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DE RUEHTA #0267/01 0440958
ZNR UUUUU ZZH
O 130958Z FEB 09
FM AMEMBASSY ASTANA
TO RUEHC/SECSTATE WASHDC IMMEDIATE 4613
INFO RUCNCIS/CIS COLLECTIVE 1188
RUCNCLS/SOUTH AND CENTRAL ASIA COLLECTIVE
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RUEHBJ/AMEMBASSY BEIJING 0585
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RHMFIUU/CDR USCENTCOM MACDILL AFB FL
RUEHAST/USOFFICE ALMATY 1203
RUEHPH/CDC ATLANTA

UNCLAS SECTION 01 OF 02 ASTANA 000267 
 
SENSITIVE 
SIPDIS 
 
STATE FOR SCA/CEN, EUR/ACE, F 
STATE PLEASE PASS TO USAID 
 
E.O. 12958: N/A 
TAGS: PGOV PREL EAID EINV SOCI KNNP KZ
SUBJECT:  KAZAKHSTAN:  NEW MINISTER OF HEALTH PLEDGES CONTINUED 
PARTNERSHIP WITH UNITED STATES 
 
ASTANA 00000267  001.2 OF 002 
 
 
¶1. (U) Sensitive but unclassified.  Not for public Internet. 
 
¶2. (SBU) SUMMARY:  On February 12, the Ambassador met for the first 
time with new Minister of Health Zhaksylyk Doskaliyev, and further 
reinforced the strong partnership that exists between the United 
States and Kazakhstan in the area of health-care reform.  Minister 
Doskaliyev praised the achievements of the past, particularly the 
training programs for primary care and family health practitioners, 
and looked forward to formalizing our bilateral partnership in 
health-care reform through a Memorandum of Understanding (MOU) 
between the Ministry and USAID.  The Minister invited the 
contributions of U.S. technical experts in the development of the 
Ministry's new multi-year health strategy, as well as assistance in 
the implementation of grant funds from the Global Fund to Fight 
AIDS, TB, and Malaria.  He welcomed further U.S. assistance provided 
through the Cooperative Threat Reduction program to establish a 
Central Reference Laboratory and expand the Electronic Integrated 
Disease Surveillance System.  The Minister also provided some advice 
that he believed would facilitate General Electric's plans to 
further market its high-tech medical equipment in Kazakhstan.  END 
SUMMARY. 
 
NEW DOSKALIYEV LIKE THE OLD DOSKALIYEV, OR NOT? 
 
¶3. (SBU) The Ambassador met with Minister of Health Zhaksylyk 
Doskaliyev on February 12 to discuss several ongoing initiatives of 
the U.S. government in health care reform.  The Minister, although 
just recently appointed to his post in November, is hardly a 
newcomer.  He previously served in the same position 2000-2004.  He 
recently served as the Rector of the Kazakh State Medical Academy in 
Astana (2004-07), and as a member of Parliament (2007-08).  During 
his first tenure as Health Minister, he was viewed as one rather set 
in his ways and not particularly forward thinking.  Shortly after he 
took office in 2001, in fact, the Government of Kazakhstan cancelled 
a loan from the World Bank on health-care restructuring.  He was 
viewed as unsupportive of programs that promoted primary health 
care, and that utilized international technical assistance and 
training programs. 
 
¶4. (SBU) However, based on his statements during his meeting with 
the Ambassador, Minister Doskaliyev is much more amenable to 
international technical assistance the second time around.  He had 
high praise for USAID assistance, particularly training programs for 
family doctors in primary health care.  He also welcomed each 
initiative that the Ambassador proposed on strengthening the 
partnership of the Ministry of Health with U.S. government 
assistance programs.  Moreover, Minister Doskaliyev welcomed a 
recent agreement with the World Bank on a comprehensive health-care 
loan and assistance program. 
 
MINISTER SUPPORTS MOU WITH USAID 
 
¶5. (SBU) The Ambassador stressed the need to continue the 
collaborative relationship in the future, particularly through a 
Memorandum of Understanding (MOU) between USAID and the Ministry 
formalizing the bilateral partnership in the area of health care 
reform.  He offered U.S. technical assistance on the development of 
Kazakhstan's new health strategy, and with the implementation of 
grant funds received by Kazakhstan from the Global Fund to Fight 
AIDS, TB, and Malaria.  The Ambassador proposed the support and 
assistance of the U.S. Centers for Disease Control and Prevention 
(CDC) and the U.S. Defense Threat Reduction Agency (DTRA) in the 
development of a long-term plan for the proposed Central Reference 
Library and U.S.-funded zonal diagnostics laboratories, as well as 
in adapting Kazakhstan's Electronic Integrated Disease Surveillance 
System to cover all reportable diseases. 
 
¶6. (SBU) The Minister endorsed formalizing the partnership between 
the Ministry and USAID with an MOU.  He stated that, "USAID can 
submit its draft MOU at any time, and I am sure we will sign it." 
 
ASTANA 00000267  002.2 OF 002 
 
 
He suggested the organization of a public event for the signing of 
the agreement to better recognize the ongoing partnership in 
health-care reform between the two countries.  (NOTE:  USAID health 
officers are working on a draft of this MOU, which we expect to 
submit to the Ministry by the end of February.  END NOTE.) 
 
WE LIKE TECHNICAL ASSISTANCE NOW 
 
¶7. (SBU) Minister Doskaliyev also welcomed USAID's contributions and 
technical assistance on the Ministry's new long-term strategy on 
health care, and invited USAID specialists to an event taking place 
later that same day.  He further stated that, "the opinions of U.S. 
experts are very important to Kazakhstan," and he welcomed their 
recommendations.  He also approved of any additional technical 
assistance USAID might be able to provide on programs implemented in 
Kazakhstan with grants received from the Global Fund to Fight AIDS, 
TB, and Malaria.  (NOTE:  To date, Kazakhstan has received two 
HIV/AIDS grants that total $57 Million, as well as two TB grants 
that total $75 Million.  END NOTE.) 
 
¶8. (SBU) Concerning the Cooperative Threat Reduction program's four 
completed zonal diagnostic laboratories and the planned Central 
Reference Laboratory, the Minister stated that these laboratories 
are badly needed given the challenges facing the country, including 
emerging health threats such as avian influenza and non-typical 
pneumonia.  The Minister then meandered through a confusing, 
pseudoscientific discussion about border-crossing rivers, the water 
temperature at which cholera is active (at this point vigorously 
prompting a bewildered staff member to nod confirmation to his guess 
of 12 degrees centigrade), and the underestimated insidiousness of 
camel pox and how it is dealt with in Kazakhstan, finally making the 
point that Kazakhstan is a transit zone for many exotic diseases 
that have to be studied together with international partners in a 
collaborative setting.  He concluded that he saw the Central 
Reference Laboratory as the perfect solution. 
 
GE -- WE BRING GOOD THINGS TO KAZAKHSTAN 
 
¶9. (SBU) Minister Doskaliyev viewed General Electric's (GE) interest 
in expanding its sales of high-tech medical equipment in Kazakhstan 
very positively.  He advised that, "to intensify cooperation 
(between the Government of Kazakhstan and GE), the company needs to 
open a factory in Kazakhstan to produce medical equipment so that GE 
can conquer the market.  Kazakhstan would invest in such a project 
also, and this fits with the President's plan of 100 hospitals."  He 
further stressed that Kazakhstan will have 300 medical laboratories 
that will need modern high-tech medical equipment.  He said that 
with a total population of 55 million in Central Asia, the potential 
market for GE stretches beyond Kazakhstan.  Now is the "golden time" 
for investment in Kazakhstan, so "let's get started." 
 
¶10.  (SBU) COMMENT:  Minister of Health Doskaliyev, at least at this 
early stage of his second time around in this post, seems much more 
disposed towards international assistance in health-care reform.  He 
supported each initiative the Ambassador raised, and expressed his 
appreciation for past assistance and pledged continued cooperation. 
While it may be too soon to reopen discussions with the Ministry on 
opportunities for cost-sharing arrangements between the Government 
of Kazakhstan and U.S. foreign assistance agencies (similar to 
Kazakhstan's agreement with USAID on the Program for Economic 
Development), such opportunities should be explored again in the 
future.  END COMMENT. 
 
HOAGLAND