AVIAN INFLUENZA RESPONSE: MOROCCO

C O N F I D E N T I A L RABAT 002532 SIPDIS SIPDIS C O R R E C T E D C O P Y - CAPTION ADDED DEPT FOR AI COORDINATOR AMBASSADOR NANCY POWELL DEPT ALSO FOR OES DANIEL SINGER AND REBECCA DALEY, AND NEA/MAG DEPT PASS TO USAID JENNIFER RAGLAND DEPT PLEASE PASS TO DEPARTMENT OF AGRICULTURE USDA FOR FAS/FAA RANDY HAGER E.O. 12958: DECL: 12/19/2015 TAGS: TBIO SENV EAGR EAID PREL MO SUBJECT: AVIAN INFLUENZA RESPONSE: MOROCCO REF: A. SECSTATE 209622 ¶B. CASABLANCA 1299 Classified By: CDA Wayne J. Bush, for reasons 1.4 b and d ¶1. (C) Summary: Post committee on Avian and Pandemic Influenza met Dec. 1 to discuss the Government of Morocco's National Pandemic Influenza Preparedness and Response Plan and to assess the Government's general level of preparedness. The GOM's National Plan is of high quality and is backed at the highest levels of government. The Plan was approved in a meeting chaired by the Prime Minister with all relevant agencies present, including the ministries of Health, Agriculture, Forestry and Interior. However, implementation may be problematic. While the GOM is making good efforts at monitoring wild and domestic bird flocks, small-scale and informal poultry producers may be less inclined to report abnormalities among their flocks, fearing lack of government compensation. Post Medical Officer is not confident that clinics and hospitals have adequate protective gear for healthworkers, and Post understands the country has no supplies of anti-virals. See Ref B for more detailed analysis of the GOM's National Plan.End Summary. ¶2. (C) Responses below are keyed to questions in Ref A. A) Preparedness/Communication: -- The Government of Morocco unveiled its National Pandemic Influenza Preparedness and Response Plan on Oct. 17. The plan, approved at the Prime Ministerial level, outlines the government's strategy for preventing avian flu from becoming a pandemic, and for containing a pandemic should one occur. The Plan largely follows World Health Organization (WHO) guidance for responding to an influenza pandemic. The GOM appears capable of implementing the plan, has identified risk areas (bird sanctuaries, e.g.) and states that it is performing adequate surveillance of these sites. The surveillance plan employs the poultry industry, private veterinarians, and the Ministries of Forestry, Agriculture, Health, and Interior, and the military. However, while the organization structure is in place, lack of resources may present a weakness. The Ministry of Agriculture does have resources earmarked to compensate poultry farmers for loss of their flocks in case of a mandated cull, but smaller, informal producers may be reluctant to report illnesses among their birds for fear of losing them without compensation. Staffing of health clinics and stocks of anti-virals may also be inadequate to protect the population in case of a human pandemic. The GOM's National Action Plan is available in French at the following website: www.sante.gov.ma -- The Government of Morocco is very unlikely to hide or delay reporting an outbreak among people or animals. The GOM will likely report any outbreak through established international channels (WHO or FAO),and will ask for help from those organizations as well as from the United States. Information about the risks of Avian and Pandemic Flu has been openly discussed and disseminated in the press, even in state-run media. An incentive for the GOM to continue to be forthcoming could be a promise of technical or financial assistance in the case of an outbreak. -- Preparing for an Avian Flu human pandemic ranks high among government priorities. The subject has been discussed at the highest levels of the government and the National Plan was approved at the Prime Ministerial level. GOM officials attended the Nov. 7-9 WHO meeting on Avian Influenza and Human Pandemic Influenza in Geneva, and the Intercountry Meeting on Avian Influenza and Preparedness in Cairo on Nov. 28-30. The Ministry of Health is the lead GOM agency on this issue, and the Minister chairs the government's national steering committee. -- It is unclear whether national laws have been reviewed on a comprehensive scale, but GOM contacts say laws are consistent with international norms and do not pose barriers to avian influenza detection, reporting, containment or response. Certain laws have been reviewed; for example, while the Ministry of Agriculture has always held the authority to execute large-scale culls of poultry flocks, a new decree has recently been created which would implicate the Ministry of Finance in the compensation process for farmers whose flocks are destroyed. -- The GOM is a member of the International Partnership on Avian and Pandemic Influenza, and is working with international organizations like WHO and FAO on the issue. The GOM has informally approached USAID and USDA representatives at post to explore what kind of assistance the U.S. may be able to provide in the case of an outbreak of human or avian influenza in Morocco. Agriculture Ministry officials have asked for USG technical assistance to train animal disease specialists in laboratory diagnosis of Avian Influenza, for training in management crisis for control of AI outbreaks, for personal protection equipment, and for diagnostic materials. AgAttache passed this request to USDA on Nov. 9 and reports that USDA Washington is looking into providing training in laboratory diagnostic techniques. Post feels the GOM would be receptive to messages from U.S. leaders through a bilateral approach, as well as through a multilateral forum such as the UN. -- Annual flu shots are available for a fee of 70 Dirhams per shot (approx. $8),a prohibitive cost for all but high income groups. Shots are in theory available free of charge to high-risk groups. Trivalent flu vaccine is not produced in Morocco and is currently imported from Europe. The GOM has approached the CDC for assistance in producing poultry vaccine. -- The issue of avian influenza has received wide press coverage through television and newspapers, but the Government has said it will not conduct a wide-ranging public education campaign until animal infection is confirmed. It is fair to say the population is informed, but does not possess a sophisticated knowledge of the issue. Prices for chicken meat have fallen due to declining demand, indicating that the population is aware of the issue but does not have a good understanding of it. Radio and television are the most effective measures for disseminating information to the rural population. B) Surveillance/Detection: -- Post Medical and Agricultural officers believe officials are capable of detecting a new strain of influenza but the GOM's National Action Plan lacks specifics on methods of surveillance and detection. There are only two labs available in country to test for routine human influenza, and neither is able to test for avian influenza. They have no quick-test capability for human or avian influenza. If the GOM suspects an outbreak of AI in humans, subtyping would need to be done abroad. To Post's knowledge the GOM is not doing random sampling at this time. -- The GOM needs increased laboratory capacity to detect human influenza. It may also need greater stocks of personal protective equipment and anti-virals like Tamiflu. Agriculture officials have asked for technical training in laboratory diagnostic of AI, training in crisis management for control of AI outbreaks, laboratory equipment for personnel protection, and diagnostic materials. AgAttache has passed this request to the Department of Agriculture. C) Response/Containment: -- Morocco does not have a stockpile of anti-viral medications. The Government has reportedly ordered from European suppliers anti-virals for approximately 35 percent of the population, or around 10 million. Post does not know when stocks will be available. -- It is unclear how much protective gear is available, but since the GOM has requested it from AgAttache, Post assumes they do not have sufficient stocks available at this time. -- Guidelines and legislation exist for culling and vaccinating birds, disinfecting facilities and limiting animal movement. Vigilance programs are in place and the GOM has the capability to destroy flocks. However, Post believes GOM resources to respond to a large-scale animal breakout may be insufficient. Post Medical officer believes that in the case of a human-to-human transmission, existing stocks of personal protective equipment will be insufficient. -- According to its National Plan the GOM may decide to restrict the entry of affected nationals and isolate them at the port of entry if necessary. Post believes the GOM is willing and capable of imposing quarantines, limiting movement and enacting social distancing measures as needed. Bush