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Cable en el que Anthony Wayne y María Graciela Ocaña discuten sobre la corrupción en la sanidad

ID: 189490
Date: 2009-01-29 19:00:00
Source: Embassy Buenos Aires
Classification: UNCLASSIFIED
Destination: VZCZCXYZ0000

DE RUEHBU #0096/01 0291900
R 291900Z JAN 09



E.O. 12958: N/A
SUBJECT: Argentina's Minister of Health - Crusader against

1. (U) Summary: Ambassador Wayne and Health Minister Maria
Graciela Ocana discussed her Ministry's efforts to fight corruption
within Argentina's public health system, the importance of drug
rehabilitation programs, and prospects for future collaboration on
health issues during a meeting on January 16. Ocana expressed
interest in the changes that President Obama would make to the U.S.
healthcare system. She acknowledged that Argentina's 2001 economic
crisis had hurt its healthcare system, which is also challenged by
financial malfeasance, increased demand, and heavy costs associated
with long-term care. They also discussed Argentina's growing drug
consumption problem. The Ambassador suggested that many of these
issues could be discussed with U.S. experts via digital video
conferences, an idea Ocana readily supported. The meeting
demonstrated new opportunities to engage the GOA on healthcare
issues where real needs exist.
End Summary.

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Financial Malfeasance Prevents Healthcare Access
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2. (U) The Ambassador commended Ocana on her efforts to fight
corruption within Argentina's public health system. (Ocana has
consistently called for greater transparency in the procurement of
pharmaceuticals by the Argentine agency responsible for providing
medicines to senior citizens following allegations of price fixing
and overcharging by suppliers, many of whom were also reportedly
prominent campaign contributors in 2007. In November, the head of
the agency resigned at the request of the government.) She confided
that it is challenging to run an efficient Ministry when the money
designated for healthcare goes "elsewhere." She added that several
sectors are not big fans of her Ministry and confided that she was
facing a difficult battle with Argentine pharmaceutical companies.

3. (U) Ocana also told the Ambassador she has uncovered corruption,
particularly in procurement of services and medications. In
addition, there have been recent incidents of pharmaceutical
laboratories manufacturing medicines that were either fraudulent or
of inadequate dosages. Centralizing the verification system is
essential to avoiding fraud, she said. The Ambassador noted that in
the United States, there exist strong procurement procedures and
systems which could be shared with Argentina. He noted that the
U.S. private sector could be very helpful partners in this area.
Ocana said she had had a very good meeting with Merck which touched
on this, and expressed her interest in collaborating with U.S.
experts to improve the Ministry's oversight capabilities.

Opportunities for Cooperation

4. (U) Ocana said she is interested in seeing what changes
President Obama will make to the U.S. healthcare system. She added
that she would find it useful for both countries to share their
experiences in healthcare reform. She cited the unions' "Obras
Sociales" ("Social Works") system as an example, noting that it does
not have an analogue in the United States. She explained that the
Social Works system is run by workers' unions that provide health
coverage to their affiliates. The Ministry of Health publishes
basic standards and conditions about the provision of health
services and the Social Works system is in charge of putting this
into practice. (Comment: This system does not guarantee good
healthcare and provides opportunities for corruption.) The
Ambassador underscored that our healthcare system is based on a
large private role.

5. (U) The Minister also relayed her interest in promoting a
Federal Health Law to guarantee universal access to Argentina's
healthcare system. (Comment: While the current system guarantees
universal healthcare, access to medical care for lower
socio-economic populations remains inadequate. The law would focus
on programs for the reduction of mother and infant mortality, and
the reduction of deaths caused by both communicable diseases such as
tuberculosis, Chagas, HIV-AIDS, dengue, yellow fever, as well as
non-communicable diseases caused by high blood pressure, diabetes,
mental health problems, drugs and tobacco.)

6. (U) Ocana acknowledged that Argentina's 2001 economic crisis
hurt Argentina's healthcare system. She remarked that the only good
result to come out of Argentina's economic crisis was that
Argentines learned they can work together to face their problems.
She added that there is a growing healthcare crisis in Argentina due
to increasing demand. To address this, she said the Ministry is
focused on improving primary care in Buenos Aires City, and they
hope to build ten new hospitals in critical zones by 2011, five with
Argentine financing, two with Spanish, and three with European Union

Increased Drug Problems

7. (U) The Ambassador mentioned his personal experience of having
observed children addicted to paco, the local version of crack, in a
previous visit to villas, or slums, in Ciudad Oculta and along the
Riachuelo. Ocana agreed that this was a serious problem, describing
it as a sickness which requires medical attention. She said her
Ministry is hoping to work with the provinces to expand treatment
for drug addiction, but noted that the National Center for Drug
Addiction has only 100 in-patient beds and limited facilities for
walk-ins. She is working with the Ministries of Social Development
and of Justice, Security, and Human Rights to develop better
treatment programs.

8. (U) Ocana commented that even when children enter the few
available treatment programs, they often do not remain and leave
uncured. Hospitals that provide emergency treatment either do not,
or are unable to, provide care for youth in need of additional
treatment. The Ambassador mentioned the positive work of the
Argentine NGO, Mothers Against Paco, in addressing drug addiction,
and cited their struggles to get more local, long-term treatment
centers. He noted that the United States has significant
experience in drug treatment programs, and offered to see if the
Embassy could bring together Argentine and U.S. healthcare experts
for digital video conferences to share experiences and ideas, an
idea that Ocana enthusiastically supported.


9. (U) Ocana was appointed head of the Ministry of Health by
President Cristina Fernandez de Kirchner in December 2007. In CFK's
2008 State of the Union address, Ocana was the only Minister to be
singled out for praise for her work. According to local press
reports, Ocana has gained substantial autonomy because of her strong
relationship with the President, but her relationship with Nestor
Kirchner is not as solid. Still, she argued that the current
government, flaws and all, is overall the best Argentines have had
since the return of democracy. Prior to assuming her current post,
she was head of PAMI, the National Institute for Social Services for
Retired Workers. From 1999-2003, Ocana served as a member of the
Lower House (1999 to 2003) as part of the Frepaso. In this
capacity, she was active in investigating corruption in former
President Menem's administration. She worked with Civic Coalition
leader Elisa Carrio in the Money Laundering Preliminary Report, and
in 2001 she joined Carrio's party, ARI. Ocana was subsequently
evicted from ARI after joining the Kirchner administration. Ocana
(nicknamed "la hormiguita", or "the little ant") is well-known for
her hard work and commitment to the causes she undertakes. Ocana
was born in 1960 in San Justo, Argentina.


10. (U) Ocana is tackling a difficult situation, worsened by
entrenched corruption, a dramatic increase in drug use, and a
Byzantine political situation that complicates public health
management issues. U.S. public and private experience with
procurement procedures, drug treatment programs and attempts to
provide affordable health care, combined with the availability of
Spanish-speaking U.S. experts, provides an opportunity to assist the
Health Ministry and engage the GOA where real needs exist.