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