VZCZCXRO9433
PP RUEHHM RUEHLN RUEHMA RUEHPB
DE RUEHKO #4369/01 2151248
ZNR UUUUU ZZH
P 031248Z AUG 06
FM AMEMBASSY TOKYO
TO RUEHC/SECSTATE WASHDC PRIORITY 4991
RUEAUSA/DEPT OF HHS WASHINGTON DC PRIORITY
INFO RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEHBJ/AMEMBASSY BEIJING 3593
RUEHFK/AMCONSUL FUKUOKA 7504
RUEHNAG/AMCONSUL NAGOYA 7340
RUEHNH/AMCONSUL NAHA 0081
RUEHOK/AMCONSUL OSAKA KOBE 0812
RUEHKSO/AMCONSUL SAPPORO 8619
RUEHRC/USDA FAS WASHDC 8304
RUEAIIA/CIA WASHDC

UNCLAS SECTION 01 OF 03 TOKYO 004369 
 
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: JAPANESE CONCERNS ON IPAPI AND REGIONAL STOCKPILES 
OF ANTIVIRAL DRUGS 
 
REF: A. TOKYO 4368 
 
¶B. 05 TOKYO 4012 
¶C. TOKYO 1613 
 
TOKYO 00004369  001.2 OF 003 
 
 
¶1. (U) This cable contains sensitive but unclassified 
information and is intended for internal USG use only. 
 
¶2. (SBU) Summary.  Japanese officials are concerned about 
management issues surrounding the International Partnership 
on Avian and Pandemic Influenza (IPAPI) and see the need 
for setting a clear strategy on the Partnership's future 
development.  IPAPI needs leadership and its meetings 
should cover substantive issues.  Tokyo is asking for the 
United States' strong leadership in this respect.  The 
Japanese would also like to see communication between the 
United States, Japan and other core members improved.  The 
Partnership needs to urgently address how to implement 
committed monies, as only a small part of the Beijing funds 
have been used to date. 
 
¶3. (SBU) Most of the guidelines for the deployment of 
Japan's ASEAN stockpile of antiviral drugs have been 
established.  Japan is not planning to allocate a specific 
amount of Tamiflu to individual countries prior to a 
pandemic.  Japanese officials are not clear why it is 
necessary to remain silent on the physical location of the 
U.S. strategic stockpile in Asia, but they agreed to keep 
the details close hold.  The more "sensitive" issue for 
Tokyo is to make clear which countries will be eligible to 
receive drugs from the stockpile.  End summary. 
 
¶4. (U) On July 25, Department of Health and Human Services 
(HHS) Assistant Secretary for Health John Agwunobi met with 
Ministry of Foreign Affairs (MOFA) Global Issues Department 
Director-General Takahiro Shinyo and others to discuss 
bilateral coordination on avian influenza preparedness 
efforts and other regional health issues.  HHS 
International Affairs Officer Erika Elvander and ESToff 
also attended the meetings. 
 
¶5. (U) Dr. Agwunobi began the meeting by thanking Japan for 
its leadership in polio eradication efforts.  He urged 
strong continued cooperation in the future.  Agwunobi also 
thanked Tokyo for its work on HIV/AIDS and said that the 
United States stands firmly behind Japan's position on the 
Board of the Global Fund to Fight AIDS, Tuberculosis and 
Malaria.  A/S Aqwunobi reiterated U.S. appreciation of 
Japanese support for Afghanistan and Iraq health and 
humanitarian efforts.  He noted his intention to visit the 
International Medical Center of Japan and the National 
Institute of Infectious Diseases, two of Japan's premier 
institutions.  Finally, he noted MHLW Minister Kawasaki's 
letter to Secretary Leavitt that he would personally 
deliver.  Director-General Shinyo responded that Japan-U.S. 
cooperation on global health issues has been very fruitful 
to date.  He explained that Japan previously announced it 
would donate USD 500 million for AIDS related projects and 
an additional USD five billion to fight other infectious 
diseases over a five-year period (see ref B).  The GOJ 
wants these efforts to be complemented and is now asking 
Japanese private companies to become more involved in the 
fight against AIDS. 
 
¶6. (SBU) Turning to the topic of avian influenza and the 
International Partnership on Avian and Pandemic Influenza 
(IPAPI), Shinyo noted that Japan was an original member of 
the core group when IPAPI was announced at the UN in 
September 2005.  He expressed concern about the nature of 
the leadership of the Partnership and that the Partnership 
is evolving into a much larger worldwide organization than 
perhaps was originally intended.  He explained that there 
are differences of opinion on how to manage IPAPI.  Shinyo 
 
TOKYO 00004369  002.2 OF 003 
 
 
said that convening IPAPI related meetings every six months 
was useful, but that it was important to set a clear 
strategy on how to move the Partnership forward.  IPAPI 
needs leadership and the discussions at the conferences 
need to be more substantive.  He asked for the United 
States to take strong leadership in this respect.  In 
addition, Shinyo said that communication between the United 
States, Japan and other original members must be improved 
and maintained.  Tokyo is concerned that the U.S. and EU 
are making bilateral deals and then presenting the results 
to the remaining partners as a "take it or leave it" 
option.  Shinyo mentioned that he has discussed this 
briefly with Under Secretary for Global Affairs Paula 
Dobriansky. 
 
¶7. (SBU) The Partnership needs to urgently address how to 
implement committed monies, as only a small part of the 
Beijing funds have been used to date.  Shinyo argued that 
it was important to speed this process up.  Coordination 
between the Partners and the World Bank is necessary.  In 
addition, closer information sharing between the members of 
IPAPI is needed -- Shinyo argued that the Partnership 
should not just be a fund raising effort.  The Southeast 
Asia experience with containment should be shared with 
other regions.  Because IPAPI meetings are growing to 
include a very large number of participants, there is a 
limited exchange of detailed information during the 
conferences.  To help solve this problem, Shinyo suggested 
that it would be useful to hold regular experts' meetings 
or breakout sessions to cover issues in depth. 
 
¶8. (SBU) The discussion then turned to the ASEAN stockpile. 
DG Shinyo said that most of the guidelines for deployment 
and usage have been established.  He asked how the U.S. 
plans to use its strategic stockpile in relation to others 
around the globe.  For Japan, Tokyo's stockpile donation 
will be considered as the "local" stockpile and will be 
used first.  Next, the WHO stockpile will be used and 
finally Japan would turn to the U.S. one.  Dr. Agwunobi 
explained the U.S. concept and underscored that it would be 
important to have a strategy that would work in any 
situation.  Shinyo said that some of the ASEAN members are 
seeking a pre-allocation of Tamiflu, but Japan does not 
feel this would be useful.  A portion of the personal 
protective equipment (PPE), however, may be allocated in 
advance to individual countries.  Agwunobi responded that 
it is important to coordinate Japan's PPE stockpile with 
what USAID is planning and mobilizing.  In addition, the 
A/S stressed that it was necessary to start conducting 
exercises on the movement of the stockpiles to help 
identify weaknesses in the system prior to an actual 
pandemic. 
 
¶9. (SBU) Concerning the public release of information on 
the U.S. stockpile's physical location, Agwunobi 
underscored that it is Washington's preference to keep that 
information close hold.  Shinyo responded that Japan has 
approached it from the perspective of the U.S.-Japan 
security relationship, and that he did not really see why 
it was necessary to "hide" the stockpile.  He did not feel 
that divulging the actual location was a sensitive issue. 
(Note: Global Issues Department Deputy Director Kyoko 
Hokugo later admitted that Japan was not eager to disclose 
the actual location due to the bilateral security pact. 
Shinyo also agreed to keep the location quiet.)  The DG 
argued that a more sensitive issue for Tokyo was to make 
clear which countries will be eligible to receive drugs 
from the U.S. stockpile -- will they be solely for the use 
of ASEAN members or will they be available to China and 
other countries that may request it.  Tokyo has specified 
in its agreement that Japan's stockpile is for ASEAN 
members.  Japan, however, would also consider making the 
 
TOKYO 00004369  003.2 OF 003 
 
 
antiviral drugs available to neighboring countries, if an 
avian influenza outbreak there would present the threat of 
impacting ASEAN member states. 
 
¶10. (SBU) Shinyo next raised communication as an important 
part of pandemic preparations.  Japan is one of only a few 
countries that have donated funds to UNICEF's risk 
communications program (see ref C).  The DG argued that it 
was important to have others assist UNICEF and the WHO in 
those efforts in order to reach as much of the public as 
possible.  Agwunobi agreed that it was necessary to quickly 
start using a central body to disseminate information in 
local languages at the community level.  Agwunobi noted the 
human cases in Indonesia as an example of the importance of 
strong cross agency, multilateral and bilateral strategies 
for communication.  He offered to link the appropriate MOFA 
officials with Bill Hall, in the office of the Assistant 
Secretary for Public Affairs at HHS. 
 
SIPDIS 
 
¶11. (SBU) Shinyo concluded the meeting by stressing the 
importance of human security as it relates to infectious 
diseases and natural disasters.  The fight against 
infectious diseases is central to Japan's strategy of human 
security.  He expressed appreciation for the USG's 
understanding of the concept.  Shinyo said that while some 
have criticized Japan's concept as being "too broad", there 
are many concrete examples such as the work being done on 
AI pandemic preparedness to validate the approach. 
Agwunobi concluded that Japan was developing a "brand" 
around the world that embodied "benevolence" and used the 
examples of Japan's assistance during the tsunami and to 
Iraq and Afghanistan.  He thanked the DG for Japan's close 
cooperation with the United States on a broad range of 
global health issues. 
 
¶12. (SBU) Comment. The meeting between Shinyo and Agwunobi 
was followed by dinner.  It was clear from the conversation 
that the GOJ considers WPRO Director General Shigeru Omi's 
nomination for Director-General of the WHO as a key 
political goal and is hoping that the U.S.-Japan bilateral 
relationship will be used in support of achieving this 
goal.  End comment. 
 
¶13. (U) Note: Taiwan was also discussed during the meeting. 
A report will follow septel. 
 
¶14. (U) HHS's Office of Global Health Affairs cleared this 
cable. 
 
SCHIEFFER