EGYPT PREPARING FOR AVIAN INFLUENZA

UNCLAS SECTION 01 OF 03 CAIRO 007552 SIPDIS SENSITIVE E.O. 12958: N/A TAGS: TBIO ECON PREL SOCI WHO KSTH SUBJECT: EGYPT PREPARING FOR AVIAN INFLUENZA REF: A. STATE 153802 ¶B. STATE 175585 ¶C. STATE 180478 This message is sensitive but unclassified, please handle accordingly. -------------- Summary -------------- ¶1. (SBU) Government of Egypt officials share our concerns regarding avian influenza (AI). The GOE's close co-operation with Cairo's U.S. Naval Medical Research Unit (NAMRU-3) has positioned it for effective surveillance of AI, though the system has some limitations. However, the political will to contain an outbreak absent a plan for compensation for poultry destruction remains a question. Post is working with the GOE to facilitate the travel of an appropriate GOE official to the October 6 partnership meeting in Washington. End summary. ¶2. (U) In separate meetings, ECPO Counselor met with representatives from the Egyptian Ministry of Health and Population (MOH) and the Ministry of Agriculture and Land Reclamation (MOA) and addressed the USG's concerns regarding AI as laid out in Ref A. ECPO Counselor was accompanied by representatives from NAMRU-3 at the MOH and from the Foreign Agricultural Service (FAS) at the MOA. ¶3. (SBU) In a separate meeting with Ministry of Foreign Affairs (MFA) Environmental Counselor Omar Ali Abou Eiche, EST officer delivered an invitation to the October 6 International Partnership on Avian and Pandemic Influenza meeting in Washington to the MFA, per Ref B. The meeting agenda and other information was separately delivered to the MFA, the MOH, and the MOA per Ref C. The MFA informed the Embassy that it had no objection to the core principles, however, funding constraints would mean the MFA probably will not be able to send a representative from Cairo to the meeting. The MOA informed FAS that Agricultural Attache Dr. Hussein Mansour from the Egyptian embassy in Washington would attend the event. (Note: Subsequent to this discussion, NAMRU-3 confirmed it can fund travel for a GOE representative to the meeting. Post is working with the GOE to identify an appropriate official and facilitate travel. End note.) -------------- AI Programs at the Ministry of Health -------------- ¶4. (U) In the meeting at the MOH with Dr. Magda A. Rakha, First Under Secretary (i.e., Deputy Minister) of Health, and Dr. Nasr El-Sayed, Under Secretary for Preventive Affairs, ECPO Counselor explained the USG's concerns regarding avian influenza (AI),stressing its worldwide effect, the possibility of a pandemic, and the need for transparency on the part of all governments, both during the preventive stages of action as well as in the event of an outbreak. ECPO Counselor noted Egypt's already close cooperation with NAMRU-3 to conduct surveillance of migratory birds and of human outbreaks through the NAMRU-initiated health surveillance system. ¶5. (U) Dr. Rakha stated that the GOE is taking the AI threat seriously and noted that the Minister of Health, Dr. Tag El Din, postponed a recent trip to Sudan in order to deal with this issue. The Ministry had also recently been briefed on the subject by the Canadian embassy. ¶6. (U) Dr. El-Sayed, who is the ministry's point of contact for AI, said that there has been much activity in the last month on AI. The Ministries of Health, Agriculture, Environment and Defense, including MOH staff from the pharmaceutical and virology departments, met on September 13 to form a National Committee and to discuss influenza pandemic preparedness with representatives from the World Health Organization (WHO) and NAMRU-3. The discussion touched on epidemiology, transmissibility and treatment options. ¶7. (U) The GOE is working with NAMRU-3 to strengthen its laboratory capabilities. The GOE is now formulating a National Plan to deal with AI, and they already have an Emergency Plan in place to coordinate among concerned agencies and the poultry industry should an outbreak occur. ¶8. (U) According to Dr. El-Sayed, Egypt will represent the Middle East region at a proposed ministerial-level meeting in Canada in mid-October. Also, the MOH received an invitation September 17 from Search for Common Ground to a meeting in December on AI. Invited to the meeting are representatives from Egypt, Israel, the Palestinian Authority, and Jordan, to develop a common vision and to discuss national, regional and global plans to combat AI. Dr. Rakha said the GOE intends to accept the invitation. -------------- Ministry of Agriculture Concerns about AI -------------- ¶9. (U) Subsequent to the meeting at the MOH, ECPO Counselor and the acting Agricultural Counselor met with MOA representatives Dr. Fadia Nossier, Undersecretary of the Central Administration for Foreign Agricultural Relations, and Dr. Mona Aly, a national laboratory director who has been named the MOA's POC for AI. ¶10. (SBU) Aly noted that her organization is working with a National Academy of Sciences project to screen chicken farms for AI. The project was begun two years ago and will finish in six months. According to Aly, AI has been detected in migratory birds in Egypt, but the strain of AI is not believed to be the virulent form of the disease. ¶11. (U) Egypt is currently working on an inspection program that visits one farm per week and focuses on problem flocks, e.g., those with high mortality, or where there is suspicion of a need for isolation. The Poultry Producers Union is cooperating with the Egyptian government on the screening of small farms. ¶12. (U) Aly reports to the Chief Veterinary Officer, Dr. Ahmed Tawfik, who in turn notifies the OIE (Office International des Epizooties/the World Organization for Animal Health) of any problems of contagion. Aly acknowledged that the system still needs a lot of work. In the event where AI is detected, the virus must be typed, and further investigation would be needed. ¶13. (SBU) GOE officials know little about the presence of AI in Egypt's neighboring countries. Saudi Arabia reported an outbreak of the low pathogen H9 strain two years ago. There have been prior instances of poultry destruction in Egypt, e.g., in a case where ducks were infected with salmonella. According to Aly, the farmers are willing to accept some ordered destruction because of the government's authority. However, large-scale destruction would be difficult to carry out if there is no compensation. ¶14. (U) Aly noted that the GOE needs to send staff abroad for laboratory training, and also needs reagent in order to carry out virus typing, but is suffering from a lack of funds. -------------- Migratory Routes and Egypt's Vulnerability -------------- ¶15. (SBU) Bird migrations in Egypt are now underway. The season begins in September-October and runs through March-May. One of the main issues for Egypt is surveillance. The country is a significant migratory route, which leaves its very large poultry sector (800 million chickens) vulnerable. Although surveillance of the domestic chicken population has begun, it needs to be extended. There is support from farmers for AI research. Many poultry farmers in Egypt are educated, and vaccinate their chickens regularly. A major problem, however, is that free-ranging chickens are common in Egypt, and chickens are kept close to migratory bird paths. -------------- Questions about Support -------------- ¶16. (SBU) Rakha and El-Sayed asked what kind of international support would be available should an AI outbreak occur. They pointed out that, for transparency to be effective, it requires that a nation be able to rely on international help, e.g., compensation for slaughtered chickens. Rakha and El-Sayed suggested that it would be difficult to persuade Egyptian producers to destroy their flocks if they were not assured of compensation. The two opined that, since it is a global problem, i.e., an international public health concern, there must be an international response. -------------- NAMRU-3's Assistance -------------- ¶17. (U) NAMRU-3 has spawned numerous collaborative efforts in health research in Egypt, and has state of the art laboratory equipment. NAMRU-3 is currently training technicians from the region in virus detection techniques. ¶18. (U) NAMRU-3 has created an electronic national surveillance system for the reporting of contagious diseases. The technology is in place, with equipment and training provided by funds from USAID. The system is near to being implemented throughout Egypt's 26 governates and 375 districts. It can be implemented by laboratory diagnostic systems in place in hospitals. The surveillance system has limited detection capabilities, and it is not set up to specifically detect AI. Few labs in the country can now do AI analysis. The system uses standard WHO kits for flu typing. Only five people in Egypt currently have the training to do flu typing. -------------- Comment -------------- ¶19. (SBU) As noted above, Egypt is vulnerable because it lies in the path of migrating birds known to carry the virus, especially the shoveler and teal. Egypt's vulnerability is increased because most poultry is kept outdoors and cannot be isolated from migrating birds. As in other countries, large-scale, uncompensated destruction of affected or potentially affected poultry would be politically very difficult, thus our interlocutors' keen interest in learning more about programs to reimburse farmers. ¶20. (SBU) The presence of NAMRU-3 and a USDA/APHIS Veterinary Officer in Cairo and the close cooperation with the Ministries of Health and Agriculture, respectively, leaves post unusually well-positioned to detect any AI outbreak in Egypt early and coordinate with the government on an effective response. Visit Embassy Cairo's Classified Website: http://www.state.sgov.gov/p/nea/cairo You can also access this site through the State Department's Classified SIPRNET website. JONES