VZCZCXYZ0001
RR RUEHWEB

DE RUEHGV #0525/01 0651041
ZNR UUUUU ZZH
R 061041Z MAR 07
FM USMISSION GENEVA
TO RUEHC/SECSTATE WASHDC 2994
INFO RUEHUJA/AMEMBASSY ABUJA 0217
RUEHEG/AMEMBASSY CAIRO 1766
RUEHIL/AMEMBASSY ISLAMABAD 4936
RUEHJA/AMEMBASSY JAKARTA 2031
RUEHBUL/AMEMBASSY KABUL 0309
RUEHNE/AMEMBASSY NEW DELHI 2798
RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUCNDT/USMISSION USUN NEW YORK 2039

UNCLAS GENEVA 000525 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
DEPT FOR G, OES, IO/T 
HHS FOR OGHA 
USAID FOR KENT HILL/ELLYN OGDEN 
 
E.O. 12958: N/A 
TAGS: TBIO WHO
SUBJECT: VISIT OF UNDER SECRETARY DOBRIANSKY - STAKEHOLDER 
CONSULTATION ON POLIO ERADICATION 
 
¶1.  Summary.  Under Secretary for Democracy and Global 
Affairs Paula J. Dobriansky visited Geneva February 28 as 
head of the U.S. delegation to the World Health Organization 
(WHO) Consultation on Polio Eradication, resulting in 
continued global commitment to eradication and establishment 
of milestones for donors and affected nations alike.  The 
Under Secretary also met with the WHO Director-General and 
delegations from the four polio-endemic countries - Nigeria, 
India, Afghanistan and Pakistan - urging head of state 
engagement on polio and addressing other critical roadblocks 
to eradication. End Summary. 
 
Stakeholder Consultation on Polio Eradication 
--------------------------------------------- 
 
¶2.  WHO Director-General Margaret Chan convened the Urgent 
Stakeholder Consultation on Polio Eradication to address the 
waning donor support and skepticism regarding the feasibility 
of eradication.  Participants included representatives from 
the spearheading partners of the Global Polio Eradication 
Initiative (GPEI) - Rotary International, the U.S. Centers 
for Disease Control and Prevention of the Department of 
Health and Human Services (HHS/CDC), UNICEF and WHO - 
representatives from the offices of the Presidents and 
ministries of health of the endemic countries, major donors, 
political organizations and independent technical experts. 
 
¶3.  Under Secretary Dobriansky led the U.S. delegation, which 
included Dr. Julie Gerberding, Director of HHS/CDC; Dr. Kent 
Hill, USAID Assistant Administrator for Global Health; Dr. 
Steve Cochi of HHS/CDC and Chair of the WHO Advisory 
Committee on Polio Eradication; Dr. Denise Johnson of 
HHS/CDC's Polio Eradication Branch; Ellyn Ogden, USAID's 
Worldwide Polio Eradication Coordinator; Jeff DeLaurentis, 
Executive Assistant to the Under Secretary; and David Hohman, 
Mission Health Attache. 
 
¶4.  Under Secretary Dobriansky addressed the consultation on 
"Eradication vs. Control: comparing the costs and polio case 
numbers."  Strongly reaffirming the global goal of polio 
eradication as a top foreign policy objective and one of the 
highest international public health priorities for the United 
States, the Under Secretary stressed the benefits derived 
from the initiative: the development of health infrastructure 
around the world, including networks of trained field staff, 
enhanced laboratory capacity, and access to a range of 
immunizations; progress in media management, social mapping, 
community outreach, religious and social leader involvement, 
and social mobilization; serving as bridges to tranquillity 
during times of conflict; and serving as a model for 
public-private partnerships. 
 
¶5.  The consultation reaffirmed the commitment to polio 
eradication and agreed to raise within 12 months - and then 
sustain for as long as needed - the levels of vaccination 
coverage and child immunity in the areas with endemic polio 
to levels that stopped the disease altogether in the 
polio-free parts of these countries. Ten other countries are 
currently fighting the tail-end of outbreaks caused by 
importations of poliovirus. 
 
¶6.  The consultation outlined specific milestones in two 
areas where improvements would raise the coverage and 
immunity levels. The first is to ensure that vaccine reaches 
children by improving the quality of polio vaccination 
campaigns, strengthening health infrastructure, addressing 
security challenges, and by enhancing acceptance of 
vaccination through tailored social mobilization and 
community engagement strategies. 
 
¶7.  The consultation also agreed there was a collective 
responsibility to mobilize the resources needed to complete 
polio eradication, in particular by filling the funding gap 
of $575 million for 2007-2008. Of that amount, $60 million is 
needed by April.  India announced in New Delhi, on the day of 
the consultation, a commitment of approximately $293 million 
for 2007-2008.  Other endemic countries outlined specific 
steps to provide domestic resources.  Members of the 
 
international donor community also reaffirmed their continued 
commitment to provide resources.  The U.N. Foundation said it 
would host a funding meeting with members of the Organization 
of the Islamic Conference (OIC), and invited the 
Director-General to attend, which she agreed to do.  In his 
closing remarks, Bruce Aylward, Director of WHO's Polio 
Eradication Initiative, reiterated the importance of "making 
the case" for finishing polio eradication at upcoming 
meetings, such as the G8 Development Ministers' meeting March 
26-27, the OECD-DAC high-level meeting April 3-4, and the 
World Bank/IMF spring meetings April 14-15. 
 
Meeting with WHO Director-General Margaret Chan 
--------------------------------------------- -- 
 
¶8.  Thanking the Director-General (DG) for convening the 
polio consultation, the Under Secretary mentioned her 
personal engagement in the eradication initiative, noting in 
particular her work with the U.N. Foundation and Rotary 
International.  The DG responded by recalling the late 
Director-General J.W. Lee's pledge to eradicate polio and her 
desire to fulfill his commitment.  Chan said her objective at 
this meeting was to get all the issues on the table, to focus 
on the reality of the situation, have a frank and transparent 
exchange of views and to take advantage of a window of 
opportunity to get the job done.  She had, for example, met 
with the Minister of Health of Pakistan to stress Pakistan's 
responsibility for the situation on its border with 
Afghanistan and the movement of people across that border, 
stressing her willingness to meet with President Karzai and 
the Prime Minister to reinforce this point.  The DG stressed 
the importance of good governance in eradication efforts, the 
need to monitor the use of resources, and suggested the 
possibility of an independent evaluation of the eradication 
program. 
 
¶9.  Under Secretary Dobriansky assured the DG of strong U.S. 
support for a final push for eradication, and said she would 
reinforce the DG's message to Pakistan in her meetings with 
the Pakistan and Afghanistan delegations later in the day. 
Turning to resource needs, the Under Secretary noted the U.S. 
contribution of $132 million last year and her efforts to 
press for increased contributions from other donors, 
including Kuwait.  The Under Secretary suggested the 
possibility of a donors' meeting later in the year, noting 
the desirability of a Muslim country, perhaps Kuwait or Saudi 
Arabia, acting as host. 
 
¶10.  Turning to the subject of avian influenza, the DG said 
she was working with the Minister of Health of Indonesia for 
the immediate resumption of sharing of virus strains for risk 
assessment purposes.  They are also discussing convening a 
meeting in Jakarta, possibly at the end of March, to focus on 
sample sharing and access to vaccines.  Noting the meeting 
would focus on WHO's Western Pacific and South East Asia 
regions, the DG confirmed the U.S. would be included. 
 
¶11.  Noting the H5N1 virus is well-entrenched in countries, 
the DG emphasized the need to work with FAO and OIE on 
agriculture and animal issues related to influenza.  These 
issues include the culture of maintaining backyard stocks of 
chickens, animal vaccination, compensation for owners of 
culled stocks, and possible regulation of trade in poultry. 
 
¶12.  In closing, the Under Secretary informed the DG about 
plans for the next meeting of the International Partnership 
on Avian and Pandemic Influenza (IPAPI), to be held in India 
in December. 
 
Meeting with Nigerian Delegation 
-------------------------------- 
 
¶13.  The Under Secretary met with Mrs. Amina Ibrahim, Senior 
Special Assistant to the President of Nigeria for Millennium 
Development Goals (MDGs); Dr. E. Abebe, Interim Coordinator 
of the National Program on Immunization; and representatives 
of the States of Kano and Katsina. 
 
¶14.  Noting the challenge of eradicating polio in Nigeria, 
especially in the north, the Under Secretary asked how the 
United States could be helpful.  Abebe expressed appreciation 
for U.S. contributions to the Nigerian Immunization Service 
and identified several priorities: stepping up social 
mobilization, especially to disabuse rumors and engage 
traditional rulers to support acceptance of vaccination; to 
increase support for vaccines for routine immunizations; and 
to strengthen surveillance capacity, especially for State 
epidemiologists.  The Kano representative emphasized 
supporting community groups and teachers at Koranic schools. 
The Katsina representative stressed working with Muslim 
women's organizations. 
 
¶15.  Responding to the Under Secretary's call for engaging 
religious leaders, Abebe said Nigeria had looked at the 
Egyptian experience in using religious leaders to support 
immunization programs and would build on that model.  Ibrahim 
stressed that funding had to be predictable and flexible and 
pledges had to be fulfilled.  The Under Secretary agreed, 
noting funds from the private sector were usually more 
flexible. 
 
Meeting with Indian Delegation 
------------------------------ 
 
¶16.  The Under Secretary met with Mr. N. Dayal, Union 
Secretary of Health and Family Welfare, and Mr. R. 
 
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Gopalakrishnan, Joint Secretary, Prime Minister's Office. 
Recalling her visit to India and her meeting with Foreign 
Secretary Menon, the Under Secretary underscored the U.S. 
 
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desire to have a strong partnership with India on polio 
eradication, particularly to work together on the challenges 
in Uttar Pradesh.  Noting that polio doesn't preclude 
cooperation on other health issues, the Under Secretary 
thanked Dayal for India's hosting the next IPAPI meeting in 
the fall. 
 
¶17.  Dayal thanked the Under Secretary for strong U.S.-India 
health cooperation, noting particularly collaboration with 
HHS's CDC and National Institutes of Health and the active 
role played by Dr. Altaf Lal, the HHS Health Attache.  Dayal 
said this cooperation had helped India maintain strong 
surveillance for avian influenza throughout the country, 
which had been free of the virus since last August.  He said 
India maintained an adequate stock of Tamiflu for cullers of 
poultry stock, although Tamiflu was not available for retail 
sales.  He noted that the Indian generic manufacturer, 
Ranbaxy, could produce Tamiflu. 
 
¶18.  Turning to polio, Dayal noted the increase in cases in 
2006 (672) compared to 2005 (66), but said the immunization 
rounds conducted at the end of last year and the beginning of 
this year gave him confidence that the cases would be 
reduced.  He observed that the National Rural Health Mission 
program would receive additional funds to address polio 
eradication and the Associated Social Health Activists 
program was recruiting women at the village level to 
integrate polio eradication in child health programs. 
 
Meeting with Delegation of Afghanistan 
-------------------------------------- 
 
¶19.  The Under Secretary met with Dr. N. Mojadidi, Advisor to 
the President of Afghanistan on Health and Education, and Dr. 
¶F. Kakar, Deputy Minister of Public Health.  The Under 
Secretary, noting the strong cooperation in health between 
 
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Afghanistan and the United States, expressed the desire for 
continued partnership on polio eradication, especially along 
the border with Pakistan. 
 
¶20.  Mojadidi, noting he had worked in WHO for thirteen years 
and had also served as Minister of Health, identified two key 
issues he wished to discuss "off the record."  He described 
the first as political - the need for the United States to 
pressure Afghanistan's "neighbors" not to interfere in its 
problems, citing particularly the holding of days of 
tranquillity.  The second issue was financial, he said, 
 
signaling that President Karzai would write to donors seeking 
financial support, but that polio was just one of many key 
priorities.  These included security issues, such as 
protecting hospitals and clinics, social mobilization, and 
infrastructure, such as schools and roads.  The Under 
Secretary responded by emphasizing President Bush's 
 
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encouragement of a broader dialog between Afghanistan and 
Pakistan, and noted the U.S. resources available for 
reconstruction. 
 
¶21.  Kakar said the goodwill of the United States for 
Afghanistan was not translated into health assistance, and 
that HHS should be more involved with Afghanistan in projects 
related to maternal and child health, nutrition, and support 
for Afghanistan's new Public Health Institute, which is 
modeled on CDC.  The Under Secretary assured Kakar she would 
raise this matter with HHS Secretary Leavitt. 
 
Meeting with Delegation of Pakistan 
----------------------------------- 
 
¶22.  The Under Secretary met with M. Nasir Khan, Federal 
Minister of Health, and Dr. R. A. Hafiz, National Programme 
Manager for Immunizations of the Ministry of Health.  In 
response to the Under Secretary's question on holding 
immunization days, the Minister said Pakistan was 
administering vaccines all the time, particularly at border 
points.  Saying immunization activities were coordinated with 
Afghanistan, the Minister said the NATO command did not 
approve tranquillity days, an issue he intended to raise with 
the American Ambassador.  He said he had also asked the DG to 
raise this issue with NATO. 
 
¶23.  Turning to the topic of U.S. assistance, the Minister 
said that the bulk of USAID funds were channeled through 
NGOs, and that USAID should give more consideration to 
government priorities and programs, a subject he has 
discussed with the USAID Mission. Saying the government is 
both transparent and accountable, he recalled former HHS 
Secretary Thompson's view that the health sector could be 
 
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used to improve communications between Pakistan and the 
United States.  The Minister said CDC had been very helpful 
with the National Institute of Health of Pakistan, modeled on 
CDC, particularly in strengthening surveillance and routine 
immunizations.  He regretted, however, that support from HHS 
to build a hospital to treat land mine victims had not been 
forthcoming.  The Under Secretary said she would raise these 
concerns with HHS Secretary Leavitt. 
 
 
Press Conference 
---------------- 
 
¶24.  The Under Secretary, joined by Dr. Kent Hill, met with 
journalists to discuss her participation in the polio 
consultation.  The well-attended event included 
representatives from Reuters, Associated Press, Agence France 
Presse, Kuwait News Service, and Voice of America.  After an 
opening statement, the Under Secretary and Dr. Hill responded 
to questions covering what was new coming out of the 
consultation, eradication vs. control, adoption of milestones 
and benchmarks, resource issues, including the role of the 
OIC, cease fires for immunization days in conflict zones and 
the role of NATO, claims that the vaccine causes infertility, 
and engaging community and religious leaders. 
 
¶25.  Under Secretary Dobriansky cleared this cable. 
TICHENOR