AVIAN INFLUENZA - LIMITED SURVEILLANCE AND

UNCLAS SECTION 01 OF 04 MANILA 005059

SIPDIS

SENSITIVE

STATE FOR OES/IHA FOR JKAUFMANN
STATE FOR INR/EAP FOR JSTROTZ
STATE PASS USDA/FAS/DL&P FOR WETZEL & MAGINNIS
STATE PASS USDA/FAS/ITP/AAD FOR GRUNENFELDER & ALEXANDER
STATE PASS USDA/FAS/FAA FOR YOUNG
STATE PASS USDA/APHIS/IS FOR SHEESLEY
STATE PASS USAID FOR DCARROLL AND ACLEMENTS
BANGKOK FOR REO JAMES WALLER
CIA FOR NATIONAL INTELLIGENCE COUNCIL NIO/EA

E.O. 12958: N/A
TAGS: ECON PINR SOCI EAGR SENV TBIO TSPL RP
SUBJECT: AVIAN INFLUENZA - LIMITED SURVEILLANCE AND
DIAGNOSTIC CAPABILITIES

REF: A) STATE 151549

B) MANILA 2053
C) MANILA 3883
D) MANILA 4278
E) STATE 183776

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SUMMARY
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1. (U) This is the third of a series of reports on the
Philippines' preparedness to avert a highly pathogenic
avian influenza (HPAI) outbreak (Refs C and D). This
report focuses on stages 1 and 2 of the Philippines'
Avian Influenza Protection Program: HPAI prevention and
the establishment of control measures for an outbreak in
domestic poultry. Future reporting will cover human
health preparedness for HPAI outbreaks, including the
mission's action plan.


2. (SBU) The implementation of the Department of
Agriculture's (DA) HPAI surveillance and response plan
continues to be constrained by inadequate resources.
Although the GRP has yet to detect evidence of the HPAI
H5N1 virus, its surveillance system is limited. The
country remains vulnerable, especially through smuggling
of poultry and visits of migratory birds from HPAI-
affected countries. Clinical testing for HPAI suffers
from inadequate laboratory facilities. In addition to
random surveillance of priority areas, DA relies on
poultry farmers to report suspected cases of HPAI.
Grassroots education and more aggressive public
information campaigns are needed. The lack of an
indemnity fund discourages the prompt reporting of
potential cases and would impede efforts to contain an
outbreak.

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LIMITED SURVEILLANCE SYSTEM
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3. (U) The GRP has designated 20 areas as priorities for
surveillance. DA conducts semi-annual collection and
testing of 180 random samples from poultry flocks in each
area (3600 samples every six months). These sites were
chosen because of their significant poultry populations
and their proximity to migratory bird sanctuaries. The
DA has formed 10-person interagency teams consisting of
regional office staff, Department of Environment and
Natural Resources and local government unit
representatives, and local police in 11 of the 15 regions
around the country. The GRP is procuring a limited
quantity of personal protective equipment (PPE) and
Tamiflu vaccines for the teams.


4. (SBU) The DA estimates that the surveillance program,
based on random sampling methods, provides 95% confidence
of detecting exposure to AI assuming an infection rate of
20% (the level of surveillance recommended by the World
Organization for Animal Health for countries where HPAI
has not been detected). However, Bureau of Animal
Industry (BAI) officials said that the actual sample
sizes were smaller than planned because of budget
constraints and the lack of cooperation among poultry
raisers.


5. (U) Since random surveillance has a limited
probability of detecting smaller and isolated outbreaks,
the DA relies on poultry farmers and provincial
veterinarians to identify suspected cases from clinical
signs and high mortality rates. The DA is conducting
public information campaigns to increase awareness and
encourage early detection of potential cases. BAI plans
two training sessions in November on diagnosis of HPAI.

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INADEQUATE DIAGNOSTIC CAPABILITIES
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6. (U) APHIS Area Director, Ag Attache and Econoffs met
with Philippine Animal Health Center (PAHC) Director
Magdalena Cruz, D.V.M. to review their testing
capabilities. PAHC, the national reference laboratory
for AI surveillance in poultry, able to conduct several
screening tests (ELISA, Agar Gel Immunodiffusion and HA
tests) and isolate the virus, but it lacks the equipment
needed to specifically identify the H5N1 virus. When
PAHC detects evidence of antigens for H5 or H7 viruses,
it can isolate the virus and forward samples to the
Australian Animal Health Laboratory (AAHL) in Geelong,
Australia, for more sensitive and confirmatory tests.


7. (U) PAHC has built a new specialized AI laboratory
within its facility that is expected to be operational in
November. PAHC also plans to procure a polymerase chain
reaction (PCR) machine to enable it to quickly identify
the H5N1 virus (and other virus types). The DA has 15
regional labs around the country, but only four labs are
equipped to perform ELISA tests and none are currently
testing for HPAI. The USDA's Animal and Plant Health
Inspection Service (APHIS) Area Director is working with
PAHC to specify training requirements and identify
potential sources of technical assistance. APHIS
underscored the immediate need to train PAHC staff to
operate the new laboratory. They also would require
training in applied methods for PCR-related research.
PAHC also prepared an $840,000 proposal for which it is
seeking funding to further upgrade and acquire supplies
for its facilities.


8. (U) The GRP will implement quarantine and control
measures for poultry under two scenarios: (1) if the PAHC
or the Australian reference laboratory isolates an HPAI
virus or (2) if at least 50% of samples test positive in
rapid tests for Influenza A with increasing mortality and
no evidence of other diseases. The identification of a
suspected case would trigger a 3-kilometer radius
quarantine around the potential outbreak while a
confirmed case would expand the quarantine area to a 7-
kilometer radius and trigger the culling of all poultry
within these areas. Vaccination of poultry is planned
only if DA detects related outbreaks in an expanding
geographic area and vaccination is deemed to be more
economical than culling. In this scenario, all poultry
would be vaccinated within a 50-kilometer radius of each
outbreak.

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INDEMNITY FUND NEEDED
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9. (U) As the GRP improves its response capacity, lack
of an indemnity fund may limit the GRP's ability to
detect, contain and eradicate any HPAI outbreaks. The DA
estimated that losses could exceed 312 million pesos
(about $5.6 million) if an HPAI outbreak occurs in a
major poultry-producing region such as Minalin, Pampanga
(based on an estimated poultry population of 4 million
within a 3 km radius and a price of 78 pesos per bird).
Wider outbreaks could incur much higher costs - USDA/FAS
estimated the Philippines' total chicken production
reached 136 million in 2004. In the absence of
indemnity, there remains a significant risk that HPAI-
infected birds could be killed and sold for human
consumption by farmers seeking to recover their
investments. If an outbreak occurs in an intensive
poultry-producing area, the GRP may need to quickly ramp
up its capacity to quarantine and cull the affected
poultry population. At present, the GRP does not appear
to have the capacity for a rapid, effective response.

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BUDGET CONSTRAINTS
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10. (U) All aspects of AI preparedness are constrained
by limited financial resources. Since President Arroyo
issued Executive Order 280 in February 2004 promising to
use 250 million pesos in discretionary lottery funds for
AI preparedness, only 40 million pesos have been
allocated to the DA. After initially allocating 20
million pesos ($360,000) to the DA, the GRP recently
added a supplementary allocation of 20 million from
lottery funds. DA has estimated budget requirements of
175 million pesos ($3.2 million) for surveillance and
preparedness for HPAI in poultry. The bulk of this is
for poultry vaccines (42 million pesos),an indemnity
fund (50 million pesos),upgrading labs (32 million
pesos) and culling operations (27 million pesos). With
the 2006 budget still under consideration by Congress,
funding levels for 2006 have not been set.

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Comments
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11. (SBU) Given the Philippines' close proximity to HPAI-
affected countries, the GRP's most pressing priority is
to strengthen its capacity to detect and contain
potential HPAI outbreaks in poultry. The GRP's
preparedness plan looks good on paper and is consistent
with international guidelines, but resource constraints
have prevented the GRP from fully implementing the plan.
With a limited surveillance program, grassroots education
and a more aggressive public information campaign along
with an adequate indemnity fund are important to ensure
that potential HPAI cases are detected and investigated.
Prompt reporting is possible in the principal poultry-
producing provinces in central Luzon, but less certain in
more remote rural areas, particularly in Mindanao. In
the absence of an indemnity fund, economic incentives and
community pressures could deter self-reporting of
possible cases.