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Cablegate: Tokyo Touts Candidate for Who Dg: Hhs a/S Agwunobi

VZCZCXRO9331
PP RUEHHM RUEHLN RUEHMA RUEHPB
DE RUEHKO #4368/01 2151238
ZNR UUUUU ZZH
P 031238Z AUG 06
FM AMEMBASSY TOKYO
TO RUEHC/SECSTATE WASHDC PRIORITY 4988
RUEAUSA/DEPT OF HHS WASHINGTON DC PRIORITY
INFO RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHBJ/AMEMBASSY BEIJING 3590
RUEHFK/AMCONSUL FUKUOKA 7501
RUEHNAG/AMCONSUL NAGOYA 7337
RUEHNH/AMCONSUL NAHA 0078
RUEHOK/AMCONSUL OSAKA KOBE 0809
RUEHKSO/AMCONSUL SAPPORO 8616
RUEHRC/USDA FAS WASHDC 8301
RUEAIIA/CIA WASHDC

UNCLAS SECTION 01 OF 03 TOKYO 004368

SIPDIS

DEPT FOR AIAG AMBASSADOR LANGE
DEPT FOR G
DEPT FOR OES/IHA SINGER AND FENDRICK
DEPT FOR EAP/J
HHS PASS TO CDC AND NIH
HHS FOR A/S AGWUNOBI
HHS FOR OGHA STEIGER, BHAT AND ELVANDER
DEPT PASS TO AID/GH/HIDN DENNIS CARROLL

SIPDIS
SENSITIVE

E.O. 12958: N/A
TAGS: TBIO KFLU KSTH ECON PREL SOCI JA
SUBJECT: TOKYO TOUTS CANDIDATE FOR WHO DG: HHS A/S AGWUNOBI
MEETINGS WITH JAPAN'S MINISTRY OF HEALTH

REF: 05 TOKYO 6750

TOKYO 00004368 001.2 OF 003


1. (SBU) Summary. On July 24, Department of Health and
Human Services (HHS) Assistant Secretary for Health John
Agwunobi met with Ministry of Health, Labor and Welfare
(MHLW) Minister Jiro Kawasaki and other senior officials to
discuss a wide range of regional and bilateral health
issues, including the selection of the World Health
Organization's (WHO) next Director-General, avian
influenza, polio eradication, and HHS-Japan bilateral
cooperation. Japan is requesting that the United States
support Dr. Shigeru Omi's candidacy for Director-General of
the WHO. End summary.

2. (U) On July 24, Department of Health and Human Services
(HHS) Assistant Secretary for Health Dr. John Agwunobi met
with Ministry of Health, Labor and Welfare (MHLW) Minister
Jiro Kawasaki, Assistant Minister for Technical Affairs
Takeshi Toguchi, MHLW Parliamentary Secretary Hiroshi Okada
and others to discuss a wide range of regional and
bilateral health issues, including the selection of the
World Health Organization's (WHO) next Director-General,
avian and pandemic influenza planning and preparedness,
polio eradication, and HHS-Japan bilateral cooperation.
Throughout the meetings, A/S Agwunobi underscored the
importance of the bilateral relationship in the area of
public health and lauded Japan's work in the region and
around the globe. HHS International Affairs Officer Erika
Elvander, ESToff and EST FSN also attended the meetings.
Agwunobi followed up with a meeting at the Ministry of
Foreign Affairs (reported septel) and site visits to the
International Medical Center of Japan (IMCJ) and the
National Institute of Infectious Diseases (NIID).

3. (SBU) Minister Kawasaki began by welcoming Dr. Agwunobi
to Japan. He highlighted the challenges posed by emerging
infectious diseases and bioterrorism. Kawasaki explained
that officials submitted a bill to the Diet this past
spring to amend Japan's infectious diseases law to prevent
bioterrorism (see reftel). The Minister hoped the Diet
would pass the bill during its fall session. He believed
that both the ruling and opposition parties have come to an
agreement on the bill. The Minister also touched on avian
influenza preparations and discussed the difficulties in
planning because of differences in how various central
governments relate to local ones around the world. He said
that some local governments in Japan are behind in their
preparations. To better coordinate Japan's international
efforts on AI and other infectious diseases, Kawasaki noted
that he plans to travel to China at the end of August and
to the European Union in September. The Minister also
mentioned that Australia's Health Minister visited Tokyo
the previous week.

4. (SBU) Kawasaki then turned to the main message of the
meeting -- Japan's request that the United States support
Dr. Shigeru Omi's candidacy for Director-General of the
WHO. The Minister explained that a cabinet decision was
made to put forth Omi's name as Japan's candidate. Omi has
done an excellent job as the WPRO director and has worked
in the area of infectious diseases for many years.
Kawasaki explained that the WHO's main challenge today is
emerging infectious diseases and that Asia is ground zero
for new outbreaks. He argued that Omi was most familiar
with the region, and given the public health challenges the
world faces in the near future, Omi would be an excellent
candidate for the job. Kawasaki passed a letter addressed
to HHS Secretary Leavitt explaining Tokyo's position and
request for support. (Note: that same day the Embassy
received a note verbale on the same topic, and Omi's
candidacy was the main topic of conversation in a dinner
hosted by the Ministry of Foreign Affairs.)

TOKYO 00004368 002.2 OF 003

5. (SBU) In response, A/S Agwunobi said that Dr. Omi is
highly respected around the world and former Director-
General Dr. Lee Jong-wook is greatly missed. Though the
international community is still mourning the former DG's
sudden death, the work of the WHO must go on. Agwunobi
explained that Washington's policy is not to indicate whom
the United States will support prior to the vote. There
will be multiple candidates to consider. The U.S. would
welcome a visit from Dr. Omi as part of this process.

6. (SBU) Agwunobi concluded by asking for Japan's continued
close cooperation on polio eradication. He stressed that
Japan's continued leadership was critical to stamping out
the disease. In response to a question from the Minister,
Agwunobi briefly discussed the status of AI vaccine
development in the United States, highlighting some of the
challenges posed by having to choose which strains should
be produced. Minister Kawasaki asked for the continued
sharing of information between the U.S. and Japan, and
mentioned that Japan could learn much from the U.S. in the
area of fighting cancer. He also asked about the
relationship between the government and pharmaceutical
companies in the United States. A/S Agwunobi noted the
recent awarding of more than USD one billion to five
pharmaceutical vaccine development companies that would
both expand domestic production capacity, develop cell
based flu vaccine technology, and expand manufacturing
capacity in general for flu vaccines. A/S Agwunobi also
noted Secretary Leavitt's potential travel to Japan in
December to attend a Global Health Security Initiative
meeting.

7. (SBU) Immediately following the meeting with Minister
Kawasaki, A/S Agwunobi met with MHLW Assistant Minister for
Technical Affairs Takeshi Toguchi. Agwunobi began his
remarks by stressing the importance of partnerships when
facing a potential avian influenza pandemic and asked about
Japan's proposed use of Tamiflu in its own preparedness
plans.

8. (SBU) Toguchi welcomed close information sharing and
said the AI threat is recognized around the world due to
the efforts of President Bush and HHS Secretary Leavitt to
raise awareness. The key to fighting AI will be to develop
public health systems in developing countries to better
deal with the disease. Japan's vaccine production
continues to be egg-based, with work progressing on strain
one vaccines. Toguchi explained that to date, there have
been no problems with the safety of the prototype vaccine.
Japan is not yet working on a strain two vaccine.
Preliminary data shows that the vaccine for strain one will
not work for strain two viruses. He said that obtaining a
vaccine that would work on all strains would be optimal,
but if that was not possible, it was important to continue
work on all strains. In addition to close information
sharing, Toguchi said that it was critical to obtain the
cooperation of developing countries in order to obtain
viral samples. The Assistant Minister explained that
consensus was reached at the World Health Assembly on this
issue, but that it remained to be seen whether developing
countries would provide the strains to Japan and the United
States quickly enough. More work is needed in this area.

9. (SBU) Japan's current AI vaccine prototype requires one
dose in the range of 15-30 micrograms. MHLW has been
working with the U.S. FDA on Tamiflu safety issues.
Agwunobi said it was important to manage the potential side
effects of public health interventions. The two officials
then turned to a discussion on antiviral prioritization.
Tamiflu usage in Japan will differ according to the
pandemic stage, with prophylactic use in earlier ones.

TOKYO 00004368 003.2 OF 003


Once phase four is reached in Japan, health authorities
will no longer prescribe Tamiflu for seasonal flu. Japan's
prioritization is to medicate first responders and critical
safety officials first. Agwunobi and Toguchi also
discussed the use of modeling to see how a pandemic could
potentially spread. Toguchi commented that given that
there are many changes still taking place in the virus,
experts in Japan have not conducted any modeling studies.
He did agree that modeling was a useful tool. The
Assistant Minister noted that because conditions will
continue to change, close cooperation would be necessary
between the two countries. Agwunobi closed by calling
Japan one of the United States' most important partners in
the area of global health and asked for further close
communication and collaboration.

10. (U) The same day, A/S Agwunobi met with MHLW
Parliamentary Secretary Hiroshi Okada. Okada said that he
would travel to Washington in August, which Agwunobi
welcomed. Okada served several terms as mayor of Mito City
where he dealt with public health emergency preparedness on
the local level. Okada noted that Tokyo provided Yen 7.7
billion (approximately USD 68 million) for avian influenza
preparedness in January as part of a supplemental budget.
Japan currently has 400,000 chicks for egg based vaccine
development. A/S Agwunobi expressed his appreciation for
Japan's leadership in ASEAN, on polio eradication and the
Global Fund, and finally with health efforts in Afghanistan
and Iraq.

11. (U) HHS's Office of Global Health Affairs cleared this
cable.

SCHIEFFER

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