CHILE: PART II - PUBLIC HEALTH PREPARATIONS FOR

UNCLAS SANTIAGO 002431 SIPDIS SIPDIS E.O. 12958: N/A TAGS: TBIO SENV ECON EAGR EAID PREL CI SUBJECT: CHILE: PART II - PUBLIC HEALTH PREPARATIONS FOR AVIAN INFLUENZA REF: A. SECSTATE 209622 ¶B. SANTIAGO 02393 ¶1. Summary: This cable outlines preparations in Chile's public health sector. An evaluation of the Chilean agricultural sector preparations was reported in reftel B. ¶2. Chile has experience with avian influenza (AI) issues due to a 2002 outbreak of the disease in poultry. The agricultural sector met the challenge and the outbreak was quickly contained. The GOC demonstrated transparency and efficiency throughout that time. While it is clear that the outbreak prompted the poultry industry and the agricultural inspectors to upgrade their biosafety measures, the public health sector did not benefit from the same level of attention and allocation of resources in 2002. In 2005, Chilean health officials have worked with international partners to address the latest global AI threats. The Ministry of Health (MOH) has prepared an extensive plan to address this issue. However, the public health sector does not enjoy the same levels of resources or manpower as the agricultural export sector to fulfill completely its emergency plans. End Summary. -------------- Historical Statistics -------------- ¶3. To raise awareness of the impact of an influenza outbreak in humans, the Ministry of Health has cited two previous outbreaks in Chile's recent history. Influenza first appeared in Chile in 1918. In a population of 3.6 million, a total of 37,500 people died from the disease between 1918 and ¶1920. ¶4. There was another influenza outbreak in 1957. Over 1.4 million people became ill, although the mortality rate was only 0.13 percent among those infected. This outbreak prompted the formation of a National Committee for Influenza to coordinate tracking and treatment of the disease. It became the public's authoritative source of information on the topic. -------------- Organizing for the Current Threat -------------- ¶5. The idea of a national committee was revived on November 30, 2004 when the Chilean Congress passed a resolution to create the National Response Commission for Outbreaks and Sanitary Emergencies. The Committee is under the jurisdiction of the MOH's Office of Epidemiology. The mandate of this committee is to: - propose contingency plans to confront the outbreaks of infectious diseases, with a particular emphasis on AI; - monitor the implementation of these contingency plans; - provide technical advice to the country's decision makers. Most members of this committee are MOH staff, but there are also representatives from the Agricultural and Livestock Service (SAG) and the Chilean Society for Infectology. Under Secretary of Public Health, Dr. Patricio Bustos, has been SIPDIS identified as the key contact for international coordination on this issue. ¶6. Other GOC agencies have been included to implement the committee's urgent response plans. These agencies include: - Ministry of Interior, Office of National Emergency Response (ONEMI) - Chile's Armed Forces and National Police (Carabineros) - Ministry of Education - Treasury Ministry - Labor Ministry - Association of Municipal Governments - Association of Private Health Clinics - Association of Scientists - Executive Office of the President -------------- Preparedness and Communication -------------- ¶7. The GOC does have a preparedness plan for preventing avian flu from becoming pandemic. A Spanish-language version of this document can be found at: http://www.minsal.gov.cl/ici/pandemiainfluenz a This plan is extensive. The GOC has identified key public health alert phases: preparatory, pandemic alert, pandemic, and post-pandemic. There are a series of actions outlined to be taken at each phase. The plan emphasizes open communication both domestically and internationally. ¶8. The GOC has been working with international partners on this issue. The Ministers of Health from the Andean region met in Lima, Peru on October 21, 2005. A declaration was signed and regional governments promised to coordinate closely with each other on this global health concern. In addition, the GOC's plan repeatedly cites coordination with the World Health Organization (WHO). ¶9. The MOH has announced it will continue its annual flu vaccine program in 2005. The MOH plans to purchase the H5N1 vaccine when it becomes available. Currently, 1.75 million Chileans receive a flu shot every year. The MOH hopes to expand the number of recipients in 2005 by also inoculating very old and very young citizens. ¶10. The GOC has prepared a list of vaccines and pharmaceutical companies that currently distribute in Chile: - Vaxigrip (Aventis Pasteur) - Fluarix (Glaxo Smith Kline) - Influvac (Solvay) - Agrippal S1 (Chiron) - Inflexal V (Berna) The MOH estimates that these vaccines cost between USD $9 and $16 per patient. ¶11. Recent press coverage has raised general awareness in Chile of global AI concerns. Contacts report that most Chileans trust their government to handle this issue in a proper manner. The GOC has made communication with the public a key part of their response plan in the event of an outbreak of AI in humans. -------------- Surveillance/Detection -------------- ¶12. The Institute for Public Health (ISP) will be the main point of contact for AI detection in Chile. It works with a network of 16 public hospitals throughout the country to identify cases of AI and to isolate infected persons in special wards. A hospital in Santiago (Hospital de Torax) will serve as the hub in the case of a widespread outbreak among humans. In order to implement their AI contingency plans, the ISP has asked the GOC for an additional USD $3.2 million for lab personnel. This request is still pending. The ISP states it will turn to the WHO if the crisis produces a lack of manpower. This is an area in which the USG could contribute to the GOC's preparations for AI. -------------- Containment -------------- ¶13. The GOC plans to contain the spread of the disease by restricting international points of entry should AI affect humans on a large scale. Internal controls would include the cancellation of classes, a restriction on large public events, and a restriction on non-essential work functions. ¶14. The GOC's plan also refers to the widespread distribution of protective gear in the event of an outbreak. Unlike SAG, the MOH does not appear to have enough supplies or resources on-hand to meet this need. This is another potential area in which the USG could provide support. YAMAUCHI