R 090726Z MAR 09
FM AMEMBASSY BAGHDAD
TO SECSTATE WASHDC 2057
AMEMBASSY ANKARA 
AMCONSUL ISTANBUL

UNCLAS BAGHDAD 000605 
 
 
E.O. 12958:  N/A 
TAGS: AORC ECIN BEXP CVIS IZ ECON PGOV PREL
SUBJECT:  IRAQ HEALTH INVESTMENT SUMMIT HIGHLIGHTS PROGRESS, 
CHALLENGES 
 
REF:  Baghdad 317 
 
¶1.  SUMMARY.  The Iraq Health Investment Summit, held on February 
19-20 in Istanbul, Turkey, was a key opportunity for the Minister of 
Health (MOH), Dr. Salih al-Hasnawi, to showcase Iraq's 2009-2013 
strategic health plan and to solicit partnerships with private 
companies for Iraq's healthcare system.  Potential investors said 
they believed there were opportunities to be tapped in this new 
healthcare market.  Despite repeated assurances from the Minister of 
Health that security in Iraq has improved and has been stable for 
over a year, the optimism was tempered by concerns over the 
fragility of the security situation and weak MOH infrastructure 
capacity.  Iraqi and American investors complained about the 
"cumbersome" U.S. visa process hampering business opportunities in 
Iraq.  Academics and medical professionals expressed optimism that 
after years of difficulty in the US-Iraq healthcare relationship, 
partnerships and exchanges with the influential medical cadre can 
help rebuild Iraqis' confidence in America. END SUMMARY. 
 
FIRST EVER IRAQ HEALTH INVESTMENT 
CONFERENCE A SUCCESS 
--------------------------------- 
¶2.  The MOH hosted over 100 medical company representatives and the 
World Health Organization to its February 19-20 Iraq Health 
Investment Summit in Istanbul.  The conference outlined the 
ministry's strategic plan for 2009-2013 and acknowledged shortfalls 
and mechanisms being put in place to reform some archaic systems, 
such as Kimadia, the state-owned and operated medical 
equipment/pharmaceutical procurement and distribution organization 
for the MOH.  The U.S.-Iraq Chamber of Commerce also provided 
practical investment guidelines to companies looking to do business 
in Iraq.  The GOI delegation was comprised of the Minister of Health 
and his most knowledgeable and articulate Director Generals, as well 
as two of the Prime Minister's representatives, a member of the 
Council of Representatives Health and Environment Committee, and 
leaders in Iraqi medicine and education.  Members of the Iraqi 
delegation challenged each other during the general sessions, asking 
tough questions, including discussion on decision making processes 
and the length of time to turn contracts around. 
 
PRIORITIES FOCUS ON PRIMARY HEALTHCARE AND NURSING 
--------------------------------------------- ----- 
¶3.  The MOH presented an ambitious strategic plan covering 26 areas, 
many aimed at achieving the Millennium Development Goals as well as 
international standards of improved healthcare.  The MOH presented 
in great detail its construction plans to expand the primary 
healthcare center (PHC) network as well as the construction of new 
hospitals across Iraq.  In the coming years, the MOH infrastructure 
expansion plan includes construction of an additional 1,500 PHCs 
(estimates for existing PHCs range from 1,200-1,900 depending on how 
clinics and satellites are defined) and increasing the number of 
hospital beds available for secondary and tertiary care.  The GOI 
has developed plans to construct seven "turn-key" hospitals in 2009 
and has already awarded over $1.5 billion in hospital contracts to 
Turkish, Australian and German companies.  The Minister of Health 
also announced that 2009 was the "Year of Nursing."  Follow-up 
discussions with the World Health Organization (WHO) country lead 
indicated that further commitment from the MOH was needed in 
addressing the nursing sector.  The MOH will focus on actions to 
garner positive publicity about nurses and the nursing profession to 
combat years of neglect and lack of training.  The WHO has already 
Qcombat years of neglect and lack of training.  The WHO has already 
been working closely with the Ministries of Health and Higher 
Education on key projects aimed at improving education of and 
services provided by nurses and addressing the stigma associated 
with the nursing profession. 
 
SECURITY AND MOH CAPACITY A LINGERING CONCERN 
--------------------------------------------- 
¶4.  The improvement in security was noted several times throughout 
the conference, both by Dr. Salih and members of his delegation. 
Despite repeated reassurances, conference participants remained 
cautious about making any concrete commitments despite the potential 
of a growing health market.  Several company representatives already 
active in Iraq's health sector, with some employing hundreds of 
individuals across the country, noted to other potential investors 
that the security situation had improved, yet reforms in MOH 
procurement and contracting were still needed.  Dr. Salih urged 
companies to "become partners" with Iraq to improve the healthcare 
system and service delivery as they developed business contracts. 
 
AMERICAN BUSINESSES AND IRAQIS CALL FOR 
REVISED U.S. VISA POLICY 
--------------------------------------- 
¶5.  While security was identified as a hindrance to doing business 
in Iraq, no other issue was raised more vehemently than the 
difficulty in obtaining U.S. visas.  Both American businesses and 
Iraqis spoke at length about the negative impact the cumbersome visa 
process was having on investment and educational exchanges.  One 
Iraqi complained of a rising cardiologist having to turn down a 
fully-sponsored invitation to the American Cardiologist Association 
meeting in Florida because he was invited with less than a four 
month window. 
 
¶6.  The Health Attach explained the visa process and encouraged 
attendees to plan their travel to the U.S. well in advance.  While 
the group appreciated the various checks built into the visa 
processing system, they were "sad to see that U.S. policies are 
preventing U.S. businesses from investing in Iraq" and noted that 
European countries, which issue visas to Iraqis in approximately two 
weeks, were "running over" American businesses.  A group of 
conference participants are currently in the process of mobilizing 
support from Congressional leaders to ask the Department to 
reexamine Iraqi visa regulations.  The business representatives 
contended that improving the visa process has the potential of 
saving many small American businesses, which lose from foreign 
competitors who are able to host Iraqis in their countries. 
 
WAY AHEAD THROUGH U.S.-IRAQI PARTNERSHIPS 
------------------------------------------- 
¶7.  The Health Attach and NEA/I Desk Officer met with a prominent 
Iraqi cardiologist who has been responsible for overseeing a 
physician exchange partnership funded by the United Kingdom's 
Department of Health.  Dr. Hillal Shawki shared in great detail the 
implementation process of this successful exchange program, which in 
two years has trained 400 Iraqi medical professionals in the United 
Kingdom for $9 million.  This program includes rigorous selection 
criteria and a strong monitoring and evaluation component carried 
out by Dr. Shawki and a group of volunteers from Iraq's medical and 
higher education professional cadre.  As part of the eight week 
observerships, participation includes courses on Change Management 
and Clinical Observation.  Dr. Shawki believed this successful UK 
model could be replicated by the U.S. as a joint commitment under 
the Strategic Framework Agreement.  Dr. Shawki encouraged the U.S. 
to implement programs that would help "win the battle of trust" by 
regaining the "hearts and minds" of the educated middle class which 
can influence younger generations. 
 
¶8.  COMMENT.  Despite security concerns, conference participants 
agreed that Iraq provides an excellent medical business market worth 
several hundred million dollars each year, and this is a critical 
time for businesses to enter the market.  As Iraq rebuilds its 
healthcare infrastructure, the MOH will need to make significant 
investments in businesses and systems to meet its public health 
needs.  In addition, health diplomacy through increased medical 
exchanges will become an effective tool at "winning the heart and 
minds" of the educated middle-class Iraqis.  This conference, 
initiated and funded by the MOH, is reflective of an Iraqi Ministry 
actively seeking willing partners to advance its strategic goals. 
In recent months, we have increasingly registered louder 
frustrations by Iraqis and American investors on the visa process in 
this and other fora; this will continue to be a thorny issue as Iraq 
opens up for business throughout all its sectors, and travel to the 
U.S. becomes a key component of bilateral exchanges.  As Iraq's 
health sector continues to develop its investments and reforms, we 
will remain engaged in our programs and foreign assistance in 
healthcare programs with a focus on maintaining stability and 
further improving service delivery.  END COMMENT. 
 
BUTENIS