteered to identify and provide new GIS software to map
the contaminated site and to accurately position sampling
locations. Surface sampling and sampling of streams flowing
from the site was more important than deep sampling because,
although dioxin contamination may be as deep as one meter,
streams move contaminated surface soil from the site to
other areas, including lakes. Deep contamination is less
likely to be disturbed. Before any samples can be taken at
any site it is necessary to obtain permission from the MOD.
Dr. Minh indicated that he would help smooth the way. We do
not know if this has happened. USEPA and NIEHS
representatives suggest that Vietnam consider preserving a
part of the contaminated area as a "natural resource". This
area would not be part of the remediated area, but would be
used to pilot test new remediation methods as they are
developed.

13. (U) A number of reputable laboratories have developed
validated techniques for analysis of dioxins and related
chemicals contained in a variety of media, e.g, soil, serum,
tissue, plant material. Dr. Minh said VAST will focus first
on gaining expertise for techniques for the analysis of
dioxin in soil, food or other media where dioxin
concentrations are moderate. He indicated that analysis of
medium containing low concentration of dioxins, such as in
human serum, is difficult to conduct and takes considerable
experience. In addition, prior to analyzing the
concentration of dioxins, it must be abstracted from the
medium. Currently, VAST does not have the facilities to
extract dioxin from soil and need to have more extensive
extraction process for analysis by GCMS. Dr. Farland
indicated that USEPA might be able to bring someone to
Vietnam from the USEPA who is knowledgeable in extraction
methods to train the Vietnamese scientists in the
methodology. Dr. Minh also noted that he wants VAST to
build capacity at the remediation site, e.g., Da Nang that
is to establish a mobile testing lab. The CALUX assay has
been validated under field conditions, and, thus can be
performed at the site.

14. (U) In 2002, VAST and USEPA scientists took soil
samples from the Da Nang site to begin the characterization
process and to begin training VAST scientists on the short-
term assays, e.g., CALUX and immunobioassays. Split samples
were shipped to the U.S. and analyzed by GCMS for a number
of analytes including dioxins and furans. The USEPA
produced a complete report. VAST was supposed to have the
split samples kept by the Vietnamese analyzed at an
independent laboratory; however, this was not accomplished
due to the lack of funding.
15. (U) VAST and USEPA set a tentative date for the
inauguration of the HRGC/MS and site characterization at the
Da Nang airport for the first week in April 2004. This may
not happen in this time frame for several reasons. The
installation and calibration of the HRGC/MS was delayed due
the refusal of the installation contractor to travel to
Vietnam due to the Avian Influenza outbreak and the need for
extra paperwork to import a pump oil.

--------------------------------------------- ------------
Request from Committee 33 for Report of Past and Proposed
Activities of USEPA and VAST
--------------------------------------------- ------------

16. (SBU) On March 4, 2004, Dr. Ha informed Embassy Health
Attache, that Minister Truc requested an accounting of all
work that had been accomplished on Project 2, the site
characterization and remediation methods development
project, and what was planned, including the amount spent on
the project and the amount planned to be spent. Scientists
from the USEPA are preparing the U.S. report based on
detailed project meeting reports. VAST scientists also
explained that the funding information from the U.S. would
permit the GVN to provide similar funding to VAST. The date
for completion of the report is open. However, it appears
that Committee 33 might not permit the Da Nang project to
move forward until this document is received.

--------------------------------------------- ---------
Activities related to NIEHS-funded Birth Defects Study
--------------------------------------------- ---------

17. (SBU) On November 8, 2003, Dr. Anne Sassaman, Director,
Extramural Grant Program, NIEHS, and Embassy Health Attache,
and Embassy EST Officer met with Minister Truc, Minister of
Natural Resources and the Environment and Chairperson of
Committee 33. Dr. Sassaman requested the meeting because of
the very long delays in the GVN review of the proposal and
the resulting delay in the start of the study. Minister
Truc said he has the responsibility to coordinate all
stakeholders in order to have a scientific assessment of the
consequences of Agent Orange in Vietnam. He continued by
saying, "Everything must be done on a scientific basis," and
expressed appreciation for the contribution of U.S.
scientists. Dr. Sassaman said that the USG wanted to make
progress on the activities specified in the MOU,
specifically regarding the health study. One issue was the
lack of the establishment of a Joint Committee, which was
included in the MOU per the request of the Vietnamese
negotiators. The U.S. has named members to the Joint
Committee; Vietnamese have not appointed their members.
Minister Truc said that the lack of a joint committee was a
stumbling block but that the key question was how to
organize the research in an effective way. One problem he
saw was that people were waiting for answers and that the
research took too long and that the research time should be
shortened. Dr Sassaman reiterated that the U.S. was anxious
to get the birth defects study started and wanted to know if
there were any problems that the Vietnamese had with the
study. He did not seem to know the answer. Mr. Truc did
not give an indication that he would facilitate the MOH and
Committee 33 review process, which may prove to a stumbling
block in the progress of the project.

18. (SBU) On November 11, 2003, Dr. Sassaman, NIEHS
official Dr. Christopher Portier, and Embassy Health Attache
met with Dr. Nguyen Van Tuong, GVN co-investigator of the
human birth defects study in order to review the progress of
the human health study of selected birth defects to be
funded by NIEHS. (NOTE: As background, Dr. David Carpenter
of the State University of New York at Albany (University at
Albany) submitted a short proposal to conduct a pilot case
control study to evaluate selected birth defects in relation
to maternal serum dioxin concentrations. The proposal was
reviewed according to NIH guidelines, revised accordingly
and approved in late 2002; after which, NIEHS signed a
cooperative agreement with Dr. Carpenter. Dr. Tuong
received the proposal in September 2002 and, in January 2003
requested that four more Vietnamese scientists be added to
the study and that four additional hospitals be added to the
proposed two. END NOTE.) A key reason for the meeting was
determine the reason for the long delay in receiving
approval from the GVN to proceed with the pilot study. Dr.
Tuong described the lengthy GVN review process, which is
largely due to the number of ministries, agencies and
committees that are separately involved, specifically:
Committee 33; MOH Science and Bioethics committees; MOH;
Vietnamese Experts; MOH; Committee 33. To date, the pilot
study proposal has undergone review through the Vietnamese
Expert Committee and is now waiting the review and approval
of Vice Minister of Health Prof. Le Ngoc Trong; the final
review and approval is completed by Committee 33. How long
Committee 33 will hold onto the proposal is unknown. So
far, the GVN has had the proposal for more than one year and
has known its contents for longer than that.

19. (SBU) A key component of the study is the verification
of the serum 2,3,7,8-TCDD levels of both the mother and the
father of the cases and controls included the study.
Without these data, exposure assessment would be not be as
strong and would weaken any results of the epidemiologic
study. The serum 2,3,7,8-TCDD levels are a more objective
measure of environmental exposure than personal histories or
residential history. Given the lawsuit of the VAAOV and the
attendant worldwide propaganda campaign (see Paragraph 20
below), self-reported exposure history for both the cases
and controls will most likely be highly biased. USG has
pressed Dr. Tuong for assurances that the serum 2,3,7,8-TCDD
samples will be analyzed by laboratories both within Vietnam
and in an accredited laboratory outside the country. Dr.
Carpenter has already contracted with an accredited
laboratory in Canada. There is concern, because in the
past, the GVN has not permitted human serum 2,3,7,8-TCDD
from leaving the country and, currently, there are no
laboratories within Vietnam that have the expertise,
equipment or facilities to measure low concentrations of
2,3,7,8-TCDD in the picogram per gram of lipid range.

--------------------------------------------- --------------
Lawsuit by the Vietnam Association for Agent Orange Victims
--------------------------------------------- --------------

20. (SBU) On January 30, 2004, the newly created "Vietnam
Association for Agent Orange Victims" (VAAOV) - an entity
sanctioned by, and probably directed by, both the GVN and
the Communist Party of Vietnam - filed suit against U.S.
chemical companies. The suit was on behalf of three
individuals from Vietnam contending that they or their
offspring suffered health affects of exposure to Agent
Orange. The lawsuit demanded compensation from the
companies that produced Agent Orange. Former Vice-President
Nguyen Thi Binh and the Vietnam Red Cross Director have been
identified as key players in VAAOV. In conjunction with
this legal suit, the Vietnamese media has intensified, after
a lull, its propaganda campaign on the AO issues. The press
has printed weekly, if not daily, articles on this issue.
Many of the articles appear aimed at soliciting donations
for the support of alleged victims of Agent Orange. The
reports show pictures of individuals, children and adults,
with all types of disabilities attributing them to the last
effects of Agent Orange, regardless of the all the possible
causes of the many types of birth and congenital
disabilities. (COMMENT: Birth defects may be caused by a
host of factors some related to the parents and others
relating to the developing fetus. These factors may include
the age of the mother and father, genetic factors, viral
infections, maternal nutrition - both before and during
pregnancy, environmental exposures, such as heavy metals and
pesticides (both parents and during pregnancy), conditions
during the birth process, e.g., anoxia, maternal health,
e.g., preeclampsia, and others. END COMMENT.)

--------------------------------------------- -------------
MINISTRY OF DEFENSE PROPOSAL TO U.S. DEPARTMENT OF DEFENSE
--------------------------------------------- -------------

21. (SBU) Reftel relays a MOD proposal to DOD for
cooperation in remediation of suspected AO/dioxin "hot
spots" in three former military bases, including the site at
Da Nang where USEPA and VAST are engaged in planning for the
site characterization and pilot remediation project. When
presenting the proposal verbally to DATT and EST Officer,
MOD personnel made no reference to the ongoing USEPA-VAST Da
Nang project. EST Officer explained the ongoing project and
asked if MOD intended for its proposal to DOD to be an
integral part of the ongoing activity, or to be an
independent endeavor. The MOD interlocutors, reluctantly
acknowledging the ongoing activity, stated that MOD-DOD
cooperation could supplement it. (COMMENT: MOD's
cooperation is vital for the success of the EPA-VAST
project. MOD owns the property and thus controls access.
END COMMENT) Embassy recommends that if DOD is willing to
engage MOD on the AO/dioxin issue by supporting remediation
efforts, that engagement should be carried out in a
coordination with EPA to support EPA's program in Da Nang.
At this time, all USG efforts in environmental research
related to AO/dioxin should be focused on the Da Nang
project.
PORTER

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