GREEK PREPAREDNESS: REQUEST FOR INFORMATION:

C O N F I D E N T I A L SECTION 01 OF 02 ATHENS 002985 SIPDIS E.O. 12958: DECL: 11/10/2015 TAGS: TBIO SENV ECON EAGR EAID PREL AVIANFLU SUBJECT: GREEK PREPAREDNESS: REQUEST FOR INFORMATION: AVIAN AND PANDEMIC INFLUENZA. REF: A. SECSTATE 206992 ¶B. ATHENS 002748 Classified By: AMBASSADOR CHARLES RIES FOR REASONS 1.4(B) AND (C) ¶1. (C) Summary: The GoG is engaged in serious efforts to prepare for a potential outbreak of Avian Influenza. However, while the specific functional responsibilities of the Agriculture, Health, and Public Order Ministries appear to be in place, lack of confidence in senior leadership as well as ministerial territorialism could detract from the overall efficiency of the GoG in the event of an outbreak. The GoG possesses the expertise to diagnose and efficiently quarantine an outbreak in the rural areas, but faces logistical and social challenges if the outbreak occurs in or migrates to an urban setting. The strong working relationship established during the 2004 Olympic Games provides a platform by which the USG can offer the appropriate advice to the GoG regarding preparations for and actions to take during a potential pandemic situation. End Summary. Preparedness and Communication -------------- ¶2. (C) On 18 November, Econoff met with Dr. Theodoros Papadimitriou, Director of the Hellenic Center for Infectious Disease Control (HCIDC) to discuss GoG preparedness with respect to Avian Influenza. Papademitriou was also the GoG representative at October's Avian summit in Washington. He complimented the USG on its aggressive preparations for Avian Flu and presented a copy of the GoG strategy relating to a potential Avian outbreak, drafted after his return from Washington. (Note: Copy of GoG strategy sent to EUR/PGI via pouch. End Note.) ¶3. (C) Papadimitriou was critical of Rural Development (Agriculture) Minister Evangelos Basiakos and his Ministry's handling of the inaccurate announcement that H5N1 was detected on the island of Oiniousses. (Reftel B) He remained concerned about Basiakos' ability to handle any outbreak and said that he would soon ask Minister of Health Nikitas Kaklamanis for greater control over preparations for Avian Influenza. At the working level, Papadimitriou assured Econoff that his "door was always open" and that at the Ministerial level, Kaklamanis would welcome a call from the Ambassador as required. ¶4. (C) While legal review of the GoG Avian strategy has not yet been completed, the process is underway. It is also worth noting that the GoG has also worked closely with its fellow EU members and according to Papadimitriou, has repeatedly consulted with Brussels on testing and preparedness issues. The public and private healthcare system currently has this year's flu shots available around the country, although the vaccines are not produced in Greece. The GoG is not currently developing an H5N1 vaccine, nor do any private Greek pharmaceutical companies possess the production capacity for such a vaccine if it did exist. Request for Assistance -------------- ¶5. (C) Papadimitriou made two requests of the USG at the meeting. The first, was assistance in the acquisition of Tamiflu. Papadimitriou was noticeably frustrated by the lack of support and financial assistance provided by the EU in the acquisition of Tamiflu. The GoG did not expect to receive its order for 100,000 doses of Tamiflu until April at the earliest. Referring to the maker of Tamiflu, Papadimitriou stated "..and Roche is French!" implying disbelief that they had not received more doses of Tamiflu from an EU member state and diplomatic ally. The GoG currently has only 5,000 doses of Tamiflu on hand. The second was access to the information on the progress for an H5N1 variant vaccine and immediate access to such a vaccine when it is developed by the USG. Econoff pledged to pass both requests to Washington. The Weakest Link -------------- ¶6. (C) The hysteria surrounding the suspected case of Avian Influenza in October (Reftel B) led the GoG and the Greek media to provide an excess of information to the Greek public, some correct and some not. Once it was confirmed that H5N1 was not in fact present in Greece, the GoG and the media made a limited attempt to bring some order to the chaos and present clear guidance. The HCIDC has the main points of the GoG plan on their website (www.keel.gr) as well as some links and travel advice for Greeks going abroad. For the rural areas in Greece without access to the internet or mass media, the Ministry of Agriculture has been keeping rural agricultural associations and veterinarians up to date. Overall the public appears to be well informed and has the perception that the GoG has been working on a plan to address Avian Influenza. However, the overall GoG public diplomacy efforts and responsibility of the Greek media are certainly the weakest link in the entire Avian Influenza preparedness chain. It is also worth noting that public demand for Tamiflu has made the drug an un-obtainable commodity in Greece, where anti-virals and anti-biotics are otherwise available over the counter. Surveillance/Detection -------------- ¶7. (C) The working level personnel of the Greek Agricultural sector are competent and dealt with the foot and mouth disease outbreak of the late 1990's competently and efficiently. The GoG possesses the latest diagnostic laboratory equipment at their Virological Laboratory in Thessaloniki but also has an arrangement with the EU lab in Weybridge U.K. to complete diagnostic testing. Like the Ministry of Health, the working level personnel in the Ministry of Agriculture question their senior leadership and the effectiveness of the Ministries of Health and Public Order. They remain confident in their expertise and communication channel with rural poultry producers to provide early warning, containment, and destruction of any infected birds. Provided a timely diagnosis of H5N1 is made, Post believes that the Agricultural system in Greece posseses the internal expertise to effectively confront an outbreak of Avian Influenza should it arrive in the region in the rural/agricultural arena. Response/Containment -------------- ¶8. (C) The GoG preparations for a biological hazard attack at the 2004 Olympic Games provide an effective basis for their response to an outbreak of Avian influenza in a major urban center. However, the current status of the individuals who worked on the bio-hazard task force remains undetermined and while Econoff was assured that there were stockpiles of personal protective equipment, this has not yet been verified. ¶9. (C) It is also worth mentioning that with roughly two-thirds of the entire Greek population in the two major urban centers of Athens and Thessaloniki, the ability of the GoG to contain an outbreak of Avian Influenza to the rural, agricultural centers is key to preventing a pandemic within its borders. The population density of Athens and to a lesser degree Thessaloniki, preclude almost any orderly social distancing or quarantine scenarios. Added to this problem is the contentious role that the police and military play in the fabric of Greek culture. (Note: Greece was under military rule from 1967-74. End Note) Any forced quarantine actions by either group would almost certainly ignite massive civil unrest that might transcend the public fears of Avian Influenza. While the GoG has looked into this scenario in its Avain Influenza strategy, the actual implementation of such a contingency would be very difficult given the social reality of Greek society. Comment -------------- ¶10. (C) It is worth noting that Minister of Health Kaklamanis, upon Papadimitriou's return from the October Avian Summit in Washington, called for a South Eastern European Avian Summit, which took place on 19 November in the Athens suburb of Glyfada. Econoff was invited to attend the roundtable discussion but was not cleared to attend the ministerial level meetings because, according to Papadimitriou, "they wouldn't want you (the USG) to see how disorganized they really were." Papdemitriou pledged to provide Econoff a summation of the meeting. The planning and organization of the summit is a clear example of the GoG placing action behind their rhetoric of making Avian preparedness a priority. While internal problems and details will surely need to be addressed with respect to the overall strategy, Post remains encouraged by the actions taken thus far by the GoG on Avian Influenza. RIES