VZCZCXYZ0003
PP RUEHWEB

DE RUEHC #1371 0652103
ZNR UUUUU ZZH
P R 062046Z MAR 09
FM SECSTATE WASHDC
TO RUEHGB/AMEMBASSY BAGHDAD PRIORITY 0000
INFO RUEHAK/AMEMBASSY ANKARA 0000

UNCLAS STATE 021371 
 
SENSITIVE 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: CMGT CVIS VO PA PGOV PREL SOCI ECON IZ
SUBJECT: IRAQ MINISTRY OF HEALTH INVESTMENT CONFERENCE: 
STRATEGIC PLAN, VISAS AND EDUCATION PARTNERSHIPS 
 
REF: BAGHDAD 317 
 
¶1. (U) Summary:  At the Iraq Health Investment Summit, held 
on February 19 and 20 in Istanbul, the Minister of Health, 
Dr. Salih al-Hasnawi, showcased Iraq's 2009-2013 health plan 
and solicited partnerships with private companies.  Potential 
investors believed there were opportunities in the new 
healthcare market.  Despite assurances from the Minister of 
Health that security in Iraq has improved and has been stable 
for over a year, some investors expressed caution.  The 
&cumbersome8 U.S. visa process was noted by Iraqis and 
American investors alike, with American investors 
highlighting lost business opportunities due to long delays 
before Iraqis could obtain U.S. visas.  Academics and medical 
professionals noted that despite years of distance in the 
U.S.-Iraq healthcare relationship, partnerships and exchanges 
could help rebuild this relationship and improve the average 
Iraqi's outlook towards America.  This is a potential area 
for cooperation under the Strategic Framework Agreement. 
 
--------------------------------- 
Iraq Health Investment Conference 
--------------------------------- 
 
¶2. (U)  The investment summit in Istanbul was well attended, 
with approximately 100 medical company representatives 
participating.  The  conference addressed the ministry's 
strategic plan, acknowledged shortfalls, cited mechanisms 
being put in place to reform some archaic systems, such as 
Kimadia, the drug procurement system.  The U.S.-Iraq Chamber 
of Commerce addressed practical investment guidelines for 
companies seeking business with Iraq.  The Iraqi delegation 
was comprised of the Ministry of Health's most knowledgeable 
and articulate directors generals, two representatives from 
Prime Minister Maliki's office, 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 of themselves and of the companies. 
 
--------------------------------------- 
Focus on Primary Healthcare and Nursing 
--------------------------------------- 
 
¶3. (SBU) The Ministry of Health laid out an ambitious 
strategic plan covering 26 areas, many of which are aimed at 
achieving U.N. Millennium Development Goals as well as 
meeting international healthcare standards.  The MOH 
presented in great detail its plans to expand the primary 
healthcare center (PHC) network as well as construct new 
hospitals across Iraq.  In the coming years, the MOH 
infrastructure expansion plan includes construction of an 
additional 1,500 PHCs (estimates of the number of existing 
PHCs range from 1,200-1,900) and increasing the number of 
hospital beds available for secondary and tertiary care.  The 
GOI has developed plans to construct seven &turn-key8 
hospitals in 2009 and has already awarded more than $1.5 
billion in hospital contracts to Turkish, Australian and 
German companies. 
 
¶4. (SBU) The Minister of Health also announced that 2009 was 
the &Year of Nursing.8  Follow-up discussions with the 
World Health Organization country lead indicated that the MOH 
needs to better address the nursing sector to make this year 
more than an empty phrase.  The steps that need to be taken, 
however, will not be grand in nature such as those associated 
with a strategic plan for nursing, but rather actions that 
increase positive publicity about nurses and the nursing 
profession.  The WHO has been working closely with the 
Ministries of Health and Higher Education on key projects to 
improve nursing education and services as well as addressing 
the stigma associated with the nursing profession in Iraq. 
 
----------------- 
Security concerns 
----------------- 
 
¶5. (U) The improvement in security was noted several times by 
Dr. Salih and members of his delegation.  Despite their 
reassurances, many participants remained cautious about 
making any concrete commitments despite the potential of a 
growing health market.  Several companies already active in 
Iraq's health sector, 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 partners8 to improve the 
healthcare system and service delivery as they developed 
business contracts. 
 
---------------- 
U.S. Visa Policy 
---------------- 
 
¶6. (U) While security was identified as a hindrance to doing 
business in Iraq, no other issue raised more difficulties 
than obtaining U.S. visas.  Both American businesses 
representatives and Iraqis spoke at length about the negative 
impact the visa process was having on investment and 
educational exchanges.  One of many examples shared by Iraqi 
professionals included a prominent 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. 
 
¶7. (U) Embassy Baghdad Health Attache and NEA/I Desk Officer 
were asked to participate in an impromptu meeting on this 
issue with representatives from several American companies. 
The Health Attache explained that for an Iraqi a visa 
currently takes about 90-120 days to process, and advised 
businesses to allow at least a four-month window for Iraqi 
participation in events in the U.S.  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 Iraq8 and noted 
that European countries, which issue visas to Iraqis in 
approximately two weeks, were &running over8 American 
businesses.  The group of businesses was currently in the 
process of mobilizing support from Congressional leaders to 
ask the USG to reexamine Iraqi visa processes and 
regulations.  The business representatives contended that 
improving the visa process has the potential of saving many 
small American businesses, which lose business to foreign 
competitors who are able to host Iraqis in their countries. 
 
---------------------------------- 
Partnerships and Medical Exchanges 
---------------------------------- 
 
¶8. (SBU) The Health Attache and NEA/I Desk Officer met with a 
prominent Iraqi cardiologist, Dr. Hillal Shawiki, responsible 
for overseeing a physician exchange partnership funded by the 
United Kingdom's Department of Health.  Dr. Shawki detailed 
the process of this successful exchange program, which in two 
years has trained 400 Iraqi medical professionals in the 
United Kingdom at a cost of nine million dollars.  This 
program includes rigorous selection criteria and strong 
monitoring and evaluation carried out by Dr. Shawki and a 
group of volunteers from Iraq's medical and higher education 
professionals.  As part of the eight-week observerships, 
participation includes courses on Change Management and 
Clinical Observation.  After nearly an hour of exchanging 
information on this successful model, which can be replicated 
by the United States as it seeks to carry out commitments 
made in the Strategic Framework Agreement with Iraq, Dr. 
Shawki shared his thoughts on the most important lesson the 
United States could learn from this process.  Surprisingly it 
was not about how to best implement or model the program, but 
rather how to &win the battle of trust8 by regaining the 
&hearts and minds8 of the Iraqi educated middle class which 
can influence younger generations. 
 
¶9. (SBU) Comment:  Participants reached consensus 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 that market.  As Iraq rebuilds 
its healthcare infrastructure, huge investments by the MOH 
will be directed toward businesses, which can meet the needs 
of this rapidly expanding system.  In addition, health 
diplomacy through increased medical exchanges is an effective 
tool at improving attitudes towards the U.S. among educated, 
middle-class Iraqis.  This conference, initiated and funded 
by the MOH, is reflective of an Iraqi ministry that is 
seeking partners willing to advance its strategic goals, 
focused mainly on primary healthcare.  Complaints about visa 
issuance delays mirror those Embassy Baghdad hears routinely 
from Iraqi officials, educators, and business leaders at all 
levels. 
CLINTON