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