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Viewing cable 09BANGKOK611, THAILAND HOSTS USG CUTTING EDGE DISEASE PROGRAMS
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| Reference ID | Created | Released | Classification | Origin |
|---|---|---|---|---|
| 09BANGKOK611 | 2009-03-10 12:45 | 2011-08-25 00:00 | UNCLASSIFIED | Embassy Bangkok |
VZCZCXRO5089
RR RUEHAST RUEHCHI RUEHDT RUEHHM RUEHLN RUEHMA RUEHNH RUEHPB RUEHPOD
RUEHTM RUEHTRO
DE RUEHBK #0611/01 0691245
ZNR UUUUU ZZH
R 101245Z MAR 09
FM AMEMBASSY BANGKOK
TO RUEHC/SECSTATE WASHDC 6339
INFO RUEHCHI/AMCONSUL CHIANG MAI 6288
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUCNASE/ASEAN MEMBER COLLECTIVE
RUEHKT/AMEMBASSY KATHMANDU 7473
RUEHSV/AMEMBASSY SUVA 0437
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEKJCS/USCINCPACLO WASHDC
RUEHPH/CDC ATLANTA GA
RUEHRC/USDA FAS WASHDC
UNCLAS SECTION 01 OF 04 BANGKOK 000611
SIPDIS
DEPARTMENT FOR OES/IHB:JJONES,LMILLER
DEPT FOR USAID/GBH
USDA FOR FAS AND APHIS
HHS FOR CDC
USCINCPACLO FOR AFRIMS/WALTER REED ARMY INST. OF RESEARCH
E.O. 12958: N/A
TAGS: TBIO WHO KPAO KFLU KHIV ECON EAID TH
SUBJECT: THAILAND HOSTS USG CUTTING EDGE DISEASE PROGRAMS
REF: State 2172
BANGKOK 00000611 001.2 OF 004
¶1. SUMMARY: With over one-fifth of Mission Bangkok's staff of
roughly 2000 working on health issues, the Embassy hosts one of the
USG's largest efforts to fight the world's most dangerous diseases:
malaria, TB, dengue, HIV/AIDS and avian/pandemic influenza. USAID,
HHS/CDC, USDA/APHIS and the Armed Forces Research Institute of
Medical Sciences (AFRIMS) collaborate with each other and Thai
counterparts, and are platforms for assistance and partnership
throughout the region. A number of important breakthroughs, such as
in the prevention of HIV/AIDS transmission from mothers to children,
were developed here. The agencies supplement their Southeast Asia
focus with collaboration in Central and South Asia as well as the
Pacific Islands. SE Asia is a critical locale as the birthplace of
avian influenza and the most drug-resistant malaria strains; our
health agencies with Thai and ASEAN counterparts do everthing from
assuring the health of U.S.-bound Burmese refugees to developing
malaria treatments and testing of HIV vaccines.
¶2. Thailand and Mission Bangkok collaborate to make a regional
health hub of excellence, relying on extensive Embassy management
support, excellent infrastructure, good air connections and pro-U.S.
attitudes. The relative sophistication of the Thai scientific and
medical community makes collaboration as useful to USG research as
it is to the Thais themselves. Thailand is emerging as a donor and
science collaborator to help other countries as far away as Africa.
AFRIMS, CDC, USDA and USAID programs reach a wide range of people,
from the military to migrants, refugees and farmers. END SUMMARY.
THE THREAT FROM EAST ASIA
-------------------------
¶3. Many of the infectious diseases that pose critical threats to the
U.S. and world have important connections to Southeast Asia. As the
birthplace of avian influenza (AI), and bearing the brunt of the
outbreaks along with China, SE Asia is the logical focus for
research in prevention and treatment. SE Asia has been the locus
for emerging strains of drug-resistant malaria pathogens.
Multiple-drug resistant strains of tuberculosis (TB) have also
emerged here. Other prevalent diseases include HIV/AIDS, hepatitis,
diarrheal and respiratory diseases, dengue fever, hand, foot and
mouth disease, and Japanese encephalitis. Climate change is also
expected to have a particularly harmful effect on the people and
ecosystems of SE Asia, coupled with significant mega-urbanization.
Research and program development are vital to this region to ensure
its economic health as rising temperatures, sea levels,
precipitation and drought combine to increase the threats,
especially from vector-borne diseases. Thailand is one of the most
developed and stable nations in the midst of this infectious disease
panorama.
WHY BANGKOK IS THE HUB
----------------------
¶4. With around one-fifth of the employees at the fourth-largest U.S.
mission working on infectious disease and health issues, Bangkok is
one of the USG's largest centers to fight the world's most dangerous
global health threats. The well-developed embassy management
platform, coupled with the excellent infrastructure, air travel
infrastructure and connections, and a generally pro-U.S. attitude
among the Thai government and populace make Bangkok the ideal USG
health hub for Asia. These same advantages make Bangkok the premier
conference site in Southeast Asia, possibly in all of East Asia.
¶5. In the past six months there have been major international
conferences here on dengue, HIV/AIDS, and other diseases, and
Thailand's transportation nexus enables agencies such as USAID to
hold NGO and national partner conferences with dozens of
institutional participants and representatives of 15 nations.
Bangkok is also home to a large number of conferences on topics
related to public health such as climate change, air pollution and
mega-urbanization; the availability of Bangkok-based USG personnel
to participate in these conferences helps both those disciplines and
USG/global health partnerships (Reftel). (Note: The airport closures
last year certainly affected the conference industry in Thailand,
but it has now largely recovered. End Note.) Having agencies
grouped here has also facilitated coordination and enhanced
cross-agency collaboration on a number of different fronts
THAILAND: THE IDEAL U.S. PARTNER
BANGKOK 00000611 002.2 OF 004
--------------------------------
¶6. The relative sophistication of the Thai scientific and medical
community makes the primary collaboration with the Thais as useful
to USG research as to the Thais. With three kinds of partners, our
health agencies cover a range of sophisticated actors in Thailand:
NGOs (USAID), the Royal Thai Army Medical Department (AFRIMS); the
Ministry of Agriculture (USAID and APHRIMS) and the Ministry of
Public Health (CDC).
¶7. Aided considerably by our partnership, Thailand is emerging as a
donor and science collaborator in its own right, helping other
countries with their health problems. The Royal Thai Government's
development agency, TICA, has programs in 27 nations, for example:
TICA sends primary health care trainers to Timor Leste and has
recently started a multifaceted cooperation project in public health
for Pacific Island countries. TICA conducts far flung programs for
malaria and HIV/AIDS (Mozambique), and medicine (Cuba). TICA has
recently proposed an AI training program, to share its successes in
prevention and control with members of the Bay of Bengal Initiative
for Multi-Sectoral Technical and Economic Cooperation public health
(BIMSEC) and the Organization of Islamic Conference (Thailand is an
observer), both of which also cooperate with Thailand on other
public health topics. The Thai International Postgraduate Programme
reaches over 50 countries with annual training and degree programs;
Thailand offers scholarships in public health in cooperation with
other donors such as JICA and UN agencies.
THE USG RESPONSE: RESEARCH, COLLABORATION AND SUCCESS
--------------------------------------------- --------
¶8. The three main health agencies - USAID/RDMA, HHS/Centers for
Disease Control (CDC) and the Armed Forces Research Institute of
Medical Sciences (AFRIMS) -- collaborate with Thai counterparts as
well as operate regional platforms for assistance and partnership.
While Southeast Asia is a focal region, the three agencies support
other USG programs in Central and South Asia as well as the Pacific
Islands. Activities run the gamut of research, treatment, capacity
building and cover other diverse subjects such as health screening
for U.S.-bound Burmese refugees (CDC); multi-country malaria
containment programs and validation of a new TB test (USAID) to the
testing of HIV vaccines (AFRIMS). USDA's food safety and animal
health programs also contribute to Mission Bangkok's human health
efforts.
¶9. The reach of these agencies from India to China and the Pacific
Islands gives our agencies in Thailand a unique middle ground
between the two Asian nations with the largest health problems and
vulnerable populations, as well as important health infrastructures
with which to partner. Bangkok-based USG agencies also partner with
those UN agencies that use Bangkok as their Asia hub. For example,
CDC's Global AIDS Program developed new technical support programs
in Laos and Papua New Guinea, working in close partnership with
AFRIMS, USAID, and WHO. A short synopsis of a few of the programs
follows.
USAID
-----
¶10. USAID's Regional Development Mission - Asia (RDMA) supports
with direct and indirect funding over 50 NGOs, other USG agencies,
and both national and multinational institutions. RDMA manages
health programs for infectious disease and chronic health problems
in eleven countries from India to China; some programs are regional,
some are bilateral and some are advisory to USAID missions in Asian
countries such as Vietnam. RDMA focuses on HIV/AIDS, malaria, TB,
dengue and Avian Influenza in the Greater Mekong Subregion. The
Asian Collaborative Training Network for Malaria brings together
National Malaria Control Programs from 11 malaria-endemic countries
in Southeast Asia for staff training and enhancement of a regional
information network. RDMA's new Asian Network of Excellence in
Quality Assurance of Medicines (ANEQAM) led the effort to identify
problematic pharmaceuticals, using Thailand and the Philippines as
its centers of excellence and partnering with the WHO and the United
States Pharmacopeia, the official standards-setting authority for
all medicines sold in the U.S. that also has a regional office in
Bangkok.
¶11. The USAID Avian Influenza program develops prevention and
control (for bird and human health) in the Mekong Region, China,
Bangladesh, India and Nepal. HIV/AIDS prevention and care programs
BANGKOK 00000611 003.2 OF 004
target Laos and Thailand. USAID supports key treatment facilities
such as the Mercy Center, visited by President Bush in 2008, for
education and home-based care to AIDS victims in low-income
communities. RDMA has played a key role in the USG health and other
responses to Cyclone Nargis as well as the health problems among
Burmese refugees, where there is a danger that AI and other diseases
could take root. The TB program among that group resulted in a new
Multi-resistant TB diagnostic test.
HHS/CENTERS FOR DISEASE CONTROL
-------------------------------
¶12. In the past ten years, the CDC Office in Thailand has nearly
doubled in size to almost 200 employees; currently almost all of
CDC's direct-hire staff have regional responsibilities. CDC assures
the quality of health screening for all U.S. -bound refugees and
immigrants from the region. CDC conducts collaborative research with
the Thai Ministry Public Health (MoPH) in areas like evaluating the
efficacy of pre-exposure prophylaxis with anti-retroviral therapy to
prevent HIV/AIDS in high risk groups such as IV drug users. With
assistance from CDC, Thailand has become a model partner
demonstrating the success and expandability of multiple HIV
programmatic interventions in the quality of HIV care and prevention
of prenatal HIV transmission, for example; the first successful drug
therapy to prevent mothers from passing the HIV virus to their
offspring was developed in a CDC program in Thailand. CDC has
documented the risks of mortality among HIV-infected TB patients in
Thailand and demonstrated the benefits of early antiretroviral
therapy.
¶13. CDC's support for the Thai Field Epidemiology Training Program
recently helped launch an electronic journal for regional outbreaks
and helped sponsor "TIGER," a regional collaboration of Mekong Basin
countries aimed at strengthening the detection and control
outbreaks. CDC has also been heavily involved in helping Thailand
develop a pandemic and all-hazards preparedness plan, and in
strengthening surveillance and diagnostic capacity for severe
respiratory illnesses. These successes have helped Thailand help
other nations. For example, CDC's Global AIDS Program, working with
AFRIMS, USAID and WHO developed new technical support programs in
Laos and Papua New Guinea, to complement the already existing USAID
HIV programs in those two countries.
ARMED FORCES RESEARCH INSTITUTE OF MEDICAL SCIENCES
--------------------------------------------- ------ 14. Over
50 years ago the U.S. Army identified the Royal Thai Army Medical
Department (RTAMD) as the ideal medical collaborator in the region
and Thailand the ideal site for its research. What is now the Armed
Forces Research Institute of Medical Sciences - U.S. Army Medical
Component (AFRIMS-USAMC) works in militarily-relevant infectious
disease research, including conducting disease surveillance, and
evaluating and testing new drugs, vaccines, and diagnostic
procedures. AFRIMS now has around 470 employees and contractors.
Beyond its in-house research on diseases of military importance to
directly benefit U.S. servicemen, AFRIMS conducts collaborative
research with Thai and international partners on HIV/AIDS, malaria,
dengue, Japanese encephalitis, scrub typhus and other rickettsioses,
diarrheal and respiratory diseases, and HIV/AIDS. Partner nations
include Cambodia, Bhutan, Nepal, Philippines and Vietnam. AFRIMS
has had a renowned HIV research program but its most striking
achievement is its HIV vaccine development program, started in 1991.
AFRIMS is currently testing a new HIV vaccine in a Phase III
efficacy trial. AFRIMS-USAMC assists the RTAMD with health
surveillance in several Thai border regions and for the large number
of UN peacekeeping forces that Thailand provides around the world.
USDA
----
¶15. The United States Department of Agriculture (USDA) contributes
to human health in several ways, with the Foreign Agriculture
Service (FAS) and Animal and Plant Health Inspection Service (APHIS)
regional offices in Bangkok working in food safety. APHIS
veterinarians also play a key role building capacity to combat Avian
Influenza (AI), as nearly all human AI cases have been attributed to
direct contact with infected birds. APHIS Bangkok oversees offices
in Burma, Cambodia, Indonesia, and Laos, and has supported
activities in other nations such as Vietnam and the Philippines.
APHIS collaborates with the other USG agencies, the various host
governments, and international organizations to provide prevention
BANGKOK 00000611 004.2 OF 004
and control activities. Programs include: developing regulatory
frameworks; field investigation; outbreak response; wildlife
surveillance; epidemiology research; laboratory diagnosis;
vaccination; compensation for producers; managing live bird markets;
and information management. As these capacity building activities
apply to general animal health programs, the APHIS promotion of
international standards for animal health activities have led to
sustained improvement in general animal health, food security and
economic infrastructure in addition to an important public health
service.
COMMENT
-------
¶16. The number of health professionals at Mission Bangkok is no
surprise when one considers the near-ideal environment Thailand
provides. Thailand is a solid ally with the infrastructure,
capacity and attitude to make USG collaboration a plus for both
countries, and a tremendous asset globally in the effort to fight
infectious disease. At the same time, Mission Bangkok's infectious
disease collaboration is one of the best agents for creating a
positive impression of the United States in this region of the
world.
JOHN