Identifier
Created
Classification
Origin
05NAIROBI4829
2005-11-18 07:22:00
UNCLASSIFIED//FOR OFFICIAL USE ONLY
Embassy Nairobi
Cable title:  

KENYA INFORMATION ON AVIAN AND PANDEMIC

Tags:  TBIO SENV ECON EAGR EAID PREL PGOV KE 
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UNCLAS SECTION 01 OF 03 NAIROBI 004829 

SIPDIS

DEPT FOR OES/IHA DSINGER AND RDALEY, INR FOR RLESTER

SENSITIVE

E.O. 12958: N/A
TAGS: TBIO SENV ECON EAGR EAID PREL PGOV KE
SUBJECT: KENYA INFORMATION ON AVIAN AND PANDEMIC
INFLUENZA

REF: STATE 209622

Sensitive-but-unclassified. Not for release outside USG
channels.

UNCLAS SECTION 01 OF 03 NAIROBI 004829

SIPDIS

DEPT FOR OES/IHA DSINGER AND RDALEY, INR FOR RLESTER

SENSITIVE

E.O. 12958: N/A
TAGS: TBIO SENV ECON EAGR EAID PREL PGOV KE
SUBJECT: KENYA INFORMATION ON AVIAN AND PANDEMIC
INFLUENZA

REF: STATE 209622

Sensitive-but-unclassified. Not for release outside USG
channels.


1. (U) Mission Nairobi responses to reftel follow:

A) Preparedness/Communication
--------------

2. (SBU) The Kenyan government has established an inter-
ministerial taskforce to create an action plan to address
the threat of avian flu. The taskforce is nominally
headed by Mrs. Rachel A. Arunga, Permanent Secretary for
Special Programs in the Office of the President. Joint
leadership for the taskforce is by Dr. James Nyikal,
Director of Medical Services (DMS - the highest ranking
medical professional in the Ministry of Health) and Dr.
Joseph Musaa, Director of Veterinary Services (DVS),from
the Ministry of Livestock Development. Due to
limitations in surveillance systems and program
enforcement capacity, Kenya will face major challenges in
fully implementing any comprehensive plan developed by
the taskforce. (A report on initial taskforce efforts
will be sent septel.)


3. (SBU) U.S. Mission believes the GOK will likely be
generally truthful and forthcoming on news of potential
or confirmed cases of avian influenza in Kenya. The DMS
and DVS are viewed as sincere in trying to create a
transparent process for monitoring and responding to this
threat and actively seek the assistance of Mission
agencies and UN officials. Mission agencies -- Centers
for Disease Control/Kenya (CDC),U.S. Army Medical
Research Unit - Kenya (MRU),and USAID -- are
participants in the GOK taskforce and would likely be
appraised of any suspected or confirmed outbreak of avian
flu in either animal or human populations. Kenya's free
and relatively dynamic press would pose a major barrier
to any GOK effort to withhold information on significant
bird deaths or a major outbreak of human illness.


4. (SBU) The Kenyan press has provided accurate coverage
of the GOK avian flu taskforce. Still, at this time,
addressing the avian flu threat is not a priority for top

policy makers. With the country, and President Kibaki's
Cabinet, strongly divided over a draft constitution, to
be voted on in a November 21 referendum, gritty partisan
politics overshadow most administration policy
initiatives at this time. Kenya will likely remain in
political turmoil for weeks, perhaps months, after the
referendum. Political gridlock could continue through
the 2007 presidential campaign. Dealing with the range
of campaign promises post referendum will require a great
deal of the Cabinet's focus. Because the Office of the
President (OP) is only moderately active in the GOK
taskforce and in the development of Kenya's avian flu
action plan, coordination among ministries and law
enforcement agencies is problematic. It will likely take
confirmed cases of human infection in Kenya or a
neighboring country to move this issue above the existing
GOK taskforce leadership as a policy priority.


5. (SBU) At this time, the DMS and DVS are effective
interlocutors for U.S. assistance in developing an action
plan. The more senior key GOK officials for high-level
engagement are Mrs. Arunga; COL Shem Amadi, Chief,
National Disaster Operations Center, Office of the
President; Hon. Mrs. Charity Ngilu, Minister of Health;
and Hon. Joseph Munyao, Minister of Livestock
Development. In the face of a heightened risk for a
human pandemic, the key coordinators of a GOK multi-
ministerial response would be Hon. John Michuki, Minister
of State for Internal Security and Joseph Kahindi,
Minister of State for Provincial Administration.


6. (SBU) It is not known if the GOK has reviewed its
laws to ensure they are consistent with international
health regulations. This issue can be raised with the
GOK taskforce.


7. (SBU) Because of Mission agencies' leadership roles
within the GOK taskforce, bilateral messages from the USG
would be effective. To date, other bilateral donors have
not played a prominent role on this issue. The GOK
taskforce has been in touch with the FAO, WHO, and the
World Bank. Each of these multilateral institutions, as
well as the Nairobi-based UN Environmental Program
(UNEP),would be useful conduits for messages to top
Kenyan officials. Should avian influenza be confirmed in
East Africa, it is likely that the East Africa Community
(headquartered in Arusha, Tanzania) and COMESA would
explore regional cooperation. Any request from bilateral
or multilateral donors for specific GOK responses or
actions will be more effective if offers of funding are
included.

8. (SBU) Annual influenza vaccines are available in
Kenya, but are relatively expensive and have limited
distribution. Kenya does not have the capability for
producing human influenza vaccine, and is not currently
producing avian flu vaccine for poultry although it
likely could do so. Kenya is not working on developing
an H5N1 vaccine, and likely does not have that capacity.
Kenya generally does not permit suits related to legal
drugs used in accordance with all prescriptions and
applicable warnings. However, this is likely not
equivalent to a codified shield to foreign makers/donors
of vaccines.


9. (SBU) In addition to reporting on the GOK taskforce,
Kenyan newspapers have reprinted foreign press articles
on recent developments and outbreaks of avian flu. The
GOK has a fairly good ability to deliver information to
rural populations, both through public and private radio
stations (including local language programming),and
though multiple layers of local government, including
veterinary extension officers.

B) Surveillance/Detection
--------------

10. (SBU) Kenya has some proven capacity for detecting
new strains of influenza among both human and animal
populations. On the human side, the Kenya Medical
Research Institute (KEMRI),with on-going assistance from
CDC and MRU, has disease monitoring systems in place at
several locations in the country. For animal
surveillance, the Department of Veterinary Services
(within the Ministry of Livestock and Fisheries) has a
fairly good network of rural partners who regularly
report on unusual diseases in livestock populations,
especially cattle, and this network is being utilized to
report on suspicious bird die-offs. In addition, the
Cairo, Egypt-based U.S. Navy Medical Research Unit 3
(NAMRU-3) has recently begun a modest surveillance
program of migratory birds in Kenya, partnering with a
couple of local ornithological hobby groups. Both the
Ministry of Health and the Ministry of Livestock have
working hotlines for local officials or the public to
report suspicious diseases.


11. (SBU) Accurate and timely diagnosis of new influenza
strains is dependent on Kenya's highly variable health
infrastructure, but the potential is in place.
Laboratory facilities are limited, and diagnosing
outbreaks in animal populations is likely more efficient
than for human cases. Tracing bird-to-human transmission
in rural areas would be problematic. CDC-Nairobi has the
capacity to subtype influenza viruses, but the GOK's
capacity is limited. With additional support and
training, labs at KEMRI (which hosts a WHO reference lab
for influenza),ILRI, and the Kabete Veterinary
Laboratories could do sub-typing. These institutions do
send samples to reference laboratories in the U.S. and to
the WHO.


12. (SBU) Kenya's critical gaps for detecting new
strains of influenza include the need for improved,
sustainable surveillance of human cases and an enhanced
capacity for testing potential virus samples, including
additional information dissemination and training.

C) Response/Containment
--------------

13. (SBU) Kenya has limited stockpiles of medications,
and likely no (or very limited) inventory of influenza
antivirals. There is no known plan to order excess
quantities. The GOK has made the decision to order
limited quantities of antivirals, but has not yet done
so. The GOK taskforce noted that the WHO is maintaining
stockpiles of critical antivirals to respond to influenza
outbreaks globally. Kenya has a limited supply of pre-
positioned personal protective gear but it is not well
inventoried.


14. (SBU) The GOK taskforce noted an existing plan for
rapid response to animal outbreaks, notably in livestock,
but now will also expand to poultry. This plan utilizes
District Veterinary Officers and some local volunteers.
The Ministry of Livestock keeps at least one vehicle for
rapid response teams. Rapid response for human outbreaks
is more ad hoc, but possible in most of the country
through District Medical Officers and the Disease
Outbreak Management Unit within the Ministry of Health.
The GOK taskforce also noted that it is considering the
need for guidelines on poultry culling. Animal vaccines
are too expensive for wide use.


15. (SBU) The GOK is willing to impose quarantines and
other social distancing measures, and has previously
closed schools in the face of disease outbreaks. The
government's ability to impose widespread or sustained
quarantine measures is limited. While Kenya's military
might be called upon to enforce such measures, its
capacity to do so is likely restricted to areas near
major army installations.

ROWE