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Cablegate: Under Secretary Dobriansky's Meeting with Egyptian


DE RUEHEG #2291/01 3071219
R 021219Z NOV 08



E.O. 12958: N/A

1. (U) Summary. In a meeting on the margins of the 6th
International Ministerial Conference on Avian and Pandemic
Influenza, Egyptian Minister of Health and Population Hatem
El Gabaly reviewed for U/S Paula Dobriansky his support for
an international agreement to coordinate efforts for
influenza virus sharing and vaccine development, and concerns
about stagnant international organizations and avian
influenza in Africa. End summary.

2. (SBU) On October 25, on the margins of the 6th
International Ministerial Conference on Avian and Pandemic
Influenza in Sharm El Sheikh, Minister of Health El Gabaly
met with U/S Dobriansky accompanied by Ambassador John Lange,
Dr. Daniel Miller (HHS) and representatives of Embassy Cairo.
El Gabaly described his vision for an international
agreement on principles to address policy issues related to
avian influenza virus sharing to be signed by both developed
and developing countries. Those principles would be: 1) equal
rights for all countries to acquire a pandemic vaccine; and
2) sharing of virus samples between countries affected by the
virus and countries that produce the vaccine. He believed
such an agreement would address concerns of countries such as
Indonesia that view U.S. policies as unfair and inequitable.
He was confident that the Indonesians would support such an

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3. (U) El Gabaly said it was important for international
donors to focus more on Africa and to establish a WHO
Collaborating Center in Africa beyond the WHO centers already
established in Australia, Japan, UK and U.S. (HHS/CDC
Atlanta). He indicated that African countries trust the GOE
and that Egypt has already provided doctors to African
countries in fields such as combating malaria. U/S
Dobriansky agreed that Egypt can play a great role in
bringing Africa into the AI effort.

4. (SBU) El Gabaly described international organizations,
such as the WHO, as stagnant and said they need a "shake up"
in the same way that financial institutions have had to
reevaluate their operations during difficult times. He
proposed that Egypt and the U.S. address the issue of
enforcing discipline in international organizations such as
the WHO, which he considers excessively bureaucratic and
politically stagnant. He complained that WHO activities in
Egypt, such as workshops and seminars, have had a minimal
impact and are not an efficient use of resources. El Gabaly
said he was disappointed in the relationship between the WHO
and GOE in Cairo and in the organization as a whole. U/S
Dobriansky agreed to carry El Gabaly's message back to
Washington and indicated that the U.S. will try to coordinate
with Egypt in its efforts.

5. (SBU) Noting that, at the last G8 Summit, countries
pledged $60 million to the development of health services in
Africa, El Gabaly asked about the current status of donor
assistance in the health sector and expressed his concern
that no action to program the pledged G8 funds has been taken
as of yet. He reiterated Egypt's ability to make a
difference in Africa. U/S Dobriansky responded that health
was indeed an important area for the G8 countries and that
health ministers have been working together on the issue
since the summit. She highlighted USAID's role in the health
sector in Africa, but agreed that other members of the G8
have not been as active. Dr. Miller told El Gabaly that the
agency is fully supportive of the G8 initiative and has been
focused on the expansion of current activities such as PEPFAR
training programs. He stated that existing mechanisms and
channels should also be embraced as opportunities for
expanding influence.

6. (U) El Gabaly highlighted the importance of women's issues
and Egypt's role in providing training to physicians and
health personnel through the Suzanne Mubarak Regional Center
for Women,s Health and Development in Alexandria. Groups
from all over Africa are trained in Egypt. El Gabaly argued
that the center's activities are in line with HHS objectives,
and suggested HHS could tackle more issues if it looked at
existing resources in Egypt such as the center. He mentioned
that Egypt will host a global conference on gender equality
in 2010 and hopes to make a formal announcement shortly.

7. (U) In light of the current financial crisis, Minister El
Gabaly expressed his concerns about potential impacts beyond
the financial sector. If current problems are not examined
and addressed, then "AAA institutions are going to become
FFF." Reform of international organizations should be
focused on revising organization charters, military order,
finances, and organization size. He believes that when the
U.S. and Egypt work together, they have more influence on
outcomes. He also believes that the U.S. has played a

significant role in aligning world views on AI since the
December 2007 New Delhi conference and in preparing for the
Sharm el-Sheikh conference by embracing lessons learned. U/S
Dobriansky stated that the U.S. will continue to support the
GOE in its efforts.

8. (SBU) Note: In a meeting that also included Minister of
Agriculture Abaza and that took place shortly before he met
with U/S Dobriansky, El Gabaly told Ambassador Lange, UN
System Influenza Coordinator David Nabarro, WHO Assistant
Director General Paul Gully, and ministerial or
sub-ministerial representatives from Indonesia, Namibia,
Malawi and Mauritania, that Egypt is willing to mediate the
dispute between the developing and the developed world over
the sharing of viruses and benefits. He proposed that
delegates meet and agree, by the end of the conference on
October 26, on an international agreement/framework under a
UN umbrella to coordinate efforts for influenza virus sharing
and vaccine development. He said that benefits such as
vaccines should be distributed on an equal basis. Nabarro
told El Gabaly that any such effort needed to be
"synchronized" with the process already underway that is
leading up to the WHO meeting in December. Ambassador Lange
discussed the ongoing talks between Indonesia and the U.S,
the two nations at the center of the dispute, and the
importance of the WHO Intergovernmental Meeting in December
in Geneva. Indonesia's Bayu Krisnamurthi stressed the
importance of increasing vaccine production capacity and of
early detection, surveillance and response. Subsequent
meetings on the margins of the conference on this subject
were inconclusive, as most countries in attendance preferred
to leave the virus/sample sharing issue to the WHO forum.
The GOE, in its concluding document, Vision for the Future,
highlighted the importance of resolving the issue in the
December meeting at WHO. End note.

9. (U) This cable has been cleared by U/S Dobriansky.

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