FLU PANDEMIC PREPAREDNESS: THAILAND

C O N F I D E N T I A L SECTION 01 OF 03 BANGKOK 005626

SIPDIS

NOFORN

E.O. 12958: DECL: 08/24/2015
TAGS: EAGR ECON PGOV PINR SOCI TBIO TH
SUBJECT: FLU PANDEMIC PREPAREDNESS: THAILAND

REF: STATE 151549

Classified By: DCM ALEX ARVIZU, REASON 1.4(D).


1. (C/NF) Summary: The responses below are in reply to
questions contained in Reftel. In general, Thailand is
increasingly capable and increasingly transparent in
detecting, reporting, and planning for and responding to
avian influenza outbreaks in animals and humans. Although
Ministry of Public Health personnel would benefit from more
intensive training in pandemic control measures and
laboratory diagnostic methods, and the Department of
Livestock Development would benefit from technical assistance
to improve its information systems management infrastructure,
Mission is confident that Thailand would respond rapidly,
effectively, and transparently to contain any outbreak of
avian influenza within its borders. End summary.


2. (C/NF) The following are Mission responses to questions
contained in Reftel:


Q. Where does preparing for an avian flu pandemic rank among
government priorities? Who and what would influence the
country to give the issue a higher priority?


A. This issue has the attention of the highest levels of the
Thai government. The Prime Minister has been directly
involved in the response, and committees have been formed at
various levels of the government to address the issue. Fresh
outbreaks among humans would likely raise it to the
government's top priority.


Q. Does the government have a strategy for preventing avian
flu from becoming a pandemic and containing a pandemic once
it occurs? If the country has a strategy, how capable is it
of implementing it?


A. Thailand has developed and published a plan for both
control of avian influenza in poultry and for a response to a
human influenza pandemic. These documents are publicly
available in English and Thai languages. Substantial
resources have been committed to avian influenza containment
and pandemic planning. Within the limits of national
resources, the Government of Thailand is capable of an
effective response to a human influenza pandemic.


Q. What measures has it taken to date to prepare for a
pandemic (stockpiling antiviral medications, conducting
surveillance, developing human vaccines, etc.)?


A. The Government of Thailand now has a national stockpile of
700,000 treatment courses of the antiviral drug oseltamivir.
Surveillance and Rapid Response Teams (SRRT) have been
trained and organized in every province of Thailand. The
National Institute of Health maintains a laboratory capable
of processing large numbers of specimens and accurately
identifying avian influenza in humans.


Q. How capable is the country of detecting and responding to
an outbreak, especially in rural areas?


A. The Government of Thailand is capable of identifying
clusters of two or more cases of avian influenza in a
locality within a few days in most cases. Isolated cases of
human infections might go undetected.


Q. How truthful will the government be in reporting the scope
of any outbreak?

A. It is possible that some under-reporting may take place
(new outbreaks could have a ruinous effect on its poultry
exports and its tourism industry). Over the past 12-16
months, however, the Government of Thailand has been
increasingly transparent in reporting suspected and confirmed
animal and human cases of avian influenza.
Laboratory-confirmed human cases have been promptly reported
to WHO. Likewise, outbreaks of the infection in poultry have
been promptly reported to the OIE.


Q. How willing and capable is the government of imposing
quarantines and social distancing measures (closing schools,
public gatherings, mass transit)?

A. The Government of Thailand is willing and capable of
establishing quarantine measures on its population if
necessary. Contingency plans for such measures have been
established, and the Ministries of Defense, Transportation,
and Education have been included in recent pandemic planning
meetings.


Q. What are the critical gaps that need to be filled in order
to enhance the country's disease detection and outbreak
response capabilities? What is the country's greatest need
from the US or other international organizations?


A. Additional, more intensive training for Ministry of Public
Health physicians and epidemiologists on avian influenza and
pandemic control measures is needed. On-site training for
sophisticated molecular and serologic laboratory diagnostic
methods is also needed. Technical assistance to improve the
information systems management infrastructure at the
Department of Livestock Development would be useful.


Q. Would government leaders be receptive to messages from US
leaders through a bilateral approach, at a multilateral forum
such as the UN or APEC, or through bilateral contacts with
another country?


A. Yes to all. Thai leaders would be receptive to messages
indicating a desire on the part of the US to support and
collaborate on efforts to control avian influenza and plan
for a human pandemic with technical assistance such as
advanced training in laboratory diagnostics. Thailand has
assumed a regional leadership role on this issue and has the
capability and willingness to function as a regional
coordinator and partner for avian flu preparedness activities.


Q. Who is the key "go-to" person or office for USG officials
to interface with?


A. Deputy Prime Minister Chaturon Chaisang and Dr. Supamitr
Chunsutiwat at the Thailand Ministry of Public Health.


Q. How well-informed is the population about the avian flu
threat and about measures they should take to mitigate the
threat?


A. The Government of Thailand has undertaken measures to
inform the public, including the distribution of printed
media, radio, and television programs. Outside of Thai
farmers and others directly engaged in applying control
measures to halt the avian/avian transmission of the virus,
however, the general Thai population is not particularly
well-informed about the avian flu threat. In particular, the
overall population knows little about the evidence of
human-to-human transmission or the possibility of mutation
that could launch a human pandemic. The broader Thai public,
therefore, has little knowledge about the potential
epidemiological implications of avian influenza mutation, the
need for rapid response to contain the spread of
human-to-human transmission, or the public health measures
required as part of that response. A recent US CDC study in
Nakhon Province in Northeast Thailand suggested that the
population there is informed regarding risk factors for avian
influenza infection, but that more work remains to effect
real behavioral changes.


Q. Is the host country already working with any international
organizations or other countries on the avian flu issue? Are
government leaders likely to ask for assistance from the US
or other countries?


A. The Government of Thailand has met with numerous political
representatives and maintains collaborative relationships
with technical experts from several regional countries
affected by avian influenza. The Government of Thailand has
asked for technical assistance from the US CDC in the past.
The US CDC continues to actively collaborate on the issue,
particularly by improving surveillance and laboratory
diagnostic capacity. The Government of Thailand is not
likely to ask for direct financial aid to address this issue,
but welcomes technical cooperation and assistance at
different levels.


Q. Would its military enforce quarantines?


A. Yes, in addition to local police forces.


Q. What would it want from the US in return for its request
efforts?


A. The Government of Thailand would appreciate political
support and technical assistance from the US to establish and
maintain a regional stockpile of antiviral drugs and personal
protective equipment.


Q. What mechanisms are available for providing additional
information to the population, particularly in rural areas,
and how effective are these measures?


A. National radio and broadcast television are the only media
to reach all parts of Thailand, and even that extensive
broadcast range includes small populations whose
comprehension of spoken Thai language is minimal. Because
all national broadcast radio and TV are government-owned or
affiliated, the Royal Thai Government could quickly
disseminate emergency information via these national media
with a good prospect of reaching a substantial proportion of
the population within as little as 48 hours. Many local
villages also employ loudspeaker systems to deliver messages
to the public. As always, the clarity of the message and the
speed with which the Royal Thai Government embraced the need
to communicate it would determine the success in any
emergency information campaign.
ARVIZU