SPAIN: RESPONSE TO REQUEST FOR INFORMATION ON

UNCLAS SECTION 01 OF 04 MADRID 004022 SIPDIS SENSITIVE STATE FOR OES/IHA (SINGER/DALEY),INR (LESTER),AND EUR/WE; HHS FOR STEIGER/BUDASHEWITZ/GAY) E.O. 12958: N/A TAGS: TBIO SENV ECON EAGR EAID PREL SP SUBJECT: SPAIN: RESPONSE TO REQUEST FOR INFORMATION ON AVIAN AND PANDEMIC INFLUENZA REF: A. SECSTATE 206992 ¶B. MADRID 3635 AND PREVIOUS Below are Post's responses to Ref A queries on Spain's response to the Avian Influenza threat. A) PREPAREDNESS/COMMUNICATION -- DOES THE GOVERNMENT HAVE A PREPAREDNESS PLAN/STRATEGY FOR PREVENTING AVIAN FLU FROM BECOMING A PANDEMIC AND CONTAINING A PANDEMIC ONCE IT OCCURS? Yes. IF THE COUNTRY HAS A STRATEGY, HOW CAPABLE IS IT OF IMPLEMENTING IT? Spain has a capable national health care system that should be able to implement this plan. Of course the plan's effectiveness depends on the nature of any possible pandemic. PLEASE PROVIDE A COPY OF THE PLAN OR THE INTERNET ADDRESS FOR THE PLAN. The human plan is entitled National Influenza Preparedness and Response Plan and is available in English at: http://www.msc.es/enfermedadesLesiones/enfTra smisi/PlanPande miaGripre/pdf/PlanGripeIngles.pdf. The animal plan can be found at http://www.mapya.es/ganaderia/pags/influenza_ aviar/plan_esta tal.pdf. -- HOW TRUTHFUL WILL THE GOVERNMENT BE IN REPORTING THE SCOPE OF ANY DISEASE OUTBREAK AMONG PEOPLE? As an EU Member state and OECD economy, we are confidant that Spain will fully comply with national, EU and WHO guidelines regarding the reporting of any disease outbreak among people. AMONG ANIMALS? Ditto. WHAT INCENTIVES COULD BE OFFERED THAT WOULD LIKELY RESULT IN MORE TRANSPARENCY? Transparency is not a likely concern vis-a-vis Spain. -- WHERE DOES PREPARING FOR AN AVIAN FLU HUMAN PANDEMIC RANK AMONG GOVERNMENT PRIORITIES? This issue has been addressed by Prime Minister Zapatero and the Spanish Council of Ministers and is a clear government priority that has received continuous and constant attention from both the Health and Agriculture Ministries. WHO AND WHAT WOULD MOST INFLUENCE THE COUNTRY TO GIVE THE ISSUE A HIGHER PRIORITY? The Health and Agriculture Ministers are on public record saying that the immediate threat of a human Avian Influenza pandemic has been exaggerated and that Spain has adequate plans in place to deal with all eventualities. Absent a sea change in the views of the Spanish scientific community, which also believes the threat has been exaggerated, influencing this policy line would likely require an approach to Prime Minister Zapatero. However, should Spanish expert analysis change (e.g., in the event of a human pandemic gradually emerging),we would expect the two Ministries to alter their policy lines in keeping with widely held expert views. The bottom line is that Spain has resisted what it believes to be the "politicization" of the issue and wants policy based on what it perceives to be a cold, hard assessment of the scientific facts. WHO IS THE KEY "GO-TO" PERSON, OFFICE OR DEPARTMENT (I.E. MINISTER FOR HEALTH, PRIME MINISTER, ETC.) FOR USG OFFICIALS TO ENGAGE ON THIS ISSUE? The key GOS official on human Avian Influenza is Health Ministry Director General for Public Health Manuel Onorbe. Be aware that Onorbe firmly believes that the threat of a human pandemic has been exaggerated. -- HAVE NATIONAL LAWS BEEN REVIEWED TO ENSURE THAT THEY ARE CONSISTENT WITH THE INTERNATIONAL HEALTH REGULATIONS AND DO NOT POSE BARRIERS TO AVIAN INFLUENZA DETECTION, REPORTING, CONTAINMENT, OR RESPONSE? Embassy is not aware of any national laws that had to be revised in connection with Spain meeting its detection, reporting, containment, or response commitments under either the national plans or international commitments. -- IS THE HOST COUNTRY ALREADY WORKING WITH INTERNATIONAL ORGANIZATIONS OR OTHER COUNTRIES ON THE AVIAN FLU ISSUE? Spain addresses this issue as an active member of relevant EU, WHO, and FAO bodies. ARE GOVERNMENT LEADERS LIKELY TO ASK FOR ASSISTANCE FROM THE US OR OTHER COUNTRIES? Spain is a strong supporter of greater EU cooperation on Avian Influenza, in particular urging the creation of an EU-wide anti-viral/vaccine repository which could be utilized for any potential outbreak inside EU borders. Spain would likely seek EU, WHO, or FAO assistance before requesting bilateral help from the U.S. WOULD GOVERNMENT LEADERS BE RECEPTIVE TO MESSAGES FROM US LEADERS THROUGH A BILATERAL APPROACH, AT A MULTILATERAL FORUM SUCH AS THE UN (WHO,FAO,ETC.) OR APEC, OR THROUGH BILATERAL CONTACTS BY A THIRD COUNTRY? Spanish authorities would be receptive to bilateral approaches from U.S. leaders. There would be no need to deliver such messages via third countries. WHAT WOULD THE COUNTRY WANT FROM THE US IN RETURN FOR ITS EFFORTS? Spain would not likely link greater Avian Influenza cooperation to other issues. -- DOES THE COUNTRY CURRENTLY ADMINISTER ANNUAL FLU SHOTS? Yes IF NOT, MIGHT IT CONSIDER DOING SO? Not applicable. WHAT IS THE PRODUCTION CAPABILITY (I.E. HOW MANY DOSES OF THE ANNUAL TRIVALENT FLU VACCINE CAN THE COUNTRY MAKE) FOR HUMAN INFLUENZA VACCINES IN THE COUNTRY? To the best of our knowledge, Spain does not currently have a flu vaccine production capability. It plans on opening such a facility in 2006. DOES THE COUNTRY PRODUCE INFLUENZA VACCINE FOR POULTRY AND IF SO HOW MUCH? Unknown. IF THE COUNTRY IS DEVELOPING AN H5N1 VACCINE, WHERE IS IT IN PRODUCTION AND TESTING? Spain does not yet have a domestic human vaccine production capability. ANY LICENSING ISSUES? Not applicable. IS THERE A LIABILITY SHIELD FOR FOREIGN MAKERS/DONORS OF VACCINES? No. While this would not likely emerge as an issue, it would be prudent for any U.S. government agency donating vaccines to Spain to request such a liability shield. IF NOT, ANY PROSPECTS OF ONE BEING ENACTED? Not to our knowledge. --HOW WELL INFORMED IS THE POPULATION ABOUT THE AVIAN FLU THREAT AND ABOUT MEASURES THEY SHOULD TAKE TO MITIGATE THE THREAT? The population is well informed about the threat and of general measures they should take to mitigate the threat. WHAT MECHANISMS ARE AVAILABLE FOR PROVIDING ADDITIONAL INFORMATION TO THE POPULATION, PARTICULARLY IN RURAL AREAS AND HOW EFFECTIVE ARE THESE MEASURES? Mechanisms exist to disseminate such information. The key challenge is convincing Spanish officials that the threat is currently serious enough to provide such information now. B) SURVEILLANCE/DETECTION -- HOW CAPABLE ARE THE MEDICAL AND AGRICULTURE SECTORS OF DETECTING A NEW STRAIN OF INFLUENZA AMONG PEOPLE OR ANIMALS RESPECTIVELY? Very capable. Appropriate detection equipment has been widely deployed. HOW LONG MIGHT IT TAKE FOR CASES TO BE PROPERLY DIAGNOSED, GIVEN OTHER ENDEMIC DISEASES? Humans: Same as in the U.S. Spanish surveillance systems are similar to those in the U.S. Spanish hospital and diagnostic skills and capabilities are comparable to those found in the U.S. Animals: Madrid's Alegete Central Veterinary Lab has robotized diagnostic equipment than can analyze over 90 samples per hour. If a suspected case is reported, the entire diagnostic process from reporting through testing would likely take less than 24 hours. CAN INFLUENZA VIRUSES BE SUBTYPED IN THE COUNTRY, IF SO BY WHO, AND IF NOT WHERE ARE THEY SENT? Humans: Yes. At the National Virus Center in a Madrid suburb. Animals: Yes. By the Alegete Lab. DOES THE COUNTRY SEND SAMPLES TO A WHO/EU/US REFERENCE LABORATORY? Yes -- for confirmation of domestic results. The samples are usually sent to the EU Lab in Weybridge, UK. -- WHAT ARE THE CRITICAL GAPS THAT NEED TO BE FILLED IN ORDER TO ENHANCE THE COUNTRY'S DISEASE DETECTION AND OUTBREAK RESPONSE CAPABILITIES? Detection: None. Outbreak: Develop a domestic vaccine production capacity and take delivery of anti-virals on back order (pending due to Roche's inability to meet current "Tamiflu" demand). WHAT IS THE COUNTRY'S GREATEST NEED IN THIS AREA FROM THE US OR INTERNATIONAL ORGANIZATIONS? More a question of time (build a vaccine production facility and take delivery of backordered anti-virals) than of assistance from the U.S. or an international organization. C) RESPONSE/CONTAINMENT -- DOES THE COUNTRY HAVE A STOCKPILE OF MEDICATIONS, PARTICULARLY OF ANTIVIRALS, AND IF SO HOW MUCH? Since the summer, Spain has begun efforts to stockpile anti-virals, in particular Roche's "Tamiflu." IF SOME HAS BEEN ORDERED, HOW MUCH AND WHEN IS IT EXPECTED? Spain has ordered anti-virals to cover approximately 25 percent of its population but has only received limited deliveries from Roche. Delivery of the entire order is not expected until late 2006. --DOES THE COUNTRY HAVE A STOCKPILE OF PRE-POSITIONED PERSONAL PROTECTIVE GEAR? Yes. There are 48 centers located around the country (at least one in each of Spain's 17 regions) that contain all necessary quick response equipment, including personal protective gear. In addition, some special police, health, fire, and armed forces units control limited stockpiles of such gear. --WHAT IS THE RAPID RESPONSE CAPACITY FOR ANIMAL AND HUMAN OUTBREAKS? The rapid response capacity is delineated in the afore-mentioned national human and animal plans. ARE GUIDELINES IN PLACE FOR THE CULLING AND VACCINATION OF BIRDS, DISINFECTION OF FACILITIES, AND LIMITATIONS ON ANIMAL MOVEMENT? Yes. They are being administered by the Agricultural Ministry, which has already ordered 15 million animal H5N1 vaccines. The government has closed down all Spanish open air poultry facilities near bird migratory routes. (Note: less than 10 percent of Spanish poultry is raised in open air facilities). -- HOW WILLING AND CAPABLE IS THE GOVERNMENT OF IMPOSING QUARANTINES AND SOCIAL DISTANCING MEASURES (CLOSING SCHOOLS, PUBLIC GATHERINGS, MASS TRANSIT)? Opposition political parties have said that such plans are being developed but this has not been addressed publicly by Spanish authorities, who have preferred to emphasize that "everything is under control" vice increasing the general alarm among the Spanish people. WOULD ITS MILITARY ENFORCE QUARANTINES? The military currently has no plans to enforce a possible quarantine and has no ongoing staff study on this subject. We believe any possible quarantine effort would be led by local government assets, supported as necessary by the National Police and Civil Guard. AGUIRRE