VZCZCXYZ0321
RR RUEHWEB

DE RUEHAM #1142/01 1080726
ZNR UUUUU ZZH
R 170726Z APR 08
FM AMEMBASSY AMMAN
TO RUEHC/SECSTATE WASHDC 2271
INFO RUEHGB/AMEMBASSY BAGHDAD 5938
RUEHTV/AMEMBASSY TEL AVIV 1137
RUEHRH/AMEMBASSY RIYADH 1932
RUEHDM/AMEMBASSY DAMASCUS 3863
RUEHEG/AMEMBASSY CAIRO 3611
RUEHYN/AMEMBASSY SANAA 0638
RUEHKH/AMEMBASSY KHARTOUM 0026
RUEHAS/AMEMBASSY ALGIERS 0200
RUEHJM/AMCONSUL JERUSALEM 4975
RUEAUSA/DEPT OF HHS WASHDC
RUEHRC/DEPT OF AGRICULTURE WASHDC

UNCLAS AMMAN 001142 
 
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SENSITIVE 
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STATE FOR OES AND NEA/ELA 
STATE PASS TO USAID 
HHS FOR JANE COURY (HHS/OGSA) 
 
E.O. 12958: N/A 
TAGS: PREL TBIO ETRD KIPR JO
SUBJECT:  HHS DEPUTY SECRETARY TROY VISIT TO JORDAN BOLSTERS MEDICAL 
DIPLOMACY 
 
(U) SENSITIVE BUT UNCLASSIFIED.  NOT FOR INTERNET DISTRIBUTION 
 
Ref:  Amman 51 
 
¶1.  (SBU) Summary: Health and Human Services (HHS) Deputy Secretary 
Tevi Troy's March 30-April 2 visit to Jordan included the 
high-profile groundbreaking for the King Hussein Institute for 
Biotechnology and Cancer (KHIBC) with King Abdullah and Queen Rania. 
 In other meetings, Troy discussed Jordan's initiatives in improving 
youth health and nutrition with the Ministry of Education, and the 
physical fitness programs undertaken by the Royal Health Awareness 
Society.  At the Wadi Mousa boys' school in the Petra area, Troy 
joined an athletic demonstration by participants in the King 
Abdullah Award for Physical Fitness (modeled after the U.S. 
President's Challenge program).  HHS Food and Drug Administration 
(FDA) Commissioner Dr. Andrew von Eschenbach joined the Deputy 
Secretary in meetings with Minister of Health Salah Mawajdah, the 
 
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Jordan Food and Drug Administration (JFDA), and representatives from 
the food and pharmaceutical sectors to discuss increases in medical 
and regulatory collaborations, the possibility of pharmaceutical 
clinical trials in Jordan, and bolstering trade between Jordan and 
the U.S.  The visit garnered positive media coverage and highlighted 
how U.S. Government investments in scientific and technical 
collaborations, as well as health diplomacy, can deliver tangible 
benefits to both Jordanian and U.S. citizens.  End Summary. 
 
KHIBC'S GOAL OF BECOMING A REGIONAL 
CENTER FOR CANCER HEALTHCARE 
------------------------------------ 
 
¶2. (U) Deputy Secretary Troy was invited by King Abdullah to attend 
the March 31 groundbreaking for the $200 million King Hussein 
Institute for Biotechnology and Cancer (KHIBC).  The high-profile 
ceremony was attended by King Abdullah, Queen Rania, Prime Minister 
Nader al-Dahabi, and Faisal El-Fayez, Chairman of the Board of 
Trustees of KHIBC.  Dr. Samir Khleif from the HHS/NIH National 
Cancer Institute (NCI) serves as the KHIBC Director-General through 
a July 2006 HHS agreement with the Government of Jordan.  Deputy 
Secretary Troy and Khleif delivered remarks highlighting USG support 
 
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to strengthen U.S.-Jordanian friendship, and how improved medical 
care and clinical trials at KHIBC could further establish Jordan as 
a leading care facility for cancer and other health innovations. 
 
¶3.  (U) The KHIBC event garnered wide coverage in newspaper and 
print media, including a seven-minute lead feature in the evening 
news on Jordanian television.  The media focused on the KHIBC vision 
of transforming Jordan into a regional leader for cancer healthcare 
and biotechnology research based on the latest scientific and 
technological advances. 
 
Healthcare Costs Rising in Jordan 
--------------------------------- 
 
¶4.  (SBU) The Deputy Secretary also met with Health Minister 
Mawajdah and the JFDA Director General Dr. Mohammad Rawashdeh on 
March 31.  After thanking HHS for strong USG support, including 
prior NCI support for the King Hussein Cancer Center, Mawajdah 
shared some of the key challenges facing Jordan's healthcare system: 
 22 percent of Jordanians lack health insurance; the increasing 
percentage of GDP spent on healthcare; and the growing prevalence of 
chronic diseases.  According to Mawajdah, the impact of Iraqi 
refugees on the healthcare system is not well understood, but he 
emphasized that the 650 healthcare centers in Jordan provide 
services to all patients irrespective of nationality.  Jordan is 
also increasing its revenues through medical tourism, estimated by 
Mawajdeh at roughly $1 billion annually, with the majority of 
foreign patients coming from Yemen, Sudan, Algeria, Syria, and the 
Gulf countries.  Other U.S. participants included FDA Commissioner 
von Eschenbach, FDA Deputy Commissioner Murray Lumpkin, and the 
Ambassador. 
 
Exploring Cooperation in Drug and Food Safety 
--------------------------------------------- - 
 
¶6.  (U) Deputy Secretary Troy hosted a working breakfast March 31 
with Health Minister Mawajdah, JFDA Director General Rawashdeh and 
 
other JFDA officials, Royal Court Economic Advisor Maher Matalka, 
Chairman and Secretary General of the Jordan Association of 
Pharmaceutical Manufacturers (JAPM), the Regional Representative of 
the Pharmaceutical Manufacturers of America (PhRMA), the Chairman of 
the American Chamber of Commerce, the CEO of Jordan Exporters 
Association, and other private sector representatives from the 
pharmaceutical and food manufacturing sectors. 
 
¶7.  (SBU) Mawajdah noted the strong cooperation between U.S. FDA and 
JFDA, which is critical to U.S.-Jordan trade in the food and 
pharmaceutical sectors, and Jordan's desire to benefit from the U.S. 
FDA experiences through even closer ties.  Matalka suggested that 
such cooperation be formalized through a memorandum of 
understanding.  Commissioner von Eschenbach praised the progress 
achieved by JFDA, and indicated that the FDA was interested in 
exploring areas of further cooperation to continue promoting Jordan 
as a leader within the Middle East. 
 
¶8.  (SBU) Rawashdeh noted that through JFDA's transparent and 
efficient approval process, drugs can sometimes be registered in 
Jordan within 4-6 months of HHS/FDA approval.  Given that the JFDA 
is highly respected in the region, he said that once drugs are 
registered in Jordan, it becomes easier to register them in other 
Middle Eastern countries.  The PhRMA representative agreed, saying 
that JFDA should become a model for the region.  Mawajdah noted that 
Jordan had proposed the idea of using JFDA as an umbrella regulatory 
organization for countries in the Middle East region, but it was met 
with a lukewarm reception given the complexities associated with 
each country's by-laws.  He proposed that Jordan and its neighbors 
might consider harmonizing their regulations as an initial step. 
 
¶9.  (U) Regarding trade, Mr. Raja Khouri, Chairman of the American 
Chamber of Commerce, and JAPM described the Jordanian pharmaceutical 
industry as a rising star, with 2007 exports worldwide totaling $432 
million and expected to rise to $1 billion by 2011.  NOTE: Jordanian 
pharmaceutical exports to the U.S. rose 40 percent to $3.96 million 
in 2007, but still only represented 2 percent of total exports to 
the U.S.  END NOTE.  In order to further increase pharmaceutical 
exports to the U.S., JAPM requested technical assistance from the 
HHS/FDA for local generic producers to better understand the HHS/FDA 
registration process and good clinical practices.  HHS/FDA agreed to 
explore the possibility of conducting such a workshop.  JAPM also 
inquired about the possibility of HHS/FDA conducting pre-inspections 
of local pharmaceutical companies before submitting a new drug 
application, which HHS/FDA responded was not normally done.  Deputy 
Commissioner Lumpkin clarified some confusion amongst the 
participants regarding the difference between U.S. requirements for 
registration versus approval.  He offered future assistance on 
clarifying U.S. standards and processes. 
 
¶10.  (U) Local food manufacturers present noted the difficulty of 
exporting food containing meat products to the U.S., and indicated a 
lack of progress after a February 2005 visit from USDA's Food Safety 
Inspection Service which detailed the necessary upgrades and 
regulatory improvements that would be needed to export to the U.S. 
(reftel).  JFDA and the Ministry of Agriculture noted that work has 
been ongoing to amend the food safety law.  When asked for 
assistance with getting HHS/FDA approval, the FDA Commissioner 
clarified that it does not provide approval for food imports, but 
the agency could help ensure better understanding of U.S. standards 
and processes.  The role of USDA in food safety was also 
highlighted. 
 
Promoting Children's Health 
--------------------------- 
 
¶11.  (U) In a meeting with Dr. Fawwaz Jaradat, Secretary General of 
the Ministry of Education (MOE), and Enaam Barrishi, Executive 
Director of the Royal Health Awareness Society, the Deputy Secretary 
discussed Jordan's initiatives in improving child and adolescent 
health through the physical fitness programs undertaken by the Royal 
Health Awareness Society.  The MOE also has 310,000 public school 
students from kindergarten through sixth grade participating in 
nutrition programs.  Students receive fortified biscuits, fruits, 
and dates.  The MOE is also increasing its school hygiene program. 
 
Physical Fitness at Wadi Mousa Boys School 
------------------------------------------ 
 
¶12.  (U) Deputy Secretary Troy visited the Wadi Mousa boys' schools 
in Petra April 1, accompanied by Samer Al-Kasih, Project Manager for 
the King Abdullah II Award for Physical Fitness.  The Deputy 
Secretary joined an athletics demonstration by school children 
 
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participating in the King Abdullah Award for Physical Fitness 
(modeled after the U.S. President's Challenge program).  The program 
has garnered impressive growth from the 19,000 participating 
students in its 2006 inception to over 172,000 participating 
students in 2008.  NOTE: In January 2008, 10 students from Jordanian 
schools visited the U.S. to understand U.S. physical fitness 
programs. END NOTE.  Media coverage for this event was 
overwhelmingly positive, highlighting the importance of the physical 
education exchange programs with several pictures of Deputy 
Secretary Troy doing push-ups along with the students. 
 
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¶13.  (U) HHS reviewed and cleared this message. 
 
Visit Amman's Classified Web Site at 
http://www.state.sgov.gov/p/nea/amman 
 
 
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