US embassy cable - 05HANOI2823

UNCLAS SECTION 01 OF 05 HANOI 002823 
 
SIPDIS 
 
SENSITIVE BUT UNCLASSIFIED - DO NOT POST ON THE INTERNET 
 
STATE FOR G; CA/OCS/ACS/EAP; EAP/EX; EAP/MLS; EAP/EP; INR; 
OES/STC (PBATES); OES/IHA (DSINGER AND NCOMELLA) 
BANGKOK FOR RMO, CDC, USAID/RDM/A (MFRIEDMAN) 
USDA FOR FAS/PASS TO APHIS 
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (LSTERN) 
HOMELAND SECURITY COUNCIL FOR RVENKAYYA 
NSC FOR FSHIRZAD AND JMELINE 
USAID FOR ANE AND GH (DCAROLL, SCLEMENTS AND PCHAPLIN) 
STATE PASS USTR (ELENA BRYAN) 
STATE ALSO PASS HHS/OGHA (WSTEIGER AND EELVANDER) 
USMISSION GENEVA FOR HEALTH ATTACHE 
ROME FOR FAO 
 
E.O. 12958: N/A 
TAGS: AMED, AMGT, CASC, EAGR, PINR, SOCI, PGOV, TBIO, VM, HIV/AIDS, AFLU 
SUBJECT: HHS SECRETARY LEAVITT'S MEETINGS WITH HAIPHONG 
OFFICIALS 
 
1. (SBU) Summary:  On his second full day in Vietnam, U.S. 
Secretary of Health and Human Services (HHS) Michael Leavitt 
 
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traveled to the port city of Haiphong to survey the avian 
influenza (AI) and HIV/AIDS situations there.  He met with 
local Haiphong Provincial Health Department officials on 
October 15 at the Provincial People's Committee Hall to 
discuss HIV/AIDs and AI.  The Director of the Provincial 
Health Department gave a presentation providing data on 
HIV/AIDS and AI cases in Haiphong, and underscored the 
strong commitment by local officials to combat HIV/AIDs and 
AI in the province, 100 kilometers outside the capital of 
Hanoi.  HHS Secretary Leavitt also paid courtesy calls up on 
Haiphong People's Committee Vice Chairman Hoang Van Ke, and 
visited a local hospital and clinic as well as the home of 
recent AI survivors to raise community awareness of AI and 
emphasize U.S. support for the Vietnamese and the GVN in its 
efforts to combat it.  End Summary. 
 
LOCAL CAPACITY NEEDS HELP 
------------------------- 
 
2.  (U) Haiphong People's Committee Vice Chairman Hoang Van 
Ke welcomed the Secretary's delegation to Haiphong, and 
expressed gratitude to the United States for its cooperation 
in combating HIV/AIDS and avian influenza (AI) in the region 
and around the world.  Noting that Haiphong is the third- 
largest city in Vietnam and an important port gateway with 
economic growth of over ten percent in the past decade, Ke 
emphasized the critical role international partners play in 
helping to properly administer and manage health projects in 
Vietnam.  Ke remarked that the country had made considerable 
advancements, and that local officials are committed to the 
timely treatment of those infected with H5N1, but Vietnam is 
still a poor country and needs the help of the international 
community. 
 
3. (U) Vice Chairman Ke also told the Secretary that 
Haiphong is following the Central Government's direction on 
AI prevention, and is focusing on vaccinating poultry, 
monitoring for a possible outbreak, and implementing a 
public awareness and education campaign.  The Secretary 
thanked the Vice Chairman for receiving him, and said the 
main purpose of his visit to Hai Phong Province was to see 
how the partnership on HIV/AIDS is progressing, and to 
better understand the challenges of preventing another AI 
outbreak at the provincial level. 
 
HIV/AIDS AND PREVENTION INTERVENTION 
------------------------------------ 
 
4. (U) Provincial Health Department (PHD) Director Nguyen 
Van Vy profiled the HIV/AIDS and avian influenza situations 
in Haiphong (copies of his presentation were distributed to 
the delegation).  (Comment: With a population of 1.7 million 
people, Haiphong has one of the highest prevalence rates of 
HIV/AIDS in the nation, around .33 percent according to HHS 
Centers for Disease Control and Prevention (CDC) estimates. 
HHS/CDC began its Global AIDS Program (GAP) in Haiphong in 
2002 in cooperation with the Vietnamese Ministry of Health, 
by creating the LIFE-GAP project and establishing a 
voluntary counseling and testing center and an adult 
outpatient clinic and a pediatrics outpatient clinic, among 
others, which now come under the funding and administrative 
umbrella of the President's Emergency Plan for AIDS Relief. 
End Comment). 
 
5. (SBU) Dr. Vy pointed to Haiphong's geographic situation 
as one reason for the rate of disease in the province. 
Haiphong shares a border with "HIV epidemic hot spots" Quang 
Ninh, Hanoi and Hai Duong.  The tourism and shipping sectors 
also contribute to the easy transmission of HIV/AIDS, and 
the city now has over 5000 intravenous drug users.  Vy 
expressed concern that the HIV/AIDS pandemic in Haiphong is 
very complex and at high risk for a potentially exponential 
increase in infection rates.  In a chart that detailed HIV 
and AIDS cases and deaths from 1993 through September 2005, 
Dr. Vy acknowledged that the number of total HIV infections 
had decreased 35-36 percent since January 2003.  By 
September 2005, he said, the cumulative number of HIV cases 
in Haiphong totaled 7,134 and cumulative AIDS cases totaled 
2,803.  So far, Haiphong has had an estimated 1,902 deaths 
from HIV/AIDS, according to the chart. 
 
6.  (U) Resolution Number 21/NQ BTV for AIDS prevention is 
an indication of the strong commitment from the highest 
levels of local leadership to combat AIDS, Dr. Vy remarked. 
The Haiphong People's Committee approved an AIDS Prevention 
Strategy for 2005-2010 to prevent and control the pandemic 
in Haiphong.  The province has also implemented an 
Information-Education-Communication (IEC) Strategy, 
including a syringe- and needle-exchange program and condom 
distribution, as "indirect vaccines" to AIDS prevention. 
(NOTE:  The President's Emergency Plan in Vietnam follows 
U.S. Government policy and does not provide financial or 
technical support to syringe- or needle-exchange programs. 
END NOTE.)    Television, radio, internet and personal 
communication methods are increasing awareness about the 
risks and prevention of HIV/AIDS, and have resulted in 
information outreach to 90 percent of urban residents and 70 
percent of the suburban residents in Haiphong Province, Dr. 
Vy said. 
 
7.  (U) According to Dr. Vy, Haiphong has tested 25,000- 
40,000 blood samples in the past ten years, and provided for 
pre- and post-test counseling, as well as established self- 
help groups and clubs to promote awareness about HIV/AIDS. 
The Provincial Health Department is also entrusted with 
sterilization of equipment and other materials, safe blood 
transfusions, preventing mother-to-child transmission, and 
treatment of AIDS patients.  Furthermore, since AIDS 
prevention is a community responsibility, the Provincial 
Health Department has joined forces with the Provincial 
Department of Labor and War Invalids-Social Affairs, the 
police, the women's union, the youth union and the National 
Fatherland Front.  International partners include Family 
Health International; HHS/CDC; SCF from the United Kingdom 
(UK); NAV from Norway; the Global Fund to Fight AIDS, 
Tuberculosis and Malaria; the Department of International 
Development of the UK Government; the United Nations (UN) 
Educational, Scientific and Cultural Organization (UNESCO); 
and the UN Children's Fund (UNICEF). 
 
8.  (U) Since October 2002, the Provincial Health Department 
has worked with HHS/CDC to establish a voluntary counseling 
and testing center, the first of its kind in Vietnam. 
Currently, there are two centers in Haiphong.  The 
Outpatient Clinic (OPC) for adults in Viet Tiep Hospital 
(the other center is in Ho Chi Minh City) provides anti- 
retroviral (ARV) drugs for patients.  Another OPC for 
children is located in the Haiphong Pediatrics Hospital, and 
the Obstetrics Hospital works to prevent mother to child 
transmissions. 
 
THE AVIAN FLU SITUATION IN HAIPHONG 
----------------------------------- 
 
9.  (SBU) According to Dr. Vy, since the beginning of 2004, 
the Provincial Health Department, under the guidance of the 
Ministry of Health and the People's Committee, has actively 
worked to collaborate with the agricultural sector to 
prevent AI and its transmission to humans.  The Committee 
has issued relevant documents for distribution at the 
commune level, promoted hygiene in poultry farms and 
equipped Viet-Tiep hospital to treat H5N1 patients. 
Haiphong has successfully treated seven patients with H5N1 
in March and April of this year.  The patients included a 
twelve-year-old girl in the Niem Nghia Ward, a nine-year-old 
girl and five persons in one family in Kien Thuy District, 
whom Secretary Leavitt visited that afternoon.  Dr. Vy 
concluded his remarks by noting that Haiphong appreciates 
the assistance it receives from HHS, including vaccines, 
medical facilities and training materials. 
 
10.  (SBU) Secretary Leavitt thanked Chairman Ke and Dr. Vy 
for their presentations, which, he said, helped the 
delegation understand the health situation at the provincial 
level.  The Secretary and others in the delegation asked for 
clarification on how the seven patients with H5N1 were 
treated and the length of time between the first indications 
of symptoms to the beginning of treatment with Tamiflu.  Dr. 
Vy responded that local officials reported the outbreak to 
the national Ministry of Health and its National Institute 
of Health and Epidemiology (NIHE), and sent the patients' 
specimens to NIHE, which provided Tamiflu to the patients 
one day after hospitalization.  The patients were probably 
hospitalized four or five days after first feeling ill, he 
added.  Diagnosis was made after the Tamiflu treatment 
began, and the patients gradually improved in health.  The 
Secretary thanked the Vietnamese delegation, and said that 
 
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he looks forward to continued cooperation between Haiphong 
institutions and HHS and other U.S. agencies. 
 
OUTREACH AND DIALOGUE 
--------------------- 
 
11.  (U) In addition to his two main meetings with Chairman 
Ke and Dr. Vy, Secretary Leavitt attended a luncheon hosted 
by Chairman Ke at the Provincial People's Committee Guest 
House.  He also visited an HIV/AIDS Voluntary Counseling and 
Testing Center and HIV/AIDS Outpatient Clinic, both funded 
by the President's Emergency Plan for AIDS Relief.  At the 
end of his trip, he stopped by a rural Commune Health 
Station and met with the family that contracted and 
recovered from AI in March 2005. 
 
PARTICIPANTS 
------------ 
 
12. (U) U.S. Participants: 
HHS Secretary Michael Leavitt 
U.S. Ambassador Michael Marine 
Kerry Weems, HHS Deputy Chief of Staff 
Dr. Kent Hill, Acting Assistant Administrator for Global 
Health, U.S. Agency for International Development (USAID) 
Dr. James Butler, 
Under Secretary for Farm and Foreign Agricultural Services, 
U.S. Department of Agriculture (USDA) Dr. Julie Gerberding, 
Director, HHS/CDC Dr. Anthony Fauci, Director, HHS/NIH/NIAID 
Suzy De Francis, Assistant Secretary for Public Affairs, 
HHSDr. William Steiger, Special Assistant for International 
Affairs, HHSDr. Vaughan Turekian, Special Assistant to Under 
Secretary Dobriansky Allyson Bell, Director of Scheduling 
 
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and Advance, HHS 
HHS Hanoi Health Attache Marie Sweeney 
HHS/CDC Chief of Party Mitchell Wolfe 
USDA/FAS Hanoi Attache John Wade 
USAID Program Manager Dan Levitt 
 
13. (U) Vietnamese Participants: 
Haiphong People's Committee Chairman Hoang Van Ke 
Vice Minister of Health Trinh Quan Huan 
Provincial Health Department (PHD) Director Nguyen Van Vy 
PHD Deputy Director Tran Thi Thanh Thuy 
LIFE-GAP Director Luu Thi Minh Chau 
LIFE-GAP Subproject Director Do Thi Minh Nguyet 
Director of International Cooperation Department of Ministry 
of Health Tran Trong Hai 
Director of Haiphong Foreign Affairs Department Pham Huu Thu 
Director of Haiphong Agriculture and Rural Development 
Department Do Trung Thoai 
Deputy Director of Haiphong Health Department Phan Trong 
Khanh 
 
14. (U) Secretary Leavitt's party has cleared this cable. 
 
BOARDMAN