GOVERNMENT OF KENYA'S PREPARATIONS FOR AVIAN

UNCLAS NAIROBI 005177

SIPDIS

SENSITIVE

SIPDIS

E.O. 12958: N/A
TAGS: AMED SEC EAID PREL CASC CMGT KHIV TBIO ECON
KE
SUBJECT: GOVERNMENT OF KENYA'S PREPARATIONS FOR AVIAN
INFLUENZA

REF: A. STATE 206588

B. Nairobi 4829

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


1. (SBU) SUMMARY: Kenya has started a comprehensive
response to the threat of avian influenza. A multi-
sectoral National Task Force has been established with
high-level representation from the ministries responsible
for human and animal health. Many of Kenya's international
partners are represented on the Task Force as well,
including CDC, USAID, MRU, and international organizations.
The Task Force has drafted an Emergency Preparedness Plan
and put forward a draft budget. The robust presence of USG
agencies in Kenya is of significant assistance to this
national effort. Next steps include finalizing and funding
the plan and quickly implementing the activities it calls
for. More broadly, Kenya needs to develop a more robust
monitoring system for possible influenza outbreaks in both
humans and birds. Key new members of President Kibaki's
cabinet also need to be brought up to speed. End summary.


KENYAN RESPONSE TO AVIAN INFLUENZA THREAT
--------------


2. (U) NATIONAL PLANNING AND COORDINATION. The first high-
level GOK meeting on avian influenza (AI) took place on 26
October 2005. Participants included the Permanent
Secretaries of the Ministry of Health (MOH) and the

SIPDIS
Ministry of Livestock and Fisheries Department (MOLFD),and
representatives from the National Disaster Response Unit in
the Office of the President. This group established the
Kenya Avian Influenza National Task Force (the NTF).


3. (U) NATIONAL AI TASK FORCE. The NTF has met regularly
since October, with the senior technical representatives of
the MOLFD and the MOH serving as co-chairs. (Note:
Disaster management experts from the National Disaster
Response Unit do not currently participate in Task Force
meetings. End note.) About 20 people from government
routinely attend. The Task Force also includes
representation from international organizations, research
groups, civil society, and the private sector. Mission
agencies -- Centers for Disease Control/Kenya (CDC),U.S.
Army Medical Research Unit Kenya (MRU),and USAID
regularly attend these meetings. Task Force members have
attended AI meetings in Kigali, Arusha, and Geneva. Task
Force co-chairs are responsible for major public
announcements and have expressed their commitment to open
reporting.


4. (U) TASK FORCE SUBCOMMITTEES. At the first meeting of
the Task Force, six subcommittees were established to plan
the various components of Kenya's response. These are:
(1) surveillance and epidemiology (both animal and human
monitoring); (2) laboratory and research facilities; (3)
information, education, communication, and mobilization (to
increase awareness); (4) infection prevention and control
(including quarantining and/or culling); (5) case
management and clinical guidelines (for human infection);
and (6) coordination and resource mobilization. These
subcommittees have been able to secure the participation of
senior Kenyan professionals in each area and have met
regularly.


5. (U) EMERGENCY PREPAREDNESS AND RESPONSE PLAN. The Task
Force has recently completed a draft National Strategic
Emergency Preparedness and Response Plan for Avian
Influenza (EPP). This includes goals and objectives of
each component represented by a subcommittee and fairly
detailed, short-term (6-month) work plans and budgets. The
Task Force is also working on medium-term (6 months to 2
years) and long-term (2-5 year) plans and budgets. Two
international experts sponsored by the World Bank, WHO, and
FAO are currently in Nairobi and will help finalize Kenya's
EPP, which will address the risk mitigation strategies
outlined in reftel.


6. (U) NEXT STEPS. The Task Force plans to have the EPP
reviewed and finalized in time for the global AI meeting in
China in mid-January 2006. The GOK will concurrently look
for funding from its own budget and from international
partners. Planned actions include obtaining Tamiflu for
"essential" workers. (No actions have been taken to date,
but no obstacles to procurement by GOK are anticipated.)


7. (U) USG SUPPORT TO NATIONAL PROGRAM. The CDC and MRU

both have staff and facilities in Kenya capable of advising
GOK institutions and assisting with monitoring and testing
of animal and human laboratory samples. Both agencies are
involved with migratory bird surveillance, which has
already started in collaboration with the Kenya Medical
Research Institute (KEMRI),the MOLFD's Division of
Veterinary Services, and the National Museums of Kenya
(which host country-wide ornithological societies). USAID
has used existing resources to support the formulation of
the EPP and will help finance migratory bird surveillance
activities. Related FY06 funding has been requested.
USAID's regional office, REDSO/ESA, is considering
additional support to laboratories in Kenya to serve as
regional referral points, and may also support
communications organizations in Kenya to create regional
media campaigns. The GOK is open to regional cooperation.


Priority areas with implications for funding support
-------------- --------------


8. (SBU) HUMAN INFLUENZA SURVEILLANCE. CDC is particularly
concerned about weaknesses in surveillance for influenza in
humans in Kenya and elsewhere in the region, particularly
because Kenya is a major regional air, land, and maritime
transit hub. The WHO strategy for local and regional
containment of influenza, while awaiting production and
availability of vaccines and antivirals, depends heavily
upon early detection of person-to-person transmission. If
an outbreak is detected early, a strategy of tight
quarantine, infection control, and aggressive use of
antiviral drugs (Tamiflu) could prevent rapid geographic
spread, buying time for vaccine development to protect U.S.
and global populations. While mechanisms for infectious
disease surveillance exist in Kenya, they are still not
fully developed. Funding, expertise, and prioritization
would be needed to ramp-up this activity. In addition,
specialized surveillance (such as detection in health care
workers and school children, which will likely be sentinels
for early recognition of pandemic influenza) needs to be
implemented.


9. (SBU) ADDITIONAL SUPPORT FOR ANIMAL SURVEILLANCE.
Surveillance for avian influenza in birds, while ongoing,
needs substantial additional support to increase the
potential that introduction of H5N1 will be rapidly
detected in the East Africa region. Kenya is a major
wintering location for a wide range of migratory birds,
most significantly from the Central Asian flyway. While no
infected birds, wild or domestic, have been detected in
Kenya to date, detection of the virus may help to prevent
spread to large numbers of chicken flocks (which will
suffer huge die-offs if the virus is introduced).
Undetected virus introduction and die-offs could lead to
persistence and wide prevalence of the virus in bird
populations in the region which, in addition to economic
implications, increases the mathematical possibility that
an avian influenza strain will recombine with other
circulating influenza viruses, forming a deadly, highly
transmittable influenza virus with pandemic potential.


10. (SBU) MISSION PREPAREDNESS. In addition to the work of
CDC, MRU, and USAID discussed above, Post's preparations
for a possible AI pandemic are well under way. Post
created its own multi-agency Avian Influenza Task Force
(AITF) on 27 October 2005. Membership of the AITF
comprises representatives from CDC (the AITF chair),USAID,
MRU, RSO, DAO, the Kenya U.S. Liaison Office (KUSLO),
Post's Medical Unit (Med),the Consular, Economic,
Political, and Public Affairs sections, and the Front
Office. The AITF meets biweekly to discuss CDC and USAID's
surveillance efforts, Med's progress on stockpiling
emergency medical supplies including Tamiflu, and other
preparations undertaken by Post's various agencies,
offices, and bureaus. The AITF also appointed a Tripwires
Subgroup, which is currently finalizing Post's tripwires
for submission to the Department. These tripwires and a
more in-depth discussion of Post's preparations will be
discussed septel.


11. (U) Post's points of contact for AI issues are: Dr.
Robert Breiman at CDC Kenya (RBreiman@ke.cdc.gov) and Tim
Smith (smithtg@state.gov).

Comment
--------------


12. (SBU) As noted in ref B, to date, the GOK has been
forward-looking and generally transparent in its

deliberations on preparations for and possible responses to
any AI outbreak in Kenya. While the political will to
prepare for a possible AI pandemic exists, recent political
instability following he recent referendum defeat of the
Government-backed draft constitution dominates political
life and will likely continue to do so for the foreseeable
future. A major cabinet shake-up over the past two weeks
will require new outreach by the Task Force, and possibly
the international community, to educate and obtain the
continued commitment of key new GOK officials, most notably
in the Ministries of Health and Defense, and in the
National Disaster Response Unit of the Office of the
President.

Bellamy