VZCZCXRO2040
PP RUEHAST RUEHDBU RUEHDH RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD RUEHSK
RUEHSL RUEHTM RUEHTRO RUEHVK RUEHYG
DE RUEHMO #3072/01 3551541
ZNR UUUUU ZZH
P 211541Z DEC 09
FM AMEMBASSY MOSCOW
TO RUEHC/SECSTATE WASHDC PRIORITY 5728
INFO RUEHVK/AMCONSUL VLADIVOSTOK 3425
RUEHYG/AMCONSUL YEKATERINBURG 3776
RUEHLN/AMCONSUL ST PETERSBURG 5552
RHEHNSC/NSC WASHDC
RUCNCIS/CIS COLLECTIVE
RUEHXD/MOSCOW POLITICAL COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHC/DEPT OF LABOR WASHDC
RULSDMK/DEPT OF TRANSPORTATION WASHDC
RUEHPH/CDC ATLANTA GA
RUEKJCS/SECDEF WASHDC
RHMFIUU/DTRA CT WASHINGTON DC
RHMFIUU/DTRA ALEX WASHINGTON DC
RUCPDOC/DEPT OF COMMERCE WASHDC
RUEHRC/USDA FAS WASHDC
RHEHNSC/NSC WASHDC
RUEAEPA/HQ EPA WASHDC

UNCLAS SECTION 01 OF 06 MOSCOW 003072 
 
SENSITIVE 
SIPDIS 
 
DEPT FOR EUR/RUS, EUR/PGI, OES/PCI, OES/IHB 
OES/FO FOR CARTER-FOSTER 
USAID FOR GH, E&E 
HHS FOR OGHA 
HHS PLEASE PASS TO NIH AND FDA 
STATE PLEASE PASS TO NAS 
USDA FOR FAS/OSTA FOR MACKE 
 
E.O. 12958: N/A 
TAGS: TBIO PREL EAID SOCI KHIV TSPL ETRD EAGR ECON PARM
KCRM, RS 
 
SUBJECT: Russia's Chief Medical Officer Wants to Expand Cooperation 
 
MOSCOW 00003072  001.2 OF 006 
 
 
SENSITIVE BUT UNCLASSIFIED -- PLEASE PROTECT ACCORDINGLY. 
 
¶1. (SBU) SUMMARY:  On December 15, Ambassador Beyrle met with Dr. 
Gennadiy Onishchenko, Russia's Chief Medical Officer and Director of 
the Russian Federal Service for Supervision in the Sphere of 
Consumer Protection and Human Well-Being (Rospotrebnadzor).  The 
almost 90-minute meeting was cordial and positive, with expressions 
of praise by Onishchenko for U.S. assistance, the activities of the 
Centers for Disease Control (CDC), the National Institutes of Health 
(NIH), and the U.S. Agency for International Development (USAID). 
Onishchenko several times expressed interest in expanded 
cooperation.  Although he categorically opposed Department of 
Defense access to Virology and Biotechnology Center "Vector," he was 
open to working with civilian agencies, particularly on Vector's 
application to the World Health Organization to become a regional 
influenza collaborating center.  He agreed to study the scientific 
materials presented on the use of chlorine in poultry processing and 
said that if U.S. representatives come to discuss the issue, we 
could reach a "mutually acceptable" solution.  End Summary. 
 
HIV/AIDS: PRAISES NIH/OAR, CDC, USAID; 
LET'S DISCUSS METHADONE 
------------------------------------- 
 
¶2.  (SBU) Onishchenko opened the meeting by thanking Ambassador 
Beyrle at length for U.S. government work in co-organizing the 
October 2009 U.S.-Russia Workshop on HIV  Prevention Science, 
convened in connection with the Third Eastern Europe-Central Asia 
AIDS Conference.  Emphasizing the "extreme importance" of the 
conference for Russia, he said that U.S. assistance in setting the 
agenda and selecting scientists helped make it so successful. 
Working together so closely on preparations for the three regional 
conferences held since the 2006 St. Petersburg G-8 summit has helped 
Russia advance its HIV programs, which now provide ARVs to over 
60,000 people.  He intends to send "thank you" letters to Dr. 
Whitescarver, Director of the Office of AIDS Research at NIH, and to 
the Ambassador.  He commented that in particular, scientists were 
very positive about the conference, adding that after such a long 
period of relatively weak scientific contact, it was good to have 
such a large number of Russian and U.S. scientists working together. 
 (Note:  The U.S. delegation included over 150 scientists.  End 
note.)  Onishchenko then recalled the regular and effective 
bilateral interaction in the Health Committee under the 
Gore-Chernomyrdin Commission, which gave many new ideas for fruitful 
cooperation.  Reflecting on the several years during the Bush 
administration when U.S.-Russia health contacts were more distant, 
Onishchenko said that he took heart in the fact that relations are 
now being restored and we can now enjoy more frequent and regular 
contact under the new Health Working Group under the Bilateral 
Presidential Commission. 
 
¶3.  (SBU) Agreeing that it is useful to have structures for 
cooperation, Ambassador Beyrle highlighted the "great promise" of 
the Health Working Group because of the many concrete results of our 
health cooperation.  Explaining that he sees our HIV/AIDS 
cooperation as a model, Ambassador Beyrle said he hoped we could 
expand HIV/AIDS cooperation, particularly programs for the most 
vulnerable.  He noted that in addition to new cooperation with NIH 
on AIDS prevention science research, USAID is expecting continued 
funding and a new HIV prevention project, which was developed in 
collaboration with Rospotrebnadzor.  Once USAID has completed the 
necessary bureaucratic formalities, it will contact Rospotrebnadzor 
to establish routine working arrangements to advance cooperation. 
 
MOSCOW 00003072  002.2 OF 006 
 
 
CDC's HIV surveillance is also very important.  Onishchenko called 
U.S. experience on HIV/AIDS "extremely interesting" for Russia, and 
stated that cooperation with USAID and CDC should "absolutely" 
continue. 
 
¶4.  (SBU) Thanking the Ambassador for personally attending the 
Regional Conference and making one of the speeches at the opening 
plenary, Onishchenko turned to the topic of the use of methadone in 
medication-assisted therapy for injecting drug users as a means of 
preventing the spread of AIDS.  (Note:  This topic was one of the 
more heated issues discussed at the conference.)  Onishchenko 
reiterated his often-stated conviction that using methadone as 
treatment is tantamount to legalizing of addictive narcotics. 
Russia does not support this approach and has "its own methods" for 
treatment of drug dependency. Onishchenko declared that he often 
uses the argument that there must still be concern in the United 
States because the federal government has not approved methadone's 
use, only some states.  (Note:  The federal government has had 
guidelines for several decades on methadone's use as treatment. 
Onishchenko could be confused because Medicaid funding for methadone 
is on a state-by-state basis, with some states including payment for 
methadone and others not.  We will try to clarify this with 
Onishchenko when the opportunity arises.  End note.)  However, he 
stated that methadone should be an acceptable subject in a 
discussion of international best practices.  He then said that he 
would welcome data about the results of methadone's use and would 
welcome the opportunity to engage with the international experts. 
The Ambassador said we would be pleased to get Onishchenko more 
information on the results of methadone.  (Note:  To follow up on 
this, USAID will work with the Substance Abuse and Mental Health 
Services Administration at HHS to collect the data.  End note.) 
 
¶5.  (SBU) Onishchenko was also positive about needle exchange 
programs, saying that they were proving effective.  He strongly 
endorsed civil society involvement in battling AIDS, saying that 
while civil society is not well developed in Russia, its engagement 
is "absolutely essential."  Peer counseling is useful.  Recalling 
the "ABC" policies (Abstinence, Being faithful and Condom use as 
appropriate) of the Bush Administration in AIDS prevention, he said 
that such a policy has an important role to play -- with children in 
school, for example.  However, for AIDS-infected adults, something 
more is needed to address both the medical and psychological aspects 
of HIV, particularly within the drug user population.  Stigma and 
discrimination are major problems and could be an area of joint work 
with the United States, which has a lot of experience in addressing 
this issue.  Noting the effectiveness of celebrities such as Anna 
Kournikova in reducing stigma, the Ambassador called her visit an 
example of a useful communication channel. Onishchenko noted that 
even in the area of stigma, Russia is making progress.  Russians are 
starting to adopt HIV-positive children, which was unheard-of only 
several years ago. 
 
INFLUENZA: THANKS FOR HELP ON H1N1; 
WANT CLOSER COOPERATION 
---------------------------------- 
 
¶6.  (SBU) Continuing his praise of U.S. cooperation, Onishchenko 
said U.S. help was much appreciated during H1N1 influenza outbreak 
in April 2009.  He particularly appreciated that CDC expeditiously 
provided strains of the virus for study in Russian labs, and later 
the vaccine strains that Russia used to develop its four vaccines. 
He stressed that it was particularly productive and encouraging to 
be able to cooperate with the native Russian-speaking experts at 
 
MOSCOW 00003072  003.2 OF 006 
 
 
CDC; this helped get past roadblocks such as the usual "ritual 
dances of diplomats" and political rhetoric to achieve practical 
successes. 
 
¶7.  (SBU) Onishchenko urged that the U.S. and Russia need to 
cooperate more closely on influenza.  He asked for U.S. support for 
Russia's plan to make the Virology and Biotechnology Center "Vector" 
near Novosibirsk the fifth WHO Regional Collaborating Center (CC) 
for influenza.  (Note:  After the CCs in the U.S. (CDC, Atlanta), 
UK, Japan, and Australia.  End note.)  He said that Vector is now 
well-equipped and he could "guarantee" professionalism and skills of 
scientists working there.  Sooner or later, he said, a major 
pandemic will appear, and we need to be prepared.  This is 
particularly troublesome in the post-Soviet space, where Russia and 
Kazakhstan share a long and porous border.  He noted that he 
particularly regrets the lack of Russian-U.S. activities in the CIS 
to prevent infectious diseases.  China could also be a source for 
the spread of many infectious diseases.  Emphasizing that pandemic 
preparedness would be a good area for bilateral cooperation, he 
recalled the discussion he had on this topic with Senator Lugar, 
whom he called a straightforward, solid professional. (Note: During 
Russia's G-8 Presidency in 2006, Onishchenko proposed that Vector 
become a full-scope WHO CC on Influenza.  Although Russia applied 
for this status soon thereafter, WHO only awarded Vector the status 
of an H5N1 (avian influenza) CC in June 2009.  WHO regional 
influenza CCs are expected to share flu strains and provide access 
to visiting foreign scientists.  However, we have heard that Vector 
is still not very active in sharing strains.  Vector regularly 
denies access to U.S. officials and we understand that Vector also 
denied access to visitors from China and Kazakhstan who came on a 
recent H5N1-related visit.  The only visit Vector allowed recently 
was from the WHO smallpox team.  In addition to Vector's lack of 
openness, there are remaining questions about its expertise in 
epidemiology.  As a virology/molecular biology research institution, 
Vector has had limited experience with human influenza.  Vector 
reports to Rospotrebnadzor, unlike Russia's two premier influenza 
institutes, the Influenza Institute in St. Petersburg and the 
Ivanovskiy Institute of Virology in Moscow, both of which are WHO 
influenza CCs for Russia and report to the Russian Academy of 
Medical Sciences.  Both of these institutes have decades of 
experience in influenza surveillance and both have made it clear to 
professional counterparts their negative view of Onischenko's desire 
to turn Vector into the regional WHO influenza CC.  End note.) 
 
CONCLUDE A COOPERATION AGREEMENT WITH CDC 
----------------------------------------- 
 
¶8.  (SBU) Returning to the subject of cooperation with CDC, 
Ambassador Beyrle recalled that during Onishchenko's June 2008 visit 
to CDC in Atlanta, both sides discussed creating a bilateral working 
group on infectious diseases.  The Ambassador relayed that CDC is 
interested in continuing those discussions and asked what 
Onishchenko's highest priorities are for cooperation.  Commented on 
how "strange" it is that a professional institution like CDC is led 
by political appointees, Onishchenko recalled that after his visit 
for meetings with CDC's previous leadership, he received the U.S. 
side's suggestions to the Rospotrebnadzor-produced draft cooperation 
agreement.  But then the U.S. elections came, and the draft 
"expired" with the coming of CDC's new leadership.  He said it would 
be "appropriate" to renew those talks and conclude an agreement to 
exchange specialists, share knowledge, and hold conferences. 
Ambassador Beyrle said that we could invite CDC to send experts to 
Moscow in early 2010 to resume those talks. 
 
MOSCOW 00003072  004.2 OF 006 
 
 
 
¶9.  (SBU) Note: We do not recall any actual draft agreement. 
However, Onishchenko's exchange of letters with then CDC Director 
Dr.Gerberding outline the following areas of interest: actions to 
advance the Declaration on Cooperation in Infectious Diseases 
Prevention, adopted at the G-8 summit in St. Petersburg in 2006; 
measures to prevent the spread of avian influenza and collaboration 
in the framework of activities of the WHO influenza collaborating 
centers; timely response to emergency situations with sanitary 
epidemiological implications, including training programs for 
experts working in this area; improving epidemiological 
surveillance, prevention and control of HIV while taking into 
account the prospects of development of an HIV vaccine; implementing 
International Health Regulations and exchange of best practices; 
implementation of WHO resolutions on smallpox in preparation for the 
World Health Assembly in 2010; and tuberculosis prevention and 
control.  Each time the Ambassador tried to propose a CDC visit or 
ask about priorities for cooperation with CDC, Onishchenko returned 
to the topic of an agreement.  To move forward, it may be helpful 
for CDC to develop a very simple letter of intent that CDC intends 
to develop a joint working group with Rospotrebandzor (and possibly 
Ministry of Health and Social Development).  We would share this 
with Rospotrebnadzor (and possibly MOHSD) prior to the visit, noting 
that CDC plans to explore specific areas for collaboration during 
the visit.  End note. 
 
SMALLPOX AND ANTHRAX COOPERATION; U.S. POSITION ON BWC? 
--------------------------------------------- --------- 
 
¶10.  (SBU) Onishchenko reflected that the United States and Russia 
share the burden and joint responsibility for working with WHO to 
safeguard our repositories of smallpox.  U.S.-Russian cooperation on 
smallpox research in the wake of 9/11 had been critical in stemming 
the fear of terrorism at that time.  He remembered the visit of 
Glenn Schweitzer and David Franz of the National Academy of Sciences 
in March 2009 and their dialog on anthrax.  Their tremendous 
experience and authority allowed them to have a frank discussion 
with him on the need for joint work, "since working alone, you can 
fall into the void."  They were persuasive that the risk of the 
"human factor" in securing biomaterials cannot ever be discounted. 
For this reason, Onishchenko agreed that continuing cooperation on 
counterterrorism would also be "appropriate."  We could, for 
example, work together under the Convention on Biological Weapons. 
He was interested in the position of the new U.S. administration on 
biological weapons convention that is "rotting" in Geneva, which he 
noted, unlike other conventions on WMD, does not have an enforcement 
mechanism.  (Note:  Post has seen Under-Secretary Tauscher's remarks 
that the Obama administration will not seek to revive negotiations 
on a verification protocol to the BWC because a legally binding 
protocol would not achieve meaningful verification or greater 
security since it is extraordinarily difficult to verify compliance. 
 However, we would appreciate Department's guidance on if/how it 
would like us to respond to Onishchenko on this topic.  End note.) 
 
SMOKING PREVENTION: VERY INTERESTED IN U.S. EXPERIENCE 
--------------------------------------------- --------- 
 
¶11.  (SBU) The Ambassador noted that when he had discussed the 
Health Working Group with Deputy Minister of Health and Social 
Development Skvortsova the previous day, Skvortsova had said she was 
open to the input of various health agencies and institutes.  He 
expressed hope that Rospotrebnadzor would be an active participant, 
noting that the current interest matrix included few Rospotrebnadzor 
 
MOSCOW 00003072  005.2 OF 006 
 
 
activities.  Onishchenko responded that he would be most interested 
in U.S. legislation and actions to prevent smoking.  He commented 
that Americans were lucky when the Clinton Administration took 
office and the "current Secretary of State" took up the cause of 
battling smoking.  The U.S. won its fight against the "fat cats." 
However, he said, "Russia was not so lucky, because the four biggest 
U.S. tobacco companies moved into our market and became an enormous 
force."  Now, he said, 400 billion cigarettes are produced every 
year in Russia even though not a single tobacco plant is grown in 
Russia.  He admired the U.S. and Canadian practice in reducing 
demand for tobacco products by raising prices through excise taxes. 
However, he said, the tobacco lobby is very strong in Russia, and 
these policies are very difficult to pass, as was witnessed by the 
adoption of tobacco technical regulations, which, according to 
Onishchenko, are too mild.  (Note:  There is draft legislation 
currently circulating in Russia to support anti-smoking measures and 
consider taxation.  End note.)  When the Ambassador told a personal 
story that proved how effective anti-smoking education was in 
schools, Onishchenko expressed strong interest in the U.S. 
experience in smoking prevention, including such programs for school 
children. 
 
CHLORINE AND CHICKEN; COOPERATION ON FOOD SAFETY 
--------------------------------------------- --- 
 
¶12.  (SBU) The Ambassador raised the issue of Russian regulations 
that threaten to cut off hundreds of millions of dollars in poultry 
and pork trade between the U.S. and Russia by strictly limiting the 
amount of chlorine that can be used in poultry processing and 
insisting on zero tolerance for antibiotics.  While our 
veterinarians continue discussing the science, the Ambassador 
argued, we should hold off on these bans.  Recalling discussions 
with U.S. experts in November 2008 on moisture content, Onishchenko 
stated that he had said at that time he was willing to negotiate and 
had agreed to that the two sides would work over the next year on a 
step-by-step basis to address the concerns, but the process had 
stopped.  Onishchenko claimed that since 1994, the vast majority of 
Russian poultry processors have abandoned the use of chlorine and 
switched over to cold airdrying and vinegar as an antibacterial 
agent.  This, he said, is a more modern, safer, and more effective 
method.  He had met two weeks earlier with a representative from the 
European Commission, which is also not using chlorine. 
 
¶13.  (SBU) The Minister Counselor for Agricultural Affairs 
emphasized that chlorine processing is effective, and several 
scientific studies have shown that it has no harmful health effects. 
 He noted that representatives from U.S. industry had travelled to 
Russia in February/March 2009, but acknowledged that their 
discussions were focused primarily on moisture content, not 
chlorine.  He explained that two U.S. universities had completed 
studies on chlorine use in poultry processing in 2009 that concluded 
that it is safe.  It is also cost effective.  Onishchenko said he 
and his experts would examine the scientific studies.  He suggested 
that U.S. poultry producers should come directly to Rospotrebnadzor 
to discuss the issue.  He also asked (perhaps rhetorically) "Why 
don't you allow your companies to transfer to the newer technology?" 
 Finally he said, "Drag them [the people who understand the science] 
here by the scruffs of their necks.  We'll talk and come to a 
mutually agreeable solution."  When the Ambassador added the 
Ministry of Health and Social Development (MOHSD) was willing to 
participate in discussions in the Agriculture Working Group of the 
Bilateral Presidential Commission on this topic and asked if 
Rospotrebnadzor would be as well, Onishchenko answered without 
 
MOSCOW 00003072  006.2 OF 006 
 
 
hesitation, "Absolutely.  We must cooperate on food safety." 
 
NO DOD ACCESS TO VECTOR LAB, EXCEPT TO COMPLETE AUDIT 
--------------------------------------------- -------- 
 
¶14.  (SBU) Turning to the issue of access to Vector, the Ambassador 
said that Onishchenko had written to the International Science and 
Technology Center that its assistance is no longer required on 
smallpox projects at Vector.  U.S. government inspectors have been 
repeatedly denied access to Vector to verify the work performed 
under a $3 million bio-security upgrade project begun in 2006, as 
required under the project agreement.  Onishchenko said that 
civilian cooperation is perfectly acceptable, as in the case of the 
two-year project being carried out now under the auspices of the 
World Health Organization (WHO). (Note: As far as we know, there is 
no current U.S.-Russian smallpox work. End note) Civilians are more 
transparent and open, he said.  However, as he told the Ambassador's 
predecessors, if the request is from the Department of Defense, he 
will never accept it, even if it is from "over the shoulder" of a 
civilian organization.  If access is necessary to complete an audit 
to fulfill reporting requirements, it can be arranged.  DTRA should 
simply re-submit their access request, and it will be re-examined. 
(Note:  DTRO-M will draft such a request.  End note.) 
 
¶15.  (SBU) Comment:  Most Russians know Onishchenko from his 
hundreds of press conferences and ceaseless travel all over Russia. 
Although most respect him for his dedication, hard work, and 
knowledge, his reputation with the broader public has been tainted 
by his central role in decisions to ban foreign food products for 
alleged safety reasons, when the bans were clearly motivated by 
political concerns.  Onishchenko does not have warm relations with 
MOHSD, to which he is technically subordinate.  He is in the midst 
of a political battle with the MOHSD that may result in a reduced 
role for Rospotrebnadzor in the area of HIV/AIDS programs and 
greater role for the MOHSD. Rospotrebnadzor may have already lost 
about 240 million rubles (apx $8 million) to the MOSHD for HIV/AIDs 
prevention work in 2010. In the past few months, he has made far 
fewer public statements on H1N1, with Deputy Minister Skvortsova 
taking the media spotlight.  This was the warmest meeting with 
Onishchenko that we can remember in the past few years.  Despite his 
political battles with MOHSD, Onishchenko still is very influential 
and a valuable partner.  It is well worth following up on the many 
openings he provided during this meeting, particularly since many 
are high priorities for the Health Working Group. 
 
BEYRLE