UAEG'S PREPARATIONS FOR AVIAN INFLUENZA

UNCLAS SECTION 01 OF 03 ABU DHABI 004902

SIPDIS

USDA/FAS FOR CMP/DLP/WETZEL

E.O. 129589: N/A
TAGS: TBIO SENV ECON EAGR EAID PREL TC
SUBJECT: UAEG'S PREPARATIONS FOR AVIAN INFLUENZA

REF: A)STATE 209622, B)STATE 153483, C)STATE 151549,
D) ABU DHABI 04225


1. (U) In response to the questions posed Reftel A regarding the
UAEG's efforts to protect against avian influenza (AI) and its
capability to respond to a pandemic, the following information is
provided.

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Preparedness
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2. (U) The UAEG has formed a National Avian Influenza Emergency
Committee (NAIEC) composed of representatives from the
Environment Agency, the General Authority for Health Services,
the Ministry of Agriculture and Fisheries, the Health Authority,
General Secretariat of Municipalities and the military to develop
a comprehensive plan to prevent and/or manage an AI pandemic in
the UAE. Majid Al Mansouri, Secretary General of the Abu Dhabi
Environment Agency, chairs the committee. Weekly meetings are
held with all members of the committee. Sheikh Mohamed bin Zayed
Al Nahyan, Crown Prince of Abu Dhabi and Deputy Supreme Commander
of the UAE Armed Forces, also attends the meetings once a month.
The UAEG's plan is based on the WHO Health and Medical Services
Contingency Plan for an Influenza Pandemic. The UAEG has a flow
sheet in Arabic detailing what their response will be in various
stages of pandemic preparation. The flow sheet details
procedures for preparation for both an avian epidemic and a human
epidemic. Emboffs along with USDA consultants reviewed the flow
chart with Ministry of Agriculture & Fisheries (MAF) officials
with regard to an avian outbreak, but were not given a copy of
this internal UAEG document.

-Prevention of an avian epidemic involves measures such as
banning the importation of live birds from countries that have
reported cases of High Pathogenic Avian Influenza (HPAI) H5N1.
The MAF is quarantining and testing non-poultry birds,
particularly falcons, which arrive at major ports of entry and is
also coordinating inspections of live bird markets, pet stores
and commercial poultry farms. The Abu Dhabi Environmental Agency
has closed live bird markets both in Abu Dhabi and Al Ain and
instructed owners to confine domestic birds indoors as an
additional precaution against inadvertent infection by migratory
birds. The UAEG established and broadly publicized a consumer
hotline. Reportedly, response time on calls to the hotline is
slow.

-The UAEG is capable of implementing any AI plan developed. This
is a country rich in fiscal resources and appears to have the
political will to address the AI issue in the event of an avian
or human epidemic.

-The UAEG will likely be forthcoming in reporting cases of AI in
humans, but not in avian populations due to sensitivities
concerning the falconry industry. (Falcons are kept as pets and
used in hunting by Gulf Arabs. The most expensive falcons cost
$30-40K.) The U.S. could offer more technical assistance to
encourage transparency and prompt reporting of AI.

-The UAEG appears to be taking the threat of AI seriously with
preparation for a pandemic high on the UAEG's list of priorities.
The key go-to person is Majid Al Mansouri, Secretary General of
the Abu Dhabi Environmental Agency, who heads the AI committee.
He reports directly to the Abu Dhabi Crown Prince. However, if
dealing with live avians, the go-to person is Asst. U/S Abdullah
Abdul Azziz, Ministry of Agriculture and Fisheries. The country
has allocated 35 million dirhams (9.5 million USD) to combat AI
via preventive programs and post-detection eradication measures.

-UAE national laws restrict the Federal Ministry of Agriculture's
ability to confiscate privately-held exotic birds. However,
municipalities are not constrained by this legal restriction and
can, and have, confiscated pet birds and poultry as a risk
reduction measure among domestic avian and poultry populations.

-The UAEG is in regular contact with the WHO and the Food and
Agricultural Organization (FAO) and has repeatedly stated that
they are following WHO planning and response guidelines. UAE
officials have met with embassy staff on several occasions and
have been helpful and responsive. Teams of AI experts from the
US, the FAO, Belgium and Australia evaluated the UAEG's AI action
plan and its implementation thus far. The UAEG remains very
interested in more bilateral assistance from the USG and is also
coordinating a multilateral approach with other GCC countries to
promote prevention, detection and eradication of AI H5N1 within
the region.

-The UAE's annual Flu Vaccine Program is implemented through
hospitals, clinics, and the preventive medicine clinic. The Flu
vaccine given is Aventis Pasteur Vaxigrip, which is produced in
Lyon, France. No flu vaccine is produced locally. The UAE does
not produce AI H5N1 vaccine for poultry, but likely would once
such vaccine is developed.

-The Abu Dhabi Environment Agency produced and distributed an
informational brochure on AI to consumers throughout the UAE
while the MAF issues a separate brochure to the poultry sector.
AI has figured prominently in the newspapers, although
comprehensive information on a)the potential avenues for AI to
spread or b) basic preventive health measures consumers could
adopt is not well disseminated. Many sectors of the population
are receiving some information about the disease, but there is a
risk that many third-country nationals will remain ill-informed.
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Surveillance/Detection
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3. (SBU) Avian surveillance is ongoing in commercial poultry,
imported avian and live bird markets. However, the Ministry of
Agriculture does not have strong diagnostic capabilities and
relies almost exclusively on a reference laboratory in England to
analyze samples. The USDA is addressing this dependency on
outside resources by sponsoring local Ministry officials for
training in the U.S. The November visit of USDA officials
revealed that MAF field officials were applying a rapid response
ELIZA test, designed for detecting H5N1 in falcons, to all avian
species. Officials seemed unaware that such a test will always
generate a false negative in an infected bird. During an
interview, MAF officials confirmed that technical advisors from
the Food and Agricultural Organization, Belgium and Australia had
also identified this field test as erroneous. The MAF explained
that this test was utilized on the order of the National Avian
Influenza Emergency Committee as the official test to be given
throughout the country.

-Testing of humans can be done at Sheikh Khalifa Medical Center.
The center already has the technical equipment needed to run the
verification tests for H5N1 in samples. Reagents for the PCR of
H5N1 have been ordered and are expected to arrive in 4 weeks.
The GAHS has a contract with a laboratory in the UK for viral
cultures needed for verification.

-There are critical gaps in the UAE's detection capabilities.
The most pressing gap in the UAE's outbreak response capability
is the threat of hospitals being overwhelmed by patients in the
event of an outbreak. There are currently 55-72 beds designated
for AI isolation. In the event of an outbreak, it is expected
that the military would be able to increase that capacity. All
AI cases would be treated at government hospitals. It is not
clear how many of those are negative flow rooms. However, the
ICU beds in the government hospitals here often have terminally
ill VIP patients who remain in the ICU for months to years,
taxing the potential response of the health care system. While
the UAE has good hospitals and equipment, an AI epidemic could
quickly overwhelm the health system.

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Response/Containment
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4. (U) The UAE public health sector has 10,000 doses of Tamiflu
stockpiled. They have ordered 4 million more doses, expecting
the first 1 million to arrive in March. One source reported that
the Health Authority has increased its order to 10 million doses.
The country also has stockpiles of antibiotics to treat secondary
infections.

-The UAE has sufficient supplies of Personal Protective Equipment
(PPE) in place for its medical staff, and have ordered more as a
back-up. The Ministry of Agriculture does not have any PPE for
its employees. Of the Municipalities, only Abu Dhabi is known to
have a limited quantity of PPE for its Department of Agriculture
veterinarians.

-The rapid response capacity for an outbreak of AI is based on
police and military support. Existing Ministry of Agriculture
guidelines would be the basis for any action taken related to
culling, facility sanitizing and animal movement control in the
event of an outbreak among avian populations, although no
official plan has been developed. The Ministry of Agriculture
appears willing to quarantine poultry and falcons, which are the
primary vector risk for the disease into the country's poultry
sector--aside from migratory fowl.

-The Health Authority and Military will likely work together in
the event of a human outbreak. Quarantine measures are
recognized as the appropriate course of action, but details on
how such measures would be implemented are still under
development. We expect that the UAE health system could be
quickly overwhelmed in the event of a regional pandemic, simply
because of the sheer numbers of desperately ill persons who would
be present at hospitals. The health care that hospitalized
patients generally receive here is of good quality based on world
standards.

-The UAEG is willing to impose quarantines. It is unclear how
these quarantines will be implemented, but it is likely that the
military would assist. It is unclear if quarantine mandates
could effectively control the movement of VIPs or other elite
segments of local society. However, it is likely that the UAEG
would be highly proactive in closing schools and banning public
gatherings. UAE officials have indicated that air travel could
also be halted.

SISON