US embassy cable - 05SINGAPORE3017

C O N F I D E N T I A L SECTION 01 OF 03 SINGAPORE 003017 
 
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G FOR RENATA WOJTASIEWICZ AND VAUGHN TUREKIAN 
HHS FOR AMAR BHAT 
 
E.O. 12958: DECL: 10/14/2015 
TAGS: PREL, PGOV, TBIO, KHIV, EAGR, ECON, SN 
SUBJECT: UNDER SECRETARY DOBRIANSKY'S OCTOBER 12 VISIT TO 
SINGAPORE 
 
 
Classified By: Charge d'Affaires Judith R. Fergin for Reason 1.4 (d) 
 
1. (U) SUMMARY: Under Secretary for Democracy and Global 
Affairs Paula Dobriansky focused on Singapore's influenza 
preparedness, its leadership role in the region on this 
emerging disease, and the International Partnership on Avian 
and Pandemic Influenza (IPAPI) during a busy half-day visit 
to Singapore October 12, 2005.  The Under Secretary met 
separately with Minister for Health Khaw Boon Wan and Second 
Minister for Foreign Affairs Raymond Lim, and also toured the 
Regional Emerging Diseases Intervention (REDI) Center, a 
joint U.S.-Singapore organization established to monitor, 
detect, and respond to existing and emerging diseases that 
threaten public health.  Public diplomacy events included a 
presentation to the American Chamber of Commerce, and a joint 
press conference with World Health Organization (WHO) 
Director General Lee Jong Wook, who accompanied the Under 
Secretary to all meetings.  END SUMMARY. 
 
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2. (U) Accompanied by Director General Lee, U/S Dobriansky 
made the following points to her broad Singapore audiences 
throughout the visit: 
 
-- A pandemic influenza is likely and would entail huge 
economic, social and security costs. 
 
-- A global response to this threat is needed. 
 
-- The United States highly values Singapore's contributions 
and leadership. 
 
-- Through the IPAPI, the United States wants to work with 
our partners to develop an effective global response. 
 
Minister for Health and Second Minister for Foreign Affairs 
--------------------------------------------- -------------- 
 
3. (U) The Under Secretary's meetings with the Minister for 
Health and Minister for Foreign Affairs centered on the 
concern of both governments that an influenza pandemic would 
cause severe social, political and economic dislocations in 
addition to the loss of life.  Minister Khaw recommended that 
IPAPI focus on establishing a systematic form of 
preparedness, to encourage a network of scientists, doctors, 
and public health officials to share information and promote 
transparency.  He urged that efforts to mitigate the spread 
of avian influenza should first focus on implementing 
government oversight over farms and wet markets in major 
cities in Southeast Asia, because changing traditional 
poultry handling practices in rural villages would be a more 
difficult, longer-term project.  Referring to the 2003 Severe 
Acute Respiratory Syndrome (SARS) epidemic, he said, "we 
learned it is worth spending millions to save billions." 
 
4. (C) Director General Lee said he considered Singapore's 
avian influenza pandemic preparedness plan "excellent" -- 
among the best he had seen.  Minister Khaw and Minister Lim 
observed that most countries lack preparedness plans or have 
plans that do not put enough emphasis on preventing or 
slowing outbreaks.  Minister Lim elaborated, stating that 
Laos, Cambodia, and Indonesia would especially benefit from 
international assistance given their poor public health 
structure.  In response to Minister Lim's question, Director 
General Lee said that a lack of reported cases in Burma does 
not necessarily mean it has had no outbreaks of avian 
influenza.  The Under Secretary encouraged regional 
engagement to advance influenza dialogue with countries such 
as Burma; she noted Secretary Rice's appreciation for the 
role the Singapore Foreign Minister had played raising this 
issue at the last ASEAN meeting. 
 
The REDI Center 
--------------- 
 
5. (C) U/S Dobriansky and Director General Lee visited the 
REDI Center, a joint U.S.-Singapore bilateral initiative 
announced by President Bush and then-Prime Minister Goh Chok 
Tong (now Singapore's Senior Minister) at the 2003 APEC 
Leaders' Meeting.  Staffed by Singapore health officials and 
supervised by an interim U.S. director, REDI aims to be a 
regional hub for improving the detection of and response to 
new and emerging infectious diseases and threats, whether 
naturally occurring or man-made.  At the REDI Center, 
Ministry of Health Deputy Secretary Goh Aik Guan proposed 
using REDI to facilitate U.S. presence in the region by its 
acting as a satellite public health and research laboratory. 
Deputy Secretary Goh said Singapore is prepared to help push 
for a rapid-response regional stockpile to be controlled by 
the REDI Center -- if the USG would drive the initiative. 
Director General Lee commented that the WHO maintains 
stockpiles of influenza, polio, and smallpox vaccines, but 
advised considering the political implications of deploying 
those stockpiles during an outbreak.  The Under Secretary 
said she would share these proposals with all the relevant 
agencies in Washington.  Deputy Secretary Goh briefed that, 
since officially opening in May 2004, REDI has held or 
planned the following training courses: Regional Meeting on 
Biosafety and Biosecurity (April 2005); Field Epidemiology 
and Training Course (May/June 2005); Pilot Health Emergency 
Preparedness Course (September 2005); Laboratory Safety 
Course (January 2006); and Lancet Medical Forum (May 2006). 
 
Public Diplomacy 
---------------- 
 
6. (U) The American Chamber of Commerce hosted a well 
attended breakfast talk by U/S Dobriansky and Director 
General Lee, who highlighted the economic and social impact 
of a potential influenza outbreak and stressed the urgency of 
countries' partnering to prevent and mitigate that 
occurrence.  The audience, consisting mostly of healthcare 
practitioners and corporate continuity and risk assessment 
advisors, focused their questions on steps being taken to 
prevent or reduce the spread of such a pandemic and loss of 
labor and markets caused by its disruptions.  The Under 
Secretary and Director General Lee pointed to a need to 
 
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improve transparency and to stockpile Tamiflu, which has been 
effective against the current strain of avian influenza, even 
though a mutated virus able to sustain efficient human-human 
transmission would undoubtedly differ from the current 
strains.  Director General Lee pointed out that the influenza 
virus attacks in waves, allowing for improvement of the 
vaccine between attacks; an imperfect vaccine is better than 
none. 
 
7. (U) The Under Secretary's visit concluded with a press 
conference. In response to questions, the Under Secretary 
pointed to recently widened geographic dispersal of 
incidences and the growing number of human cases, underscored 
by expert predictions that avian influenza could be the first 
major influenza pandemic of this century.  But, noted the 
Director General, with preparation, the next influenza 
pandemic could cause less social, political, and economic 
loss than the pandemics of the last century. The Under 
Secretary and the Director General also gave a morning 
 
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interview to Straits Times, the leading Singapore 
English-language newspaper.  Local media gave wide coverage 
to U/S Dobriansky's visit (we have forwarded press articles 
to the Department). 
 
Participants 
------------ 
 
8. (SBU) U/S Dobriansky and her delegation met with the 
following officials during her visit: 
 
Ministry of Health (MOH) 
-- Minister for Health KHAW Boon Wan 
-- Mr. KOH Peng Keng, Senior Director, Operations Group 
-- Prof. SATKU (Satkunanantham) Kandiah, Director of Medical 
Services 
-- A/Prof. CHEW Suok Kai, Deputy Director of Medical Services 
 
Ministry of Foreign Affairs 
-- Second Minister for Foreign Affairs Raymond LIM 
-- Ms. LEOW Siu Lin, Deputy Director, America's Desk, North 
America Branch 
 
REDI Center 
-- MOH Deputy Secretary GOH Aik Guan 
-- MR. KOH Peng Keng, MOH Senior Director, Operations Group 
-- Ms. Meng Har LEE, Acting Director, REDI Center 
 
Her delegation included: 
 
-- Under Secretary Paula Dobriansky 
-- Charge' d'Affaires Judith R. Fergin, U.S. Embassy Singapore 
-- WHO Director General Lee Jong Woon 
-- Dr. Ken Bernard, Advisor to the WHO Director General 
-- Dr. Vaughan Turekian, Special Assistant to the Under 
Secretary 
 
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-- Dr. Thomas Yun, Regional Medical Officer, U.S. Embassy 
Singapore 
-- Paul Horowitz, First Secretary Economic Officer, U.S. 
Embassy Singapore 
-- Qiana Bradford, Second Secretary Economic Officer, U.S. 
Embassy Singapore 
 
9. (U) The Under Secretary's party has cleared this message. 
FERGIN