VZCZCXRO7791
RR RUEHHM
DE RUEHHI #1293/01 3291041
ZNR UUUUU ZZH
R 241041Z NOV 08
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 8769
INFO RUEHHM/AMCONSUL HO CHI MINH 5321
RUEHBK/AMEMBASSY BANGKOK 6528
RUEHPH/CDC ATLANTA GA
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUEAUSA/DEPT OF HHS WASHINGTON DC

UNCLAS SECTION 01 OF 02 HANOI 001293 
 
SENSITIVE 
SIPDIS 
 
STATE FOR AMBASSADOR MARK DYBUL 
STATE FOR EAP/MLS, EAP/EP, INR, OES/STC, OES/IHA, OGAC 
STATE PASS TO USAID FOR ANE AND GH 
HHS/OSSI/DSI PASS TO OGHA (WSTIEGER/LVALDEZ/MABDOO), FIC/NIH 
(RGLASS), AND FDA (MLUMPKIN/WBATTS) 
CDC FOR COGH (SBLOUNT/KMCALL) 
BANGKOK FOR RDM/A (CBOWES/MACARTHUR/MBRADY) 
 
E.O. 12958: N/A 
TAGS: TBIO PREL PGOV SOCI KHIV KFLU VM
SUBJECT: AMBASSADOR REVIEWS BROADER HEALTH COOPERATION WITH VICE 
MINISTER OF HEALTH 
 
¶1. (SBU) Summary.  Ambassador Michalak and Vice Minister of Health 
Nguyen Thi Kim Tien met to discuss their vision for the future of 
U.S.-Vietnam health cooperation.  Tien spoke highly of her recent 
trip to the United States, during which she met with professionals 
from U.S. government agencies, universities, and the private sector 
to discuss health care capacity building and the development of the 
health sector in Vietnam.  Tien acknowledged substantial obstacles 
to that development, notably in human resources, infrastructure, and 
regulatory reform.  Ambassador Michalak noted that growing U.S. 
educational initiative could boost Vietnamese capacity.  Both cited 
the need to increase the focus on holistic, sector-wide cooperation, 
relative to disease-specific assistance.  The upcoming negotiation 
on a "compact" under the re-authorization of the President's Plan 
for Emergency AIDS Relief (PEPFAR) represents the most probable 
avenue to contribute more broadly to health systems strengthening. 
Vice Minister Tien pledged to work with Ambassador Michalak and the 
Embassy health team to organize more detailed discussions on the way 
forward.  End Summary. 
 
¶2. (SBU) Vice Minister Tien, whose portfolio includes international 
cooperation, research, and human resource development, expressed 
pleasure with her recent trip to the United States.  In addition to 
meeting with Deputy Secretary of Health, Dr. Troy, she met with 
staff from National Institutes of Health and the Food and Drug 
Administration.  She highlighted her visit to Johnson and Johnson, 
Inc., during which she discussed the establishment of training 
project and other collaborative work, including in the medical 
device industry, in Vietnam, similar to cooperation with Russia, 
China, and India.  Tien also called on Johns Hopkins University, 
where she attended meetings at the Hospital and School of Public 
Health to discuss projects to build epidemiological capacity and 
academic exchange and training. 
 
¶3. (SBU) Vice Minister Tien asked for U.S. assistance to help 
Vietnam develop a regulatory framework for the medical device 
industry.  Currently, Vietnam must import 90 percent of this 
equipment.  Unlike pharmaceuticals, Vietnam has yet to develop the 
necessary regulatory infrastructure for medical devices and needs 
help from top to bottom.  Tien noted that the U.S. ASEAN Business 
Council planned to host a seminar in Hanoi in January 2009 on the 
medical device industry and asked that the Ambassador participate. 
The Health Attache is working with agencies in the Department of 
Health and Human Services (HHS) to identify possible assistance. 
 
¶4. (SBU) The Vice Minister emphasized three primary obstacles to the 
development of the Vietnamese health sector: 1) lack of human 
resources, 2) poor infrastructure, and 3) an inadequate legal and 
regulatory system.  Tien listed human resource development as her 
top priority, particularly in the fields of medical research and 
hospital management.  She also wanted Vietnam to increase the number 
of private hospitals and facilities competent to conduct medical 
training by international standards.  Tien acknowledged that lack of 
English language skills limited training opportunities for 
Vietnamese health professionals and urged initiatives that could 
help remedy this deficiency.  The Ministry of Planning and 
Information chaired the inter-Ministerial committee on human 
resource development, but, as a member, MOH, primarily Tien herself, 
played an important role.  Ambassador Michalak noted that the 
Embassy Education Task Force might be able to address some of 
Vietnam's health care human resource needs, though this was a 
long-term issue. 
 
¶5. (SBU) The Ambassador and the Vice Minister agreed that the two 
nations needed to take a more holistic view towards public health 
cooperation.  First, they acknowledged that preventive medicine and 
public health are not the same thing.  While helping Vietnam build 
the former, a focused discipline, was worthwhile, it did not 
substitute for overall needed development of the health sector, 
grounded in a public health framework.  Second, both noted that that 
the United States and most other donors currently align support by 
disease.  In Vietnam, the United States has strong programs for 
HIV/AIDS, influenza, and disabilities.  Indeed, she quoted one 
official on the trip to the United States as saying that U.S. 
assistance remained overly focused on HIV/AIDS, instead of building 
overall capacity.  However, as Vietnam's health care system 
develops, assistance should focus on improvements that contribute to 
health systems strengthening, rather than solely focusing on 
specific diseases.  The two nations need to prioritize this 
assistance and Ambassador Michalak and Vice Minister Tien reviewed 
 
HANOI 00001293  002 OF 002 
 
 
how to expand and improve bilateral health cooperation, building on 
the bilateral 2006 Agreement on Health and Medical Science 
Cooperation, with an eye to developing sustainable initiatives not 
completely dependent on ongoing U.S. assistance. 
 
¶6. (SBU) In light of the re-authorization of the President's Plan 
for Emergency AIDS Relief (PEPFAR), the Ambassador described the 
process of re-negotiation and our intention to establish a 5-year 
"compact."  While funding is not assured, the added emphasis on a 
broader approach to human resource development and health systems 
strengthening addresses GVN's more pressing needs.  As the two 
nations begin to discuss the nature of ongoing assistance, Tien 
agreed to meet with her Minister to select a single point of contact 
to coordinate Government of Vietnam (GVN) input.  Though the 
Ministry of Health (MOH) may take the lead, three other ministries 
also play important roles: Public Security; Education and Training; 
and Labor, Invalids, and Social Affairs. 
 
¶7. (SBU) The Ambassador and Vice Minister exchanged information on 
the ongoing development of the letter of intent (LOI) on health 
between the GVN and donors.  The LOI is being led by the MOH under 
Tien with assistance from the World Health Organization.  The 
planned non-binding LOI is a "sub-statement" on health development 
that follows from the Hanoi Core Statement on overall aid 
effectiveness, which in turn is modeled after the Paris Declaration. 
 The goal of the process is to strengthen needed advocacy in health, 
boost needed dialog on health systems strengthening (which, 
practical terms, will assist the sustainability of our HIV and 
influenza investments), and leverage better multilateral 
coordination.  As economic development usually trumps interest at 
higher levels, Tien noted the increasing role of the 40-member 
Social Affairs Committee within the National Assembly in debating 
health care policy.  She suggested that Ambassador Michalak meet 
with that body to review ongoing cooperation and discuss plans for 
the future of Vietnamese health care. 
 
Michalak