VZCZCXRO7220
RR RUEHCN RUEHGH RUEHVC
DE RUEHGZ #2406/01 3520233
ZNR UUUUU ZZH
R 180233Z DEC 06
FM AMCONSUL GUANGZHOU
TO RUEHC/SECSTATE WASHDC 5582
INFO RUEHOO/CHINA POSTS COLLECTIVE
RUEAUSA/DEPT OF HHS WASHDC
RUEHPH/CDC ATLANTA GA
RUEHBK/AMEMBASSY BANGKOK 3777
RUCPDOC/USDOC WASHDC

UNCLAS SECTION 01 OF 04 GUANGZHOU 032406 
 
SIPDIS 
 
PACOM FOR FPA 
STATE FOR EAP/CM, EB, AND OES 
HHS FOR MCKEOWN, STEIGER, AND BHAT, OGHA 
CDC FOR BLOUNT, COGH 
BANGKOK FOR ESTH AND CDC 
 
SENSITIVE 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: TBIO SOCI ECON ELAB PGOV SCUL SENV CH
SUBJECT: Visit of HHS Secretary to Guangzhou Highlights Infectious 
Diseases and Preparedness 
 
REF:  A) Guangzhou 17685; B) Guangzhou 6174 
 
¶1. (SBU) SUMMARY.  U.S. Health and Human Services (HHS) Secretary 
Michael O. Leavitt and his delegation met with doctors, hospital and 
orphanage administrators, students, and businesspersons to discuss 
infectious diseases and health-care issues during a December 11-12, 
2006 visit to Guangzhou.  Highlights of his visit included a 
conversation with an unusually lively and forthright group of 
students at Zhongshan Medical School; a meeting with a medical 
worker at a hospital who had contracted and recovered from Severe 
Acute Respiratory Syndrome (SARS); a review of cooperative projects 
between HHS, the World Health Organization (WHO) and Guangzhou City 
authorities; and a walk through a wet market to observe health 
measures taken by Guangdong municipal authorities to prevent an 
outbreak of avian influenza.  Local media provided extensive 
coverage of the visit; local and Provincial Chinese officials with 
whom the Secretary met were overwhelmingly positive in their 
feedback.  END SUMMARY. 
 
¶2. (U) During a December 11-12, 2006, visit to Guangzhou, HHS 
Secretary Michael O. Leavitt visited the Guangzhou Children's 
 
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Welfare Institute, the Number 3 Teaching Hospital, the Number 8 
People's Hospital, the Guangdong Provincial Center for disease 
Control (GDCDC), a city "wet market" (live-animal market), and the 
Guangdong Vice Governor in charge of health issues.  The Secretary's 
delegation of 15 persons included HHS Chief of Staff Richard 
McKeown; HHS Assistant Secretary for Public Affairs Suzy DeFrancis; 
HHS Assistant Secretary for Health ADM John Agwunobi; and HHS 
Special Assistant for International Affairs William Steiger. 
Chinese Vice Minister of Health Chen Ziaohong and Dr. Ren Minghui, 
Deputy Director of the Department of International Cooperation in 
the Chinese Ministry of Health, also accompanied the Secretary. 
 
AmCham Breakfast: Preparing for an Epidemic 
------------------------------------------- 
 
¶3. (SBU) During a December 11 breakfast sponsored by the American 
Chamber of Commerce (AmCham) of South China, Dr. Zhong Nanshan, 
Chair of the China Medical Association and President of the 
Guangzhou Respiratory Diseases Research Institute, presented an 
overview of China's experience to date with the H5N1 strain of 
highly pathogenic avian influenza.  According to Dr. Zhong, China 
has had 21 human cases of H5N1, 14 of which were fatal.  The 
majority of victims contracted the disease through contact with sick 
or dead poultry, including at open-air markets.  Eight cases, 
however, showed no sign of such contact, and transmission could have 
occurred through contact with wild birds. 
 
¶4. (SBU) Dr. Zhong, known as the "SARS hero" because of his 
leadership during the SARS outbreak in 2002 and 2003, highlighted 
the importance of transparency and rapid response in treating AI 
cases.  In a June 2006 case in Shenzhen, doctors cured an H5N1 
victim who was succumbing to multiple organ failure by performing a 
tracheotomy and administering convalescent serum collected from 
another patient who had contracted the H5N1 virus and survived. 
[Note: ADM Agwunobi and the HHS medical professionals regard this 
technique as particularly risky and unproven. End Note].  Dr. Zhong 
expressed confidence in a new human H5N1 vaccine - currently in the 
experimental phase - that he and Chinese colleagues are developing. 
The event also featured Dr. Tang Xiaoping, President and 
Chief-Physician of Guangzhou Number 8 People's Hospital, who said 
the nature of infectious diseases makes containment impossible in 
today's global world.  Cooperation between countries, especially the 
United States and China, is essential to prevent the next pandemic. 
 
 
More Than an Orphanage 
---------------------- 
 
¶5. (SBU) During a visit to the Guangzhou Children's Welfare 
Institute, which currently houses 700 children and supervises an 
additional 600 in family-based foster care, the Secretary had an 
opportunity to observe and interact with children between the ages 
of one and three.  The Institute employs 380 medical personnel, 
including surgeons, who are especially skilled in care for those who 
come to the orphanage with disabilities.  The facility also provides 
education - from pre-school to occupational training - so the 
children can become independent adults.  The facility assists adult 
children in finding work, though those who are disabled can stay to 
live on-site. 
 
 
GUANGZHOU 00032406  002 OF 004 
 
 
¶6. (SBU) Zhang Mengchuan, director of the orphanage, said that 80 
percent of the 40 children adopted by international families each 
year are from the United States.  Zhang praised the coordination of 
the U.S. and Chinese Governments in processing adoptions.  [Note: 
Consulate Guangzhou operates the only immigrant visa unit among the 
China posts, and will process approximately 7,000 adoptions in 2006. 
End Note]  He explained the China Center for Adoption Affairs (CCAA) 
in Beijing makes matches based on the prospective adoptive parents' 
requests for age and special needs, as well as according to the 
availability of children for adoption throughout China. 
 
An Open Discussion with Medical Students 
---------------------------------------- 
 
¶7. (U) On the afternoon of December 11, 2006, the Secretary 
participated in a lively, forthright give-and-take conducted in 
English, marked with good-natured asides, with students from the 
Number 3 Teaching Hospital of Zhong Shan University.  During the 
discussion, the Secretary said he was looking forward to discussing 
with his Chinese counterparts strategies to combat infectious 
diseases, deliver health care to rural patients, promote scientific 
cooperation, and finance medical care on a sustainable basis. 
Students asked questions about pandemic preparedness, protections 
for rights of Americans with disabilities, the role of Traditional 
Chinese Medicine (TCM), health-insurance and the challenge of the 
uninsured in the United States, and the Secretary's background and 
own role in health policy.  The Secretary emphasized HHS's role in 
promoting international cooperation on controlling infectious 
diseases through bilateral cooperation with China and multilateral 
efforts under the auspices of the WHO. [Comment: The questions from 
the students and subsequent discussions were remarkably lively and 
open.  Students had done their homework on the Secretary's 
background and current policies at HHS and spoke good English with 
confidence.  One girl, who said polio had crippled her as a child, 
wanted more information on the HHS Office of Disabilities and 
whether the U.S. Government had plans to help with the 
rehabilitation of the disabled in developing countries.  A young man 
told the Secretary he "had been praying for him  and praying that 
[he] would have a chance to ask a question."  Other students did not 
shy away from asking the Secretary about access to medical care by 
the poor in the United States. End Comment.] 
 
Guangzhou No. 8 Hospital: Lessons from SARS 
------------------------------------------- 
 
¶8. (SBU) During a tour of the Guangzhou Number 8 People's Hospital 
infectious-disease ward, Director Tang Xiaoping discussed the 
hospital's experiences during the SARS crisis.  He pointed out 
improvements in the hospital since the outbreak, including 
ventilation fans in the halls that blow the air out of the rooms to 
the outside to decrease the likelihood of the infection's spreading 
within the facility.  During the SARS crisis, Tang said the 
Provincial Government held regular briefings and also published 
daily updates in the newspaper.  He described how the hospital was 
able to maintain sufficient staffing levels during the crisis, for 
example, through the use of monetary rewards.  He emphasized that 
high morale was the key to ensuring medical workers performed their 
responsibilities under very stressful conditions.  The Secretary 
also had an opportunity for a memorable exchange with one medical 
worker who contracted and recovered from the SARS virus. After the 
tour of the hospital, Secretary Leavitt and his delegation had a 
roundtable exchange with Dr. Tang, Vice Minister Chen and hospital 
staff.  In a rare display of emotion, Vice Minister Chen teared up 
during a discussion of the courage of Chinese health-care workers 
during the SARS outbreak; he said his own daughter was a nurse who 
was the age of many of the nurses who had battled and contracted the 
disease in Guangzhou. 
 
¶9. (SBU) The Number 8 Hospital's Red Ribbon AIDS research center has 
40 beds, and is partially staffed by volunteers.  Tang noted China 
has encouraged more HIV/AIDS testing recently; this naturally has 
led to a large increase in the reporting of new cases. 
Nevertheless, he said, the fatality rate among new HIV/AIDS patients 
is decreasing because of the use of anti-retroviral drugs. 
Guangdong has three levels of hospitals for infectious diseases, as 
well as teams of experts who can travel to other hospitals to assist 
staff. 
 
Visit to a Wet Market 
--------------------- 
 
 
GUANGZHOU 00032406  003 OF 004 
 
 
¶10. (SBU) On December 12, 2006, the Secretary visited Dajiangyuan 
Wet Market.   The indoor market, a favorite of Guangzhou locals, has 
stalls that sell fresh produce as well as live fish and chickens. 
The poultry workers were suitably dressed in white smocks, wore 
plastic gloves and covered their mouths with masks (though in most 
wet markets, workers do not use gloves).  Signs posted on the walls 
of the market warned of the dangers of avian flu, and described how 
to identify sick poultry, cautioned against handling dead birds, and 
told how to report suspicious bird deaths to authorities.  The signs 
cautioned against keeping poultry and pigs in the same area, warned 
against letting poultry roam free, and ordered that all poultry be 
vaccinated against avian flu.  The delegation also noticed signs 
hung in a nearby neighborhood that displayed prevention messages 
about the dangers of HIV/AIDS sexually transmitted diseases. 
 
Meeting with Guangdong Vice Governor 
-------------------------- 
 
¶11. (SBU) Following his visit to the market, the Secretary met with 
Guangdong Vice Governor Lei Yulan, who is responsible for 
public-health issues in the Province.  In her remarks, Lei noted 
that Guangdong's dramatic rise in living standards has mirrored an 
expansion of social programs, including those that cover public 
health, and discussed initiatives that assist rural populations, 
fund research and development (R&D), build community clinics in 
urban areas, and train world-class physicians.  Madame Lei said that 
since the SARS outbreak, the Provincial Government had invested over 
RMB 10 billion (USD 1.25 billion) to enhance its capabilities to 
deal with public-health emergencies such as highly pathogenic avian 
influenza and dengue fever.  Lei said Guangdong has increased its 
R&D capabilities through cooperation with U.S. entities: 
-- A joint USD 300,000 HIV/AIDS project with HHS to monitor and 
assist in the early prevention of HIV, part of the Global AIDS 
Program activities in China under the President's Emergency Plan for 
AIDS Relief; 
-- A separate joint project between Guangdong Province and the U.S. 
National Cancer Institute, part of the National Institutes of Health 
at HHS and the University of California Berkeley, with an investment 
of USD 110,000; and 
-- A joint project between Guangzhou's Zhong Shan University and the 
University of Pennsylvania on the development of vaccines against 
emerging epidemics; such as novel strains of influenza and dengue 
fever. 
 
Guangdong CDC: SARS, Influenza, and HIV/AIDS 
--------------------------------------------- ----- 
 
¶12. (SBU) During the Secretary's meeting with the Guangdong Center 
for Disease Control (GDCDC), Dr. Lin Jinyan, Deputy Director of 
GDCDC, discussed Guangdong's experience in dealing with SARS, the 
H5N1 strain of avian influenza, and HIV/AIDS.  Guangzhou and other 
Pearl River Delta cities accounted for 97 percent of all SARS cases 
in Guangdong.  Lin said Provincial officials contained SARS through 
a combination of early detection, rapid reporting, isolation of sick 
patients, along with a policy of local quarantine and rapid 
treatment.  When asked how GDCDC would respond differently if a SARS 
outbreak were to occur again, Lin said GDCDC would improve case 
management, public education, the identification of sources of 
infection, and the prevention of infection among hospital staff. 
[Comment: Dr. Lin and Provincial officials did not acknowledge that 
obfuscation by Provincial and national authorities allowed the SARS 
virus to spread to Guangdong around the world. End Comment.] 
 
¶13. (SBU) Guangdong has seen two human cases of H5N1 avian flu this 
year.  The first was a salesman from a food company in Guangzhou who 
died on March 2, 2006 (ref B), the second was a truck driver in 
Shenzhen who died on August 2, 2006 (ref A).  The suspected source 
of the first case was a wet market, but the source of the second 
case is still unknown.  Lin described control and prevention 
measures against avian influenza in animals, such as surveillance, 
case quarantine and treatment, the timely exclusion of non-cases, 
and epidemiologic investigations.  Ke Changwen, Director of GDCDC's 
Institute of Microbiology, said gene-sequencing tests have shown 
there have been no significant developments in the disease's 
human-to-human transmission capability.  Ke added the GDCDC is 
currently conducting a project with the WHO on animal-to-human 
transmission. 
 
¶14. (SBU) According to official statistics, Guangdong province has 
17,855 reported HIV/AIDS cases, the fifth-highest number in China. 
The five largest cities of the Pearl River Delta account for over 75 
 
GUANGZHOU 00032406  004 OF 004 
 
 
percent of these cases.  To combat HIV/AIDS, GDCDC continues to 
promote awareness through public campaigns, and provides 
comprehensive treatment, intervention, and care to prevent secondary 
infections.  GDCDC also sponsors intervention programs, such as 
syringe exchanges and condom promotion. 
 
¶15. (SBU) Dr. Yang Xingfen said the WHO and the Chinese Ministry of 
Health launched a training center for the surveillance and detection 
of emerging diseases in Guangdong in June 2006. The goal is to 
improve surveillance capacity, improve animal-husbandry techniques, 
research animal-to-human interaction in the transmission of highly 
pathogenic influenza, establish a training base for neighboring 
Southeast Asian countries, and provide greater information sharing 
with the WHO Secretariat and its partners. 
 
¶16. (SBU) When asked about the role of GDCDC in responding to an 
outbreak emergency, Dr. Lin Jinyan said that after receiving local 
case reports the GDCDC arranges "initial diagnosis-and-exclusion" 
activities.  The local CDC will go to the site for sampling, and 
begin an epidemiological study.  GDCDC decides whether to include 
national or more advanced experts, who will coordinate control 
measures.  Lin noted that GDCDC announced the two human cases of 
H5N1 influenza to the media before testing was completed, the first 
time this had been done and a sign of improved transparency. 
 
Press Coverage: Extensive and Positive 
-------------------------------------- 
 
¶17. (SBU) Local media outlets were present at every part of the 
Secretary's visit (except for the AmCham event), and coverage was 
 
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overwhelmingly positive.  Newspapers made special mention of the 
Secretary's session with medical students, and his visit to the wet 
 
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market.  In addition, the China Daily, which has national 
distribution, conducted an interview with the Secretary during the 
visit.  The article quoted the Secretary on health-care issues and 
U.S.-China collaboration, and mentioned the Secretary's trip in 
Chengdu on December 9-10, 2006. 
 
¶18. (U) The HHS delegation has cleared this cable. 
 
GOLDBERG