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