VZCZCXRO9063
PP RUEHCHI RUEHDT RUEHHM RUEHNH
DE RUEHGP #0110/01 0270917
ZNY CCCCC ZZH
P 270917Z JAN 10
FM AMEMBASSY SINGAPORE
TO RUEHC/SECSTATE WASHDC PRIORITY 7737
INFO RUCNASE/ASEAN MEMBER COLLECTIVE PRIORITY
RUEHPH/CDC ATLANTA GA PRIORITY
RUEAUSA/DEPT OF HHS WASHDC PRIORITY
RUEHRC/DEPT OF AGRICULTURE WASHDC PRIORITY
RHMFISS/DEPT OF HOMELAND SECURITY WASHINGTON DC PRIORITY
RUEHGP/ODC SINGAPORE SN PRIORITY
RUEHBS/USEU BRUSSELS PRIORITY

C O N F I D E N T I A L SECTION 01 OF 04 SINGAPORE 000110 
 
SIPDIS 
 
 
STATE PASS DHHS FOR DAN MILLER AND ADRIENNE GOODRICH-DOCTOR 
DEPT FOR OES/IHB CRAIG SHAPIRO 
 
E.O. 12958: DECL: 01/27/2020 
TAGS: AORC KFLU TBIO PREL PGOV SN
SUBJECT: REDI CENTER'S FUTURE UNCERTAIN AS USG FUNDING 
PROCESS CHANGES 
 
REF: 09 SINGAPORE 1168 
 
Classified By: CDA Daniel Shields for reasons 1.4 (b) and (d) 
 
SUMMARY AND ACTION REQUEST 
---------------------------- 
 
¶1.  (SBU) SUMMARY: Dr. Daniel Miller and Dr. Adrienne 
Goodrich-Doctor of the Department of Health and Human 
Services (DHHS) met with CDA and Ministry of Health (MOH) 
officials on December 3 and 4, 2009 to discuss the future of 
the Regional Emerging Diseases Intervention (REDI) Center and 
recent changes to DHHS funding procedures that will affect 
the Center's governance. Dr. Miller and MOH discussed several 
issues, including: the future direction of REDI's activities; 
prospects for expanding REDI to include partners from other 
economies and the private sector; and the leadership issues 
that will arise when current DHHS funding mechanisms end in 
August 20l0 and REDI begins to seek grants from DHHS 
Operating Divisions such as the National Institutes of Health 
(NIH) and the Centers for Disease Control and Prevention 
(CDC).  DHHS and MOH agreed to another round of discussions 
in early 20l0 following separate internal USG and GOS reviews 
to revisit the priorities for the USG and GOS engagement in 
health for the next five years; determine if the REDI Center 
has met the original objectives and if there is interest from 
other USG agencies in continuing to work with REDI; and to 
determine the best way to move forward to meet the goals of 
the collaboration.  MOH remains supportive of the REDI Center 
but understands the new U.S. funding changes and stated 
strong opinions about the types of new USG representation the 
GOS would accept for the Board of Governors (BoG) of the REDI 
Center. The confluence of administrative issues and competing 
opinions about how to take REDI forward in the face of 
funding changes raises questions about the Center's 
continuing viability as a government-to-government 
initiative.  End Summary. 
 
¶2. (SBU) ACTION REQUEST: Embassy Singapore requests that the 
Department coordinate an interagency discussion regarding the 
future direction of the bilateral health cooperation with 
GOS; the REDI Center's merits and USG interest in working 
with the REDI Center; the leadership implications of REDI 
seeking grants on a competitive basis from DHHS agencies and 
whether it can continue as an intergovernmental organization. 
 The discussion should also cover who in the USG could assume 
responsibility for providing scientific and strategic 
direction to the REDI Center and selecting key 
representation, such as the U.S. members of REDI's BoG, the 
deputy director, and likely the next executive director.  The 
United States and Singapore established the REDI Center to 
monitor, detect and respond to naturally occurring infectious 
diseases and man-made biological threats. The Department and 
other USG agencies with programs aimed at addressing these 
threats may find working with REDI valuable, as it has an 
established presence in Southeast Asia. This message is 
intended to inform relevant agencies of REDI's situation so 
they can convey any interest they may have in working with 
the REDI Center and participate in a Department led 
interagency discussion on REDI and future health cooperation 
with the GOS.  End Action Request. 
 
DHHS Funding Changes Complicate USG-GOS Arrangement 
--------------------------------------------- ------ 
 
¶3. (SBU) On December 4, Econoffs joined Dr. Daniel Miller and 
Dr. Adrienne Goodrich-Doctor of the DHHS Office of Global 
Health Affairs (OGHA) in a meeting to discuss recent changes 
to DHHS funding mechanisms for the REDI Center with GOH Aik 
Guan, Deputy Secretary for Health Services at MOH and 
Chairperson of REDI Center's Board of Governors.  At REDI's 
establishment in 2005, OGHA awarded REDI a non-competitive 
sole-source cooperative agreement which was not typical of 
similar DHHS initiatives, Dr. Miller said. The funds 
committed by the United States under terms of the REDI Center 
agreement were not line items in the DHHS budget. Under the 
current Administration, OGHA will focus solely on policy and 
will shift responsibility for program management out of OGHA 
to implementing agencies like the CDC and the NIH. REDI 
continues to receive substantial support from the GOS. 
However, funding is no longer available directly from OGHA, 
and REDI will therefore have to apply and compete for CDC, 
 
SINGAPORE 00000110  002 OF 004 
 
 
NIH or other USG or private-sector funding. 
 
¶4. (SBU) Once REDI begins to apply for USG funding, those USG 
personnel that have funding review and approval authority 
will no longer be able to serve on its BoG due to legal and 
ethical restrictions in U.S. laws and regulations.  Dr. 
Miller currently serves on REDI's BoG, along with two other 
members representing CDC and NIH. The other three BoG 
members, including Depsec Goh, are from Singapore. Dr. Miller 
suggested that appropriate USG candidates for REDI's future 
BoG might include health experts from DHHS or CDC seconded to 
the State Department as they would not be in line to approve 
or reject grant applications but would have relevant health 
expertise. The change in funding and the associated 
governance challenges outlined by Dr. Miller prompted 
questions from DepSec Goh regarding whether the REDI Center 
could realistically continue as a government-to-government 
initiative. Singapore does not want the United States to 
install proxy BoG members that have no decision-making power 
and no direct links to the USG, DepSec Goh stated strongly. 
Dr. Miller agreed and assured DepSec Goh that the USG had 
several options that could be explored. 
 
Concerns about REDI Center's Executive Director 
--------------------------------------------- -- 
 
¶5. (SBU) Under the terms of the USG-GOS agreement, Singapore 
is in line to nominate the next Executive Director (ED) once 
the current ED contract expires.  However, DepSec Goh said he 
would prefer to allow the United States to choose the next ED 
to ensure that person can effectively navigate the USG grant 
application process. Goh and Miller agreed that the ED should 
be entrepreneurial and adept at working with the private 
sector. 
 
Change Can be a Good Thing 
-------------------------- 
 
¶6. (SBU) Dr. Miller framed the discussion on REDI in positive 
terms, suggesting that the changes with DHHS funding 
mechanisms presented an opportunity to revisit the goals and 
objectives of the current agreement with the GOS to determine 
if priorities have changed and to consider planning for the 
next five years of engagement, as well as to do a thorough 
stock-taking of REDI's achievements and if necessary realign 
the Center's mission with the current global health 
environment. REDI was established following the 2003 outbreak 
of Severe Acute Respiratory Syndrome (SARS) and represented 
the U.S. and Singapore's goals to develop an effective 
international initiative to monitor, detect and address both 
natural and man-made threats. Much of REDI's work to date has 
been focused on public health capacity-building initiatives 
related to Avian Influenza (AI) threats in Indonesia. REDI 
has done little so far regarding man-made biological threats 
and that may be an area to expand in the future, Miller and 
Goh agreed. 
 
¶7. (SBU) Goh said that the two governments had created the 
REDI Center out of a political desire to forge bilateral 
cooperation in health, but with inadequate thought as to how 
REDI would achieve the goals and objectives in the current 
USG/GOS agreement in practical terms. Goh advocated putting 
more emphasis on how REDI could work with the private sector 
to bring benefits to industry. For example, one proposal he 
suggested pertained to bringing Food and Drug Administration 
officials to Singapore to help harmonize health product 
standards and facilitate export of Singapore goods to the 
United States.  (Note: In Post's assessment, this does not 
fit with REDI stated mission. End Note.) 
 
More Emphasis on Man-Made Threats 
--------------------------------- 
 
¶8. (SBU) During a separate meeting with CDA ahead of the 
December 4 meeting with MOH, Dr. Miller and Emboffs noted 
that other USG agencies and foreign governments have 
expressed an interest in the area of biological threat 
reduction, an area that REDI was established to address. 
Representatives from the Department of Defense (DOD) Defense 
Threat Reduction Agency (DTRA) visited REDI in December and 
found that REDI's positive relationships with health 
organizations and ministries in Southeast Asia could be 
 
SINGAPORE 00000110  003 OF 004 
 
 
useful to DTRA's mission. DTRA is considering developing a 
proposal with REDI regarding how they can work together on a 
bio-threat reduction roadmap for the region. The Bureau of 
International Security and Nonproliferation (ISN) asked 
Emboffs to observe a European Union (EU) meeting with 
Association of Southeast Asian Nations (ASEAN) regarding 
establishing a CBRN (chemical, biological, radiological, and 
nuclear) Center of Excellence in the region (reftel).  The EU 
did not mention REDI specifically, but intends to create the 
Center of Excellence by building on existing regional and 
bilateral initiatives that deal with biological threats. 
President Obama recently released the National Strategy for 
Countering Biological Threats, which included objectives such 
as reinforcing norms of safe and responsible conduct and 
obtaining timely and accurate insight on current and emerging 
risks, which are capabilities that the REDI Center was 
designed to cultivate in the region. 
 
Singapore Cautious About Other Government Partners 
--------------------------------------------- ----- 
 
¶9. (C) Singapore and the United States began REDI as a 
bilateral organization, but envisaged expanding it into a 
multilateral organization by including other Asia-Pacific 
Economic Cooperation (APEC) member economies.  DepSec Goh 
said that Taiwan was the first APEC economy to ask to join 
but Singapore did not want to bring in Taiwan and risk 
upsetting China.  As a result, REDI has never expanded beyond 
a bilateral organization.  Emboffs asked about making REDI an 
ASEAN initiative, citing the EU's interest in an ASEAN CBRN 
Center of Excellence and a proposed deliverable from the 
recent U.S.-ASEAN Leaders Meeting that included greater 
pandemic-preparedness cooperation with the private sector. 
Goh adamantly opposed the ASEAN option, saying that given 
ASEAN's lack of success in program management it would be the 
"kiss of death" to getting anything accomplished.  Goh was 
more receptive to bringing in partners like the EU or 
Australia.  Goh also proposed establishing an international 
advisory panel for REDI, which would allow foreign government 
and even private sector representatives to provide guidance 
to REDI, without directly tying that guidance to funding and 
a formal government-to-government agreement.  Goh suggested 
that might mitigate some GOS concerns about including Taiwan. 
 
Finding a Way Forward 
--------------------- 
 
¶10. (SBU) Emboffs, Dr. Miller and DepSec Goh agreed during 
the December 4 meeting that both the USG and the GOS need to 
complete separate internal reviews to revisit priorities for 
bilateral engagement in health for the next five years, and 
to determine whether the REDI Center has met its original 
objectives and has value for the future.  Both sides 
acknowledged that the review process might determine that the 
current bilateral agreement be revised or perhaps terminated 
if there was no perceived role of REDI in the GOS/USG health 
engagement.  Goh said that he would have to consult with the 
Ministry of Foreign Affairs, but he did not think there would 
be much GOS objection to allowing the REDI Center agreement 
to terminate, especially if the United States could not find 
suitable BoG members with decision-making capacity. However, 
if both sides determine that REDI Center should continue, Goh 
said that a government-to-government agreement would be 
required to ensure adequate oversight and momentum. The 
governments must be involved to provide the bigger-picture 
policy objectives and spur action by any agencies or private 
companies involved in the Center, Goh concluded. 
 
Comment: Post's Concerns about REDI Governance 
--------------------------------------------- - 
 
¶11.  (C) Embassy Singapore has spent considerable time and 
effort coming to a better understanding of how changes to the 
DHHS funding mechanisms will affect the viability of the REDI 
Center.  Now that the picture is clearer, Post is most 
concerned about the governance issues caused by the funding 
changes.  If the OGHA and current BoG members can no longer 
provide guidance to REDI, there is currently no easily 
identifiable USG office that can take the lead on finding new 
BoG members, the next Executive Director, and 
Deputy Director as well as follow through on renegotiating 
the USG-GOS agreement.  Dr. Miller proposed appointing for 
 
SINGAPORE 00000110  004 OF 004 
 
 
example, senior level USG personnel from DHHS or CDC detailed 
to the Department. Embassy Singapore is not equipped to 
assume these responsibilities and notes that most of REDI's 
work has been outside Singapore in countries like Indonesia 
and Vietnam.  It would be more appropriate for a Department 
office, which would have operational but not grant-awarding 
responsibilities, to assume oversight for REDI if the 
Department and other agencies like DTRA and perhaps USAID see 
value in partnering with REDI. 
 
¶12.  (C) Given the continued USG focus on addressing 
biological threats in Asia, it would be unfortunate to allow 
a functioning organization like REDI to terminate. 
However, if no USG office can take the lead as administrator 
for REDI, Post sees no bilateral issues with allowing USG 
support for the REDI Center to cease once USG funding ends 
and the terms of the current agreement conclude.  USG and GOS 
financial obligations to the Center will continue for at 
least two years regardless of whether the agreement is 
renewed or not.  REDI may also be able to continue operations 
if it secures its own funding.  However, it would not be able 
to function as an international organization. 
 
Comment: DHHS/OGHA Meeting Comments 
----------------------------------- 
 
¶13. (C) DHHS fully supports in principle, the REDI Center and 
the bilateral health agreement with the GOS.  However, it was 
determined during the meeting with DepSec Goh that there was 
a need for both the USG and the GOS to have internal 
discussions before determining whether to revise or terminate 
the current bilateral agreement.  DHHS agreed to participate 
in an interagency discussion led by the State Department to 
explore ideas for future bilateral health cooperation with 
the GOS that would be of benefit to the Asia Pacific Region 
and to plan for the next five years of engagement.  The other 
part of the interagency discussion would focus on a review of 
the REDI Center to determine whether it has effectively 
assisted the USG and the GOS with meeting the goals and 
objectives in the bilateral agreement and to determine if 
there is any USG interest in working with the Center.  The 
interagency discussion should first focus on planning for the 
next five years of engagement and determining if there should 
be any changes in priorities and goals before discussing and 
how REDI is equipped to assist the USG and the GOS in the 
future. 
 
¶14. (C) Dr. Miller agreed with DepSec Goh that appointing 
proxy USG representatives to the BOG would not be beneficial 
and assured DepSec Goh that there are plenty of qualified USG 
candidates to serve on the BOG for the REDI and there are 
several options that the USG can explore.  The USG would only 
nominate qualified senior level USG representatives to serve 
on the BOG. 
 
Additional Background on the REDI Center 
---------------------------------------- 
 
¶15. (SBU) If USG offices have specific questions about the 
REDI Center, they can contact: Econoffs - Ulla Saleh at 
SalehUR@state.gov (through April 15 only) and Peter Thorin 
(ThorinPD@state.gov); and/or OGHA officers - Dr. Daniel 
Miller at Daniel.Miller@hhs.gov and Dr. Adrienne 
Goodrich-Doctor at Adrienne.Goodrich-Doctor@hhs.gov. 
Additional background may be found on the REDI Center's 
Website at http://www.redi.org.sg 
 
¶16.  (U) DHHS cleared this cable. 
SHIELDS 
 
Visit Embassy Singapore's Classified website: 
http://www.state.sgov.gov/p/eap/singapore/ind ex.cfm