Cablegate: Follow-Up On President's Announcement to Expand

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R 251458Z SEP 09


E.O. 12958: N/A

REF: STATE 97471


1. (U) Embassy pol-econ counselor delivered reftel points to
Swiss Federal Office of Public Health (FOPH) International
Affairs Office Vice Director Dr. Gaudenz Silberschmidt MD. on
September 25. Silberschmidt indicated that his office would
be the coordinating center for Switzerland's participation in
the international/WHO effort on H1N1. He then proceeded to
outline the details of Switzerland's current national and
international effort.

Swiss Effort

2. (U) Switzerland's Federal Council approved and earmarked
money for a mass domestic vaccination program in summer 2009.
Switzerland subsequently ordered 13 million doses of H1N1
vaccine from Sanofi and Glaxo Smith Kline, at a price
exceeding 10 CHF (US$10) a dose. Silberschmidt said that he
estimates this is roughly four times the concessional
per-dose price the WHO could probably obtain from the
pharmaceutical firms for inoculation campaigns in developing
countries. The FOPH estimates that 13 million doses will be
enough to inoculate the entire Swiss population (7.8
million), assuming two doses are needed per child and one for
each adult. Silberschmidt said he does not know when the
first batch of vaccines will become available. Production is
going more slowly than anticipated, due to the unanticipated
difficulty of growing the vaccine. For this reason,
estimates of annual global H1N1 vaccine production capacity
have been reduced from 5 billion doses to 3 billion.

3. (U) With regard to the international effort, Switzerland
is making available 5 million CHF ($5 million) for the WHO to
purchase vaccines. Silberschmidt figures that this will be
enough to buy roughly 1.5 million doses of vaccine at the
$2-3 a dose concessional WHO price. Switzerland figures that
this is therefore equivalent to roughly 10 percent of its
overall vaccine procurement. In addition, Switzerland will
provide vaccines to UN system employees living in or cycling
through Switzerland. Finally, Switzerland does not yet know
if the 13 million doses it is buying for its national program
will be more than needed. If it turns out that Switzerland
has over-purchased, then some additional donations may be

4. (U) Switzerland has opted to separate the WHO procurement
effort (at $2-3 a dose) from its domestic purchase. This
will allow FOPH to avoid using expensive Swiss reference
price vaccines for the WHO's developing country program, a
costly strategy which would only subsidize pharmaceutical
suppliers. The FOPH also did not think it would be feasible
to negotiate price reductions for a portion of its already
contracted orders, in order to provide these vaccines to the
WHO. Instead, the Swiss-financed vaccine orders for WHO
programs will be additional to those being purchased for the
national Swiss program. In this way, the FOPH believes it
can avoid a negative industry reaction.

Concern about Liability

5. (U) Silberschmidt said that the Swiss government is
concerned that liability issues could greatly complicate
organization of the international action. For example, if a
dual U.S./local national in a country like Botswana has an
adverse reaction to a WHO-donated vaccination, will that
person be able to sue the donors or the manufacturers in a
U.S. court? If so, this could vastly increase the product
liability risk (and therefore the manufacturer's vaccine
price) for campaigns in developing countries.

Swiss Questions

6. (U) Silberschmidt indicated that he had the following
questions regarding U.S. planning.

-- Which agency and which office specifically is in charge of
leading the U.S. international response to H1N1? Can the
U.S. provide appropriate points of contact and their e-mail,
phone and fax numbers?

-- Does the U.S. have plans to supply vaccines to UN agency
personnel living in or cycling through the United States?

-- Would the U.S. consider providing inoculations to members
of other diplomatic missions in countries where the local
authorities have limited capabilities? Switzerland has
dozens of small diplomatic missions with no capacity for cold
pack vaccine transport and storage.

-- How does the U.S. plan to guarantee provision of vaccines
to U.S. citizens residing overseas?

Swiss Contact points

7. (U) The following Swiss Government officials should be
included in WHO-related donor coordinating discussions:

Dr. Gaudenz Silberschmidt MD
Vice Director
Head of Division
Division of Intenational Affairs
Federal Office of Public Health
Federal Department of the Interior
Tel: 41-31-322-6650
Fax: 41-31-322-1131

Ms. Rhena Forrer
Division of International Affairs
Federal Office of Public Health
Federal Department of the Interior
Tel: 41-31-325-5417
Fax: 41-31-322-1131

Ms. Stephanie Gratwohl Egg
Diplomatic Officer
Political Division V
Transport, Energy and Health Section
Federal Department of Foreign Affairs
Tel: 41-31-322-7531
Fax: 41-31-324-1063

Action Request

8. (U) Embassy requests Department's assistance to respond
to GOS questions posed in paragraph 6.


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