VIETNAM: AVIAN INFLUENZA WEEKLY REPORT FOR OCTOBER

UNCLAS SECTION 01 OF 04 HANOI 002762

SIPDIS

USAID WASHDC
USAID/RDM-A/BANGKOK PRIORITY

SENSITIVE

STATE FOR G; CA/OCS/ACS/EAP; EAP/EX; EAP/BCLTV; EAP/EP; INR;
OES/STC (PBATES); OES/IHA (DSINGER AND NCOMELLA)
BANGKOK FOR RMO, CDC, USAID/RDM/A (MFRIEDMAN)
USDA FOR FAS/PASS TO APHIS
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (LSTERN)
USAID FOR ANE AND GH (DCAROLL, SCLEMENTS AND PCHAPLIN)
STATE PASS USTR (ELENA BRYAN)
STATE ALSO PASS HHS/OGHA (EELVANDER)
ROME FOR FAO

E.O. 12958: N/A
TAGS: AMED AMGT CASC EAGR PINR SOCI PGOV TBIO VM AFLU
SUBJECT: VIETNAM: AVIAN INFLUENZA WEEKLY REPORT FOR OCTOBER
20, 2005

REF: A) Hanoi 2655 and previous


1. (U) Summary. There have been no new cases of human Avian
Influenza (AI) reported since Mission Vietnam's last weekly
update on October 13 (reftel). The Government of Vietnam
(GVN) is showing increasing commitment to deal seriously
with AI. The level of direct involvement in dealing with a
potential AI pandemic has risen to the Office of Prime
Minister and the chain of command has been streamlined.
Secretary of Health and Human Services Michael Leavitt and

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his delegation met with GVN officials to discuss the AI
situation firsthand during their four day visit to Hanoi.
Poultry vaccinations continue in Vietnam and the need for
assistance to increase lab capacity and provide 20,000-
30,000 injector guns was highlighted during U.S. Department
of Agriculture (USDA) Undersecretary James Butler's visit.
The Embassy and Consulate General held AI Town Hall Meetings
for American citizens. End Summary.

No New Human Cases
--------------


2. (U) There have been no new human AI cases since August

29.

The Level of Concern for AI is High
--------------


3. (SBU) Over the past week, it has become clear that the
level of concern for an AI epidemic has risen to the Office
of Prime Minister and the chain of command has been
streamlined. The GVN has named Deputy Prime Minister Nguyen
Tan Dung as chair of a National Steering Committee for AI
Control, which is currently finalizing a draft Emergency
Action Plan for Vietnam. Furthermore, Minister of
Agriculture and Rural Development (MARD) Cao Duc Phat has
been assigned an AI coordinating role that expands beyond
MARD. (Note: Mission will provide comment on the draft AI
Emergency Action Plan once it has been translated and
received. End note.)


4. (U) Prime Minister Phan Van Khai issued a directive for
all concerned ministries, agencies and sectors on October 15
to urgently develop and implement their respective action
plans. The directive expands the GVN's contingency planning
beyond the Ministries of Health (MOH) and MARD to include
the Ministries of Culture and Information, Public Security,
and Transportation.

READY OR NOT...
--------------


5. (SBU) Several GVN officials have directly indicated that
Vietnam is ill-prepared for a widespread AI pandemic, such
as a worst case scenario where ten percent of the population
is infected with Avian Influenza. During a side
conversation at an AI Donor Meeting October 13, MARD
Minister Phat specifically told the Deputy Chief of Mission
(DCM) that Vietnam does not have sufficient stockpiles of
Tamiflu and respirators to respond to more than a few AI
cases at the same time. For example, in high-risk areas
such as Haiphong Province in northern Vietnam, there are
approximately 20 respirators for a population of nearly
700,000 people.

PRESS REPORTS ON AI
--------------


6. (U) The press has also reported on the potential effects
to the healthcare system. The Ministry of Health (MOH) has
directed hospitals to set up steering boards against bird
flu, build isolation rooms for bird flu patients, and
prepare a sufficient supply of standard equipment amidst the
threat of bird flu outbreaks. MOH also urged hospitals at
all levels to obtain adequate reserves of anti-bird flu
drugs and supplies of medical equipment in order to provide
immediate treatment to patients. The Associated Press
quoted Deputy Head of Haiphong Department of Preventative
Medicine Dr. Le Thi Song Huong (translated),"We can cope
with a small-scale epidemic, as it has already happened over
the past two years, (but if a pandemic occurs),we don't
know what to do."


7. (U) Quoting Ho Chi Minh City Health Service Vice-Director
Dr. Le Truong Giang, the Nguoi Lao Dong Daily said that an
AI preparedness plan has been issued to all local related
agencies in Ho Chi Minh City. The plan is focused on the
quarantine and monitoring systems at the district healthcare
level. Press reports indicate that Ho Chi Minh City is
importing 14 kilograms of Tamiflu powder as part of its AI
preparedness plan. According to Giang, however, this amount
of Tamiflu, in additional to 1,000 courses of Tamiflu that
Ho Chi Minh City has already stockpiled, is only enough to
cope with a pandemic of approximately 15,000 people.

HHS Secretary Leavitt Visit to Vietnam
--------------


8. (U) U.S. Health and Human Services (HHS) Secretary
Michael Leavitt and his delegation of AI experts visited
Vietnam October 15-18. The Secretary met with MOH, MARD,
Vietnam's National Institute of Hygiene and Epidemiology
(NIHE),Haiphong People's Committee, Haiphong Health
Department and Hospital, and toured an HHS/CDC funded
HIV/AIDS Voluntary Counseling and Testing Center (septels).
The Secretary also visited a Hanoi wet market and met with a
family that had contracted and survived AI during his four
day visit.


9. (U) The Secretary's delegation included: Undersecretary
of State for Global Affairs Paula Dobriansky, HHS Deputy
Chief of Staff Kerry Weems, U.S. Agency for International
Development Assistant Administrator Kent Hill, USDA
Undersecretary James Butler, Center for Disease Control
Director Julie Gerberding, National Institute of Allergy and
Infectious Diseases Director Anthony Fauci, HHS National
Vaccine Program Office Director Bruce Gellin, HHS Assistant
Secretary Suzy De Francis, HHS Special Assistant (S/A)

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Steiger, Department of State S/A Turekian, and HHS S/A Bell.

Poultry Vaccination Program Update
--------------


10. (U) According to Vietnam News, the GVN has spent VND
700 billion (USD 44.3 million) for the national vaccination
program, and has vaccinated 50 million birds to date. The
program plans to vaccinate an additional 100 million in
November. According to the World Bank, the GVN is in the
process of purchasing an additional 260 million doses.
Since winter 2004, the GVN has implemented a three-prong
strategy to prevent new outbreaks of AI in poultry and
waterfowl, namely culling, bio-security and movement control
and large-scale vaccination campaign for domestic poultry
and ducks.


11. (SBU) USDA Undersecretary James Butler observed poultry
vaccinations in Bac Ninh province and had discussions with
officials from MARD's Department of Animal Health (DAH) on
October 12. Butler's visit was useful in defining USDA's
role in assisting Vietnam's AI control program. USDA APHIS
Epidemiologist Dr. Cheryl Hall, who has expertise in
training in real time PCR (a diagnostic test),will be
posted to Hanoi as an Embassy Science Fellow. DAH currently
has one laboratory capable of real time PCR, but needs to
extend the capability to two more labs. The additional
equipment and supplies for this expansion would cost in
total $100,000 to $150,000. (Note: Embassy believes that
USDA should consider providing equipment along with a
laboratory expert. USDA could also use its AI funding to
replace some of the inadequate Chinese injection guns being
used in the vaccination program with better American models.
FAO has identified 2 suppliers in Europe to provide better
guns but it will probably take additional suppliers to
quickly procure 20,000-30,000 vaccination guns Vietnam
needs. End Note)

U.S. and Other Donor Assistance and Coordination
-------------- ---


12. (U) The United Nations Resident Representative hosted a
meeting of resident ambassadors in Vietnam on October 17 to
discuss AI issues with the new Global Coordinator for AI
David Navarro. Navarro spoke about the importance of donor
coordination and of balancing short-term efforts with medium
to long-term planning. He encouraged support for the
upcoming November 7-9 meeting of international donors which
will determine the principles for AI funding distribution
and establish a mechanism for donor communication.

AI Town Hall Meetings
--------------


13. (SBU) The DCM hosted an AI preparedness "Town Hall
Meeting" for private American citizens and representatives
of U.S. companies on October 19 (septel). Sponsored by
AmCham, there were more than 100 and others present. During
a side conversation, SOS, a private clinic serving the
expatriate community, said they were informed by Roche Drug
Company on October 14 that they will not be able deliver
their current Tamiflu order. Roche told SOS that the GVN
was "taking" the drugs for their use in the country. (Note:
This is unconfirmed but likely an indication of the GVN's
efforts to stockpile Tamiflu under Central Government
control. End Note.)


14. (U) In Ho Chi Minh City, the U.S. Consulate General also
gave an AI presentation to approximately 110 AmCham members.
The session touched on what is known about AI in Vietnam,
fact vs. speculation, and the ConGen's own plans and
responsibilities to the Amcit community in case of a broader
AI outbreak. ConGen's medical staff was on hand to give an
overview of causes of, symptoms of, and preparedness for AI,
including a summary of Tamiflu's potential role in treatment
and prophylaxis. The presentation was followed by a
question and answer period, during which AmCham members
raised a wide range of issues, including alternatives to
Tamiflu, flu shots, and the Consulate's warden system.

BOARDMAN