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Cablegate: Ambassador Michalak and New Vietnamese Minister of Health

VZCZCXRO9979
OO RUEHCHI RUEHCN RUEHDT RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
DE RUEHHI #1841/01 2990909
ZNR UUUUU ZZH
O 260909Z OCT 07
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC IMMEDIATE 6584
INFO RUEHHM/AMCONSUL HO CHI MINH 3856
RUEHZS/ASEAN REGIONAL FORUM COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHPH/CDC ATLANTA GA
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEKJCS/SECDEF WASHINGTON DC//USDP/ISA/AP//
RHMFISS/CJCS WASHINGTON DC//J2/J3/J5//
RHEFDIA/DIA WASHINGTON DC//DHO-3//
RHMFIUU/CDR USPACOM HONOLULU HI//J00/J2/J3/J5//
RHEFAFM/DIRAFMIC FT DETRICK MD//MA-1A//
RUEHSUN/USUN ROME IT

UNCLAS SECTION 01 OF 02 HANOI 001841

SIPDIS

SENSITIVE
SIPDIS

STATE FOR EAP/MLS, EAP/EP, INR, OES/STC, OES/IHA, MED
STATE PASS TO USAID FOR ANE AND GH
STATE PASS TO HHS/OGHA (WSTIEGER/LVALDEZ/DMILLER/CHICKEY)
BANGKOK FOR USAID (OCARDUNER, JMACARTHUR, WBRADY)
BANGKOK FOR APHIS (NCARDENAS), REO(JWALLER)
BEIJING FOR HHS HEALTH ATTACHE (BROSS)
CDC FOR COGH (SBLOUT) AND MCOHEN/RJSIMONDS/NCOX/TSINKS
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (STERN)
HHS PASS TO FIC/NIH (RGLASS) AND FDA (MPLAISER)
PHNOM PENH FOR CDC INFLUENZA COORDINATOR(WBRADY)
ROME FOR FAO
USDA PASS TO APHIS, FAS (OSTA AND OCRA), FSIS
VIENTIANE FOR CDC INFLUENZA COORDINATOR (ACORWIN)

E.O. 12958: N/A
TAGS: PGOV PROP SOCI TBIO EAID KHIV KFLU VM

SUBJECT: AMBASSADOR MICHALAK AND NEW VIETNAMESE MINISTER OF HEALTH
REVIEW COOPERATIVE EFFORTS

HANOI 00001841 001.2 OF 002


1. (U) Summary: On October 25, Ambassador Michalak paid an
introductory call on the new Minister of Health, Nguyen Quoc Trieu.
After reviewing Trieu's strong political experience and connections,
the Ambassador noted leading USG health cooperation priorities,
particularly medication assisted therapy for intravenous drug users
to prevent HIV infection and avian and pandemic influenza
preparedness. Trieu stressed long-term objectives such as health
financing goals and the development of a private health sector,
along with short-term goals for infectious disease prevention, food
safety, and the need for investment in hospitals and training
investment. Trieu sought increased U.S. assistance to support
Vietnamese food safety efforts and requested U.S. and NGO support
for the construction of increased hospital capacity. End Summary.

Minister Trieu's Background
----------------------------------

2. (SBU) Though Trieu has a medical degree and significant health
care experience, he has spent much of his professional life outside
of the health arena. He obtained a doctorate of philosophy in
"socio-politics" in Moscow and just finished his term as Chair of
the Hanoi People's Committee. Though he referred to himself
colloquially as the "Mayor of Hanoi," Trieu defended his medical
credentials. The Ambassador noted the value of Trieu's non-medical
experience in tackling the current problems of the Ministry of
Health (MOH). The Minister is a member of the Communist Party and
has visited the United States several times.

HIV and PEPFAR
--------------
3. (SBU) After introducing the comprehensive U.S.-supported HIV/AIDS
programs under the President's Emergency Plan for AIDS Relief
(PEPFAR), the Ambassador focused on medication assisted therapy
(MAT), including the use of methadone, and highlighted the delayed
initiation of a PEPFAR-sponsored pilot program. Trieu made little
reference to HIV/AIDS or to PEPFAR programs other than to state that
"Vietnam is appreciative of PEPFAR and Clinton Foundation support,"
lumping together these two disparate efforts. The Ambassador
suggested that the U.S. Health Attache return to introduce the newly
arrived PEPFAR Coordinator, Jim Sarns, to Vice Minister Trinh Quan
Huan at an early date.

Public Health Issues
--------------------

4. (U) The Ambassador praised the Government of Vietnam's (GVN)
efforts to respond to and prepare for avian and pandemic influenza,
indicating that Vietnam has instituted a model approach worthy of
global attention, founded on partnership and information and sample
sharing. As an example of broad-based contribution to the
development of public health capacity, the Ambassador pointed to the
start of the World Health Organization Epidemiology Training Program
(FETP) with the MOH's Vietnam Administration of Preventive Medicine
department, which receives USAID and AusAID funding and CDC
technical assistance. Trieu broadly addressed avian influenza
several times by pointing to the MOH priority to prepare for
"natural disasters and epidemics," including severe acute
respiratory syndrome (SARS) and avian influenza.

Minister Trieu's First 85 Days
------------------------------

5. (SBU) Trieu detailed three accomplishments from his first 85 days
in office. First, he secured approval from the National Assembly to

HANOI 00001841 002.2 OF 002


issue government bonds valued at 5000 billion Vietnamese dong
(VND)(approximately USD 310 million) to upgrade 387 of Vietnam's 659
district hospitals by 2009. Second, the Vietnam Development and
Investment Bank committed to provide 1600 billion VND (approximately
USD 100 million) in soft loans to upgrade central and national
hospitals. Finally, Trieu has begun to address the tremendous need
for human resource development and asked for U.S. NGO-based
resources to support medical training. The Ambassador pointed out
the experience and capacity of U.S. companies to provide technical
assistance in the areas of medical equipment and hospital
management.

The Minister's Platform
-----------------------

6. (SBU) Trieu described two long-term priorities: health care
financing and development of the private health care sector. Trieu
acknowledged the limits of the GVN overall national budget, which
currently appropriates 8 USD per citizen on health care (6.2 percent
of the total national budget), and Vietnam's poor ranking by the
World Health Organization (187 out of 190 nations) national
investment in health. With poor domestic investment, Trieu
recognized the concordant dependency of many health care programs on
international donor and project support. Further, he referenced the
need to "mobilize the non-public" sector by providing "encouragement
through the creation of favorable conditions for private providers."
Despite listing private health care financing and development as
priorities, the Minister offered no proposed initiative or
solutions. In contrast to the priorities of his predecessor, Trieu
did not mention public health function specifically and strategies
that target the poor.

7. (SBU) Trieu stressed three short-term priorities, including the
prevention of epidemic infectious diseases such as SARS and avian
influenza, improved food safety controls, requesting U.S. Food and
Drug Administration (FDA) assistance for the latter. The Ambassador
raised the possibility of enhanced future cooperation in food
safety.

Comment
-------

8. (SBU) As expected, Trieu focused on the prevention and control of
infectious epidemics. Trieu's appeal for U.S. food safety
assistance follows a detailed request recently submitted to the
Embassy by the MOH Food Administration Department. This week, Prime
Minister Dung highlighted food safety issues in his recent annual
address to the National Assembly, reflecting the growing importance
the GVN places on this issue. Though lumping PEPFAR and Clinton
Foundation support together might indicate insufficient
understanding of HIV coordination, more likely it reflects that
Trieu is still working his way up the learning curve in his new
position. We welcome Trieu's focus on health financing, but await
more concrete proposals. The Ambassador concluded with "USG health
developments efforts must contribute to general strengthening of the
health system." End comment.

MICHALAK

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