ECUADOR - AVIAN AND PANDEMIC INFLUENZA

UNCLAS SECTION 01 OF 02 QUITO 002673

SIPDIS

E.O. 12958: N/A
TAGS: TBIO SENV EAGR EAID ECON PREL EC
SUBJECT: ECUADOR - AVIAN AND PANDEMIC INFLUENZA
PREPAREDNESS

REF: STATE 209622


1. Per reftel, post is providing the following information
regarding the GOE's efforts to control Avian Influenza (AI)
and its capability to respond to an influenza pandemic. The
answers are keyed to reftel questions.

A) PREPAREDNESS/COMMUNICATION

-- The GOE began working on a preparedness plan to prevent
and contain AI in September 2005. National Director of
Public Health Dr. Marcelo Aguilar will provide Econoff with
a copy of the plan upon its completion on December 15. The
plan divides up preparedness and containment duties among
the Ministry of Public Health (MPH),the Ministry of
Agriculture (MAG),and the Ministry of Environment (MOE).
The MAG, to include its Ecuadorian Sanitary Service (SESA),
will be the main point of contact on AI. The MPH will be
the lead for human components of influenza viruses. The MOE
will focus on wild migratory bird issues.

-- Individual interests are able to manipulate the national
discourse through their influence over the press. This
influence could extend to AI discussions as well. The lack
of professionalism in the Ecuadorian press makes them
susceptible to such pressure. Meanwhile, delayed or
inaccurate reporting on AI outbreaks in either humans or
animals also could result from poor communication within the
GOE rather than a lack of desire to be forthcoming. For
example, Dr. Aguilar notes that poor inter-Ministry
communication is his biggest fear regarding the accurate and
timely reporting of outbreaks.

-- The GOE is preoccupied with a number of politically
charged issues that detract from AI. While within health
circles AI is a top priority, concern with its political
survival keeps the presidency from making AI issues more
prominent. Only an outbreak of AI in Ecuador would raise
the issue to a higher priority.

-- In the MAG, the main contact for AI is Dr. Abel Viteri,
the Director of SESA. The MPH contact is National Director
of Public Health Dr. Marcelo Aguilar.

-- The National Health System Law establishes an inter-
institutional and regional network of detection, reporting,
and containment that would guide the country's response to
an AI outbreak. Post has no indication that this Law would
undermine GOE preparedness regarding AI. MPH officials
report that the Law is consistent with international health
regulations.

-- The GOE is engaged with the World Health Organization
(WHO) and the Pan American Health Organization (PAHO) on AI
and other health-related issues. GOE leaders would be more
receptive to messages from international organizations,
rather than the USG. In addition, the MPH has expressed
concern that from an operational (though not scientific)
perspective, language barriers would undermine any bilateral
programs with the United States.

-- The GOE currently does not administer annual flu shots.
Ecuador does not have any production capability for flu
shots and would purchase vaccines from Brazil if it
initiates a flu shot campaign planned for 2006. Ecuador is
not technologically capable of developing an H5N1 vaccine.
Ecuador's Sanitary Registry Law provides for liability
protection.

-- The MPH and the MAG maintain their own press offices
through which they share information with the press and with
a network of public officials. Community-based radio is one
of the more effective means of informing rural areas.
Meanwhile, sensationalism by the press can misinform the
public. For example, following the October 2005 detection
of a low pathogenicity strain of avian influenza in Colombia
that was not/not identified as the H5N1 strain, Ecuadorian
press provided extensive coverage about the hazards AI poses
to human health. Ecuadorian consumers, out of fear for AI
and uninformed about the exact nature of the Colombian avian
influenza strain, drastically reduced poultry consumption.
This triggered a 30% drop in poultry sales that lowered
poultry prices to unsustainable levels and caused financial
problems within the feed industry. Currently, the poultry
industry, through the Poultry Producers Association
(CONAVE),is investing large amounts of money in radio spots
and other media to educate consumers regarding the real
consequences of AI.

B) SURVEILLANCE/DETECTION

-- The GOE maintains 3 labs that could provide initial
testing of samples. The labs are geographically located in
the north (Quito),the coastal region (Guayaquil),and the
south (Cuenca). The GOE also maintains a relationship with
the CDC to which isolated samples can be sent for
verification.

-- The most critical gap in Ecuador's detection and response
capabilities is a lack of anti-viral stockpiles. Despite
the countrywide network of health-care professionals,
Ecuadorian health care services lack equipment and
adequately trained personnel necessary to adequately respond
to an AI outbreak. Dr. Aguilar also noted the lack of field
emergency hospitals that would assist in responding to
outbreaks in rural areas.

C) RESPONSE/CONTAINMENT

-- The GOE maintains no stockpiles of Amantadine,
Rimantadine, Oseltamivir, or Relenza. The MPH reports that
they have placed orders for Oseltamivir (Tamiflu). The
delivery date for this order is not known. The MPH
maintains a network of vaccine banks that provides
refrigeration capabilities for the distribution of vaccines.
Supplies of protective gear, while available in some areas,
are very low.

-- The GOE is in the process of finalizing guidelines for
the culling and vaccination of birds, disinfection of
facilities, and animal movement with respect to an outbreak
of AI. However, finalized guidelines will not guarantee a
rapid response because GOE institutions can be highly
ineffective and inter-institutional communication is
wanting.

-- The banning last month of poultry imports from Colombia
shows the GOE's willingness and ability to take action
swiftly. At the same time, the action also shows erroneous
application of World Organization for Animal Health (OIE)
standards since the AI outbreak in Colombia was proven to be
a low-pathogenic strain of the virus, making the import ban
unjustified under OIE. Such decisions, whether or not they
are justified on public health grounds or used as an excuse
to limit competition for local producers, require the
necessary political will and interest. The Ecuadorian
military is capable of imposing quarantines and social
distancing measures. The Ecuadorian military currently
participates in regional response exercises with local and
international health agencies.

JEWELL