Viewing cable 09VILNIUS615

09VILNIUS6152009-11-18 15:15:00 2011-08-30 01:44:00 CONFIDENTIAL Embassy Vilnius

DE RUEHVL #0615/01 3221515
P 181515Z NOV 09
C O N F I D E N T I A L VILNIUS 000615 
E.O. 12958: DECL: 11/18/2019 
Classified By: Ambassador Anne E. Derse for reasons 1.4 (b) and (d). 
¶1.  (C) SUMMARY:  During her initial meeting with Minister of 
Health Algis Caplikas, Ambassador Derse heard that the budget 
crisis was forcing the ministry to speed up its reforms in 
the health-care sector, that the GOL believes it is prepared 
for the worsening flu pandemic, and that the ministry will 
decide within two months whether it can take advantage of a 
program that offers lower drug prices to fight tuberculosis. 
The Minister, who also is a member of the Seimas 
(parliament), said at the moment everything is taking a back 
seat to the effort to pass the 2010 budget.  End summary. 
¶2.  (U) Ambassador Derse on November 16 paid her first call 
on Minister of Health Algis Caplikas, who is a member of the 
Seimas from the Liberal and Center Union party and in an 
earlier government served as Minister of Construction and 
Urban Development and as Minister of Environment.  Caplikas 
told the Ambassador that the biggest issues facing his 
ministry were health-care reform, budgetary constraints and 
pandemic flu. 
Health-care reform 
¶3.  (C)  Caplikas said Lithuania had too wide a hospital 
network, with too many doctors and too many beds.  "Such a 
huge network is patient friendly, but we'd have to have two 
times the budget we have" to operate it, he said.  Because of 
the GOL's current fiscal crisis, he said, budget cuts are 
forcing the ministry to implement reforms more quickly than 
it would like to.  Neighboring countries have already 
implemented such reforms and can provide models for Lithuania 
he said, particularly in areas such as 
controlling public procurement and safeguarding public money. 
 Reforms will also lead to better patient care in some areas, 
such as allowing for more effective and efficient use of 
expensive medical equipment that is currently underutilized, 
the Minister said. 
Savings on tuberculosis drugs 
¶4.  (C)  The Ambassador told the Minister that she was 
concerned that the GOL has yet to take advantage of the Green 
Light Program of the World Health Organization (WHO), which 
allows member countries to purchase reduced-cost medicines to 
fight multi-drug-resistant tuberculosis (MDR-TB).  Lithuania 
has one of the world's highest MDR-TB rates, and became a 
Green Light member with significant USG assistance earlier 
this decade.  The Ambassador pointed out that the GOL could 
save significant amounts of money in these difficult times 
simply by utilizing a program it already has access to. 
Caplikas said Lithuanian law made it "difficult or sometimes 
impossible" for the government to buy drugs from a 
centralized source rather than holding a public tender.  The 
Ambassador reminded the Minister that WHO had expressed 
willingness to participate in such tenders, but had received 
no response from the GOL.  Caplikas said, "What I can promise 
is more clarity in terms of the Green Light program.  In the 
next two months, we will have clarity in how to go forward 
with the program or to end our involvement in the program. 
But the savings are obvious, and I think it will be possible. 
 We'll try to find the way forward." 
Pandemic flu 
¶5.  (C)  The Minister told the Ambassador that the number of 
people infected with flu or similar respiratory illnesses 
"has increased dramatically" in recent days, and that 10 
municipalities were at epidemic levels of more than 100 cases 
per 10,000 inhabitants.  Because there is no doubt that an 
epidemic exists, he said, the GOL has stopped routine testing 
for H1N1 virus.  There have been no reported flu-related 
deaths so far this year, he said.  (NOTE:  Two days after the 
meeting, Lithuanian media reported the country's first flu 
death: a 14-year-old boy in Kaunas without any reported 
underlying health conditions.  Embassy intends to provide 
more information septel. End note.)  Caplikas said he was 
concerned that parents were starting to panic and keeping 
their children home from school without reason, which only 
made it seem as if more children were sick and alarmed even 
more parents. 
¶6.  (C)  Caplikas said that GOL officials were in constant 
contact with WHO and European health officials to exchange 
information and track flu trends.  He also said Lithuania was 
doing well compared to neighboring countries in terms of the 
financial resources dedicated to fighting the flu.  He said 
Lithuania has stockpiled antiviral drugs and hoped to 
purchase H1N1 vaccine by the end of the year to protect 
medical workers and people in high-risk groups.  (NOTE: 
After leaving the Minister's office, the Ambassador had a 
chance hallway meeting with Audrius Sceponavicius, director 
of the Public Health Department and the ministry's point 
person on flu issues.  He told her that the GOL had acquired 
120,000 courses of Tamiflu and Relenza, and hoped to buy 
20,000 doses of the H1N1 vaccine from other countries in 
December. End note.) 
¶7.  (C)  Ministry officials also told the Ambassador that 
Sweden, as holder of the EU Presidency, would host a meeting 
of all countries in the Schengen visa zone in early December 
to discuss the flu pandemic and hear reports on the situation 
in each country.  Lithuania will participate in that meeting, 
as well as in a December 1 meeting in Brussels at which 
health ministers of EU countries will discuss pandemic flu. 
Budget trumps all 
¶8.  (C) Caplikas, who appeared tired and distracted during 
the meeting, said he looked forward to speaking with the 
Ambassador more fully in the future, but that at present all 
of his time and attention were taken by the need for the GOL 
to get a 2010 budget passed by the Seimas.