BURMA: HOST COUNTRY AVIAN INFLUENZA PREPAREDNESS

C O N F I D E N T I A L SECTION 01 OF 03 RANGOON 001036 SIPDIS STATE FOR EAP/MLS; PACOM FOR FPA E.O. 12958: DECL: 09/07/2015 TAGS: PINR SOCI PGOV PHUM EAID EAGR BM SUBJECT: BURMA: HOST COUNTRY AVIAN INFLUENZA PREPAREDNESS REF: A. STATE 153483 ¶B. RANGOON 988 Classified By: Poloff Dean Tidwell for Reasons 1.4 (b, d) ¶1. (SBU) SUMMARY: This cable contains responses to questions sent to post (ref A) on the level of preparedness of the Government of Burma (GOB) for a possible outbreak of Avian Influenza. Official GOB data is difficult to obtain and is often not reliable. Our responses are based on the best information currently reliable. END SUMMARY. ¶2. (C) The questions and Post's responses follow: Q: WHERE DOES PREPARING FOR AN AVIAN INFLUENZA (AI) PANDEMIC RANK AMONG GOVERNMENT PRIORITIES? WHO AND WHAT WOULD MOST INFLUENCE THE COUNTRY TO GIVE THE ISSUE A HIGHER PRIORITY? A: AI currently does not appear to be a high priority among government leaders. A few articles have appeared in newspapers describing AI outbreaks in neighboring countries and in 2005, state media published a WHO press release on the global threat of AI, but it does not appear to be a topic that the top leadership considers on a regular basis. If neighboring and other ASEAN countries impress upon Burma that it is in the regional interest to give more attention to AI issues, and that an outbreak would have negative effects on trade and tourism in Burma, the GOB might make AI a higher priority. The UN Food and Agriculture Organization (FAO) and the World Health Organization (WHO) are two key international organizations (IOs) that could exert positive influence on the GOB to make AI a priority. Q: DOES THE GOVERNMENT HAVE A STRATEGY FOR PREVENTING AI FROM BECOMING A PANDEMIC AND CONTAINING A PANDEMIC ONCE IT OCCURS? IF THE COUNTRY HAS A STRATEGY, HOW CAPABLE IS IT OF IMPLEMENTING IT? A: We do not believe that the GOB has a serious plan for dealing with an AI pandemic. According to FAO in Burma, there is only one center in Rangoon that can test for the AI virus. It reportedly has the capability of classifying the virus from H1 through H15. There is no clear plan in the field for identifying, reporting, and transporting suspected cases to Rangoon for testing. It would likely take days or weeks from the first detection of dead animals in the field, or a suspected human case, until the test results could be determined in Rangoon. According to FAO, the GOB has not prepared advance media messages that could be broadcast to the country to advise people what to do in the event of a suspected outbreak, how to handle dead animals, or what personal hygiene measures are important. Even if a strategy is devised, the infrastructure for implementing it from the central to the grassroots level is very poorly developed. Q: WHAT MEASURES HAS THE GOVERNMENT TAKEN TO DATE TO PREPARE FOR A PANDEMIC (STOCKPILING ANTIVIRAL MEDICATIONS, CONDUCTING SURVEILLANCE, DEVELOPING HUMAN VACCINES, ETC.)? A: We are not aware of any plan by the GOB to stockpile Tamiflu for widespread use, though it is reportedly available on an extremely limited basis through a few high-end health care providers for wealthy clientele. It is possible that the GOB may have some limited stockpiles for use by the upper echelons of the government. We are unaware of any regional stockpile plan that includes Burma. We understand that there has been at least one instance where a Burmese border checkpoint intercepted a shipment of over 2,000 newly hatched chickens that were being smuggled into Burma from Thailand and exterminated all of them. We do not believe Burma has any capacity to develop human vaccines. Q: HOW CAPABLE IS THE COUNTRY OF DETECTING AND RESPONDING TO AN OUTBREAK, ESPECIALLY IN RURAL AREAS? A: According to the FAO, the Livestock Breeding and Veterinary Department has positioned a government veterinary officer in every district, but they lack transportation and budget to travel to rural areas. They must depend on voluntary reporting by community leaders and citizens in the field. There very likely would be a significant time lag from the onset of an epidemic until this information reached the Ministry of Livestock and Fisheries in Rangoon, particularly from remote areas where GOB infrastructure is minimal. Q: HOW TRUTHFUL WILL THE GOVERNMENT BE IN REPORTING THE SCOPE OF ANY OUTBREAK? A: Based on the GOB's response during previous crises, we have low expectations that they will provide any useful, timely information. According to the U Maung Maung Nyunt, Director General of the Livestock Breeding and Veterinary Department, Burma does not export poultry products so the GOB has no economic reason for trying to cover up an outbreak. In reality, however, there is no independent press and regime does not report negative news, in part because of cultural superstitions that a natural disaster or epidemic is a sign of divine disfavor of current rulers. Q: HOW WILLING AND CAPABLE IS THE GOVERNMENT OF IMPOSING QUARANTINES AND SOCIAL DISTANCING MEASURES (CLOSING SCHOOLS, PUBLIC GATHERINGS, MASS TRANSIT)? A: This is one area where the authoritarian regime has demonstrated strong capacity. If the GOB is convinced of the importance of imposing quarantines, they will effectively do so. Q: WHAT ARE THE CRITICAL GAPS THAT NEED TO BE FILLED IN ORDER TO ENHANCE THE COUNTRY'S DISEASE DETECTION AND OUTBREAK RESPONSE CAPABILITIES? WHAT IS THE COUNTRY'S GREATEST NEED FROM THE USG OR INTERNATIONAL ORGANIZATIONS? A: The greatest need is probably training for officials from the central to the grassroots level. Raising awareness among the general populace is also urgently needed. While the government claims to have adequate testing equipment in Rangoon, well-equipped regional centers are also needed, so that outbreaks can be more quickly verified. Furthermore, Burma's general health care system has some well-qualified personnel, but is woefully lacking in medical resources. The GOB would be unable to manage an AI pandemic. Q: WOULD GOB LEADERS BE RECEPTIVE TO MESSAGES FROM U.S. LEADERS THROUGH A BILATERAL APPROACH, AT A MULTILATERAL FORUM SUCH AS THE UN OR APEC, OR THROUGH BILATERAL CONTACTS WITH ANOTHER COUNTRY? A: Currently strained relations between the GOB and USG would likely make a bilateral approach problematical; however, an outbreak of AI might prove to be a catalyst for greater dialogue. A multilateral organization, such as WHO or FAO, or working through intermediary countries such as ASEAN members, would probably be the most effective approach at this time. China has the most influence. Q: WHO IS THE KEY "GO-TO" PERSON OR OFFICE FOR USG OFFICIALS TO INTERFACE WITH? A: From the GOB the best person to interface with is the Minister of Health Dr. Kyaw Myint. He is about the only civilian minister in the current government. U.N. agencies and international NGOs consider him forward-looking and a rare official here who seems to have a genuine concern for the welfare of the Burmese people. The Director General of the Livestock Breeding and Veterinary Department, U Maung Maung Nyunt, is another potential GOB interlocutor. If obtaining regular access to GOB officials is a problem, USG officials can also work with the FAO, WHO, UNDP, and other international NGOs in Burma to address AI issues. Q: HOW WELL INFORMED IS THE POPULATION ABOUT THE AI THREAT AND ABOUT MEASURES THEY SHOULD TAKE TO MITIGATE THE THREAT? A: Public awareness about AI is extremely low in Burma due to a lack of independent media and minimal AI coverage in official media. The GOB urgently needs to inform the public about how to mitigate an AI pandemic. Absent GOB action, international radio media, including VOA, Radio Free Asia, BBC, and the Democratic Voice of Burma, could play a vital role in raising awareness of AI issues via their Burmese language broadcasts. Q: IS THE GOB ALREADY WORKING WITH ANY INTERNATIONAL ORGANIZATIONS OR OTHER COUNTRIES ON THE AI ISSUE? ARE GOVERNMENT LEADERS LIKELY TO ASK FOR ASSISTANCE FROM THE UNITED STATES OR OTHER COUNTRIES? A: The FAO, and to a lesser extent, the WHO, have been in dialogue with their GOB counterparts on AI issues. The Ministry of Livestock and Fisheries also maintains contacts with the World Animal Health Organization (OIE). The Japanese government has provided testing equipment and some AI training to the GOB. Burma also cooperates modestly with its ASEAN counterparts on AI issues, although Burma was absent from the special ASEAN meeting held in early 2005. Q: WOULD ITS MILITARY ENFORCE QUARANTINES? A: Yes, the military is the most logical organization in the country for enforcing quarantines and would do so, if so ordered. Q: WHAT WOULD IT WANT FROM THE UNITED STATES IN RETURN FOR ITS EFFORTS? A: Given the poor health infrastructure that exists in Burma, coupled with many health challenges faced by the population, the GOB would welcome material assistance from almost any source. The GOB's wariness of foreign influence probably means that technical expertise would be less welcome than financial or material assistance. Q: WHAT MECHANISMS ARE AVAILABLE FOR PROVIDING ADDITIONAL INFORMATION TO THE POPULATION, PARTICULARLY IN RURAL AREAS, AND HOW EFFECTIVE ARE THESE MEASURES? A: Radio and, to a lesser extent, TV are the best media for reaching people in rural areas, particularly in their own ethnic languages. Both domestic and international media can also play a significant role in broadcasting health messages to the Burmese population. Villarosa