VZCZCXRO8503
PP RUEHLH RUEHPW
DE RUEHIL #2970/01 2531122
ZNR UUUUU ZZH
P 091122Z SEP 08
FM AMEMBASSY ISLAMABAD
TO RUEHC/SECSTATE WASHDC PRIORITY 8703
INFO RUEHNE/AMEMBASSY NEW DELHI 3741
RUEHKP/AMCONSUL KARACHI 0281
RUEHLH/AMCONSUL LAHORE 6023
RUEHPW/AMCONSUL PESHAWAR 4828

UNCLAS SECTION 01 OF 02 ISLAMABAD 002970 
 
DEPT OF HHS WASHINGTON DC 
 
SENSITIVE 
AIDAC 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: TBIO EAID PGOV PK SOCI KOCI
SUBJECT: HHS SECRETARY LEAVITT'S MEETING WITH THE MINISTER OF HEALTH 
 
¶1. (SBU) Summary: On August 19, Health and Human Services Secretary 
Michael Leavitt and the Minister of Health Sherry Rehman met at the 
Ministry of Health (MOH). The Minister and the MOH Director General 
identified the lack of health services and state presence in parts 
of Pakistan as contributing to anti-government political trends in 
some regions.  They summarized the current government's priority 
areas for the health sector: improving maternal and child health and 
meeting the Millennium Development Goals; training health workers; 
upgrading infrastructure; building a regulatory framework for 
pharmaceuticals; and developing capacity to produce and export 
quality medicines and vaccines. Secretary Leavitt said that the U.S. 
would like to continue to work with the Minister and her staff to 
identify areas for exchange and assistance.  End summary. 
 
¶2. (SBU) On August 19, the Secretary of the U.S. Department of 
Health and Human Services (HHS) Michael Leavitt and Pakistan 
Minister of Health Sherry Rehman met at the Ministry of Health in 
Islamabad. Minister of Health Sherry Rehman (who is also the 
Minister of Information and Broadcasting) thanked Secretary Leavitt 
for responding quickly to the invitation she had extended during 
their recent meeting in Washington, D.C.  She expressed her hope 
that, going forward, Pakistan would benefit from U.S. expertise and 
best practices in the health sector. Secretary Leavitt called his 
visit "health diplomacy" and stated that his purpose was to learn 
more about health issues in Pakistan. 
 
¶3. (SBU) MOH Director General Dr. Rashid Jooma declared that the 
current government, unlike the previous one, would do more than give 
lip service to improving primary health care in Pakistan. He stated 
that the GOP plans to augment health services, especially where the 
state has been weak or absent in the past.  Dr. Jooma and Minister 
Rehman ascribed the political "reorientation" of segments of 
Pakistan's population to the government's inadequate delivery of 
services in certain parts of the country. 
 
¶4. (SBU) Dr. Jooma said that although Pakistan's resource 
limitations make it difficult to fill the significant gaps in the 
health sector, reforms are underway.  The MOH's 3-fold approach to 
improving the health sector focuses on (1) infrastructure; (2) 
training; and, (3) well-designed and monitored services. The MOH 
plans to continue to expand the Lady Health Workers cadre (that 
implements a successful rural health care program); increase births 
in health care facilities to reduce maternal and infant mortality 
(which remain high in Pakistan); increase childhood vaccination 
rates; and increase access to safe drinking water.  Pakistan would 
welcome assistance from the U.S. in all of these areas, Dr. Jooma 
added. 
 
¶5. (SBU) The Minister and DG requested assistance from the U.S. to 
boost the quality and competitiveness of its fledgling 
pharmaceutical industry, which cannot export to the U.S. now because 
products do not conform to U.S. standards.  The Minister stated that 
the GOP's drug regulatory authority will most likely be placed 
outside of the MOH.  She requested assistance to develop an FDA-like 
agency, with statutory and regulatory authority that would in turn 
strengthen the country's pharmaceutical sector. She also would like 
help with pricing of pharmaceuticals, and making Pakistan eligible 
for participation in drug trials. 
 
¶6. (SBU) Secretary Leavitt observed that the U.S.G is highly 
concerned with the safety and quality of imported products.  In the 
face of increasing import volume, there has been a major shift in 
U.S. policy away from direct inspection.  Instead, the U.S.G will 
assume the role of accreditor of independent certification bodies 
that will conduct inspections of production facilities.  He cited 
discussions now underway among the U.S., Canada, Japan, Australia, 
the UK and others to begin harmonizing pharmaceutical standards. 
 
¶7. (SBU) The Secretary recommended that Pakistan align itself with 
these global trends in order to build a pharmaceutical industry with 
global credibility.  He and his team also stressed the importance of 
intellectual property rights (IPR) and data exclusivity. Leavitt 
said that the HHS would make production rights available to Pakistan 
for Hepatitis E vaccine. 
 
¶8. (SBU) The Minister and DG also requested help in the areas of 
health insurance and training and retention of nurses.  The 
Secretary noted that these are difficult issues facing the U.S. as 
well. He suggested that there may be areas for collaboration in 
setting standards for training of nurses and other health workers. 
 
 
¶9. (SBU) The Minister said one of the most daunting problems facing 
the MOH is how to reach women in the tribal areas and parts of 
Balochistan.  She explained that there is a "cultural resistance" 
 
ISLAMABAD 00002970  002 OF 002 
 
 
that has worsened in the last 5-7 years.  Even Lady Health Workers 
"meet with lots of opprobrium."  She recounted that there have been 
attacks on mobile health units and on health workers. At the same 
time, remote communities want curative care services. 
 
¶10. (SBU) Leavitt inquired about the use of telemedicine in 
Pakistan, and suggested that it could be helpful for dispersed rural 
populations.  The DG said that there are two telemedicine hubs now 
operating from teaching hospitals: one in Karachi and one in 
Rawalpindi. 
 
¶11. (SBU) The principals agreed to work together over the next six 
months to define potential areas of cooperation. 
 
¶12. (SBU) Comment: USAID is currently providing assistance exceeding 
$100 million in FY08 to the health care sector in Pakistan in 
maternal and child health, family planning, water and sanitation, 
and control of infectious diseases. USAID and CDC collaborate 
closely on public health training and infectious diseases programs. 
End comment. 
 
¶13. (U) This cable has not been cleared by Secretary Leavitt. 
 
PATTERSON