Identifier
Created
Classification
Origin
06AMMAN2068
2006-03-22 06:18:00
UNCLASSIFIED//FOR OFFICIAL USE ONLY
Embassy Amman
Cable title:  

AI Task Force Meets With Diplomatic Community,

Tags:  TBIO KFLU XF JO 
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RR RUEHWEB

DE RUEHAM #2068/01 0810618
ZNR UUUUU ZZH
R 220618Z MAR 06
FM AMEMBASSY AMMAN
TO RUEHC/SECSTATE WASHDC 9053
RUEHPH/CDC ATLANTA GA
RUEHRC/USDA FAS WASHDC
RUEHNC/AMEMBASSY NICOSIA 0855
RUEHAK/AMEMBASSY ANKARA 0402
RUEHFR/AMEMBASSY PARIS 1199
RUEHLO/AMEMBASSY LONDON 1020
RUEHRO/AMEMBASSY ROME 1364
RUEHIT/AMCONSUL ISTANBUL 0099
RUEHTV/AMEMBASSY TEL AVIV 4089
RUEHDM/AMEMBASSY DAMASCUS 3237
RUEHEG/AMEMBASSY CAIRO 2262
RUEHBY/AMEMBASSY CANBERRA 0086
RUEHJM/AMCONSUL JERUSALEM 3790
RUEHBS/AMEMBASSY BRUSSELS 0205
RUEHGV/USMISSION GENEVA 0484
UNCLAS AMMAN 002068 

SIPDIS

STATE PASS USAID FOR GLOBAL HEALTH/K HILL, D CARROLL
USDA FOR APHIS
STATE FOR M/MED DASHO DR. TRIPLET
GENEVA FOR WHO REPRESENTATIVE
ROME PASS US MISSION FAO
OES FOR SINGER, DALEY
NEA FOR RA/LAWSON

SENSITIVE
SIPDIS

E.O. 12958: N/A
TAGS: TBIO KFLU XF JO
SUBJECT: AI Task Force Meets With Diplomatic Community,
Jordan Officials

REF: A) Amman 905
B) Amman 457
C) 05 Amman 9923
D) 05 Amman 9093

SENSITIVE BUT UNCLASSIFIED. HANDLE ACCORDINGLY.

UNCLAS AMMAN 002068

SIPDIS

STATE PASS USAID FOR GLOBAL HEALTH/K HILL, D CARROLL
USDA FOR APHIS
STATE FOR M/MED DASHO DR. TRIPLET
GENEVA FOR WHO REPRESENTATIVE
ROME PASS US MISSION FAO
OES FOR SINGER, DALEY
NEA FOR RA/LAWSON

SENSITIVE
SIPDIS

E.O. 12958: N/A
TAGS: TBIO KFLU XF JO
SUBJECT: AI Task Force Meets With Diplomatic Community,
Jordan Officials

REF: A) Amman 905
B) Amman 457
C) 05 Amman 9923
D) 05 Amman 9093

SENSITIVE BUT UNCLASSIFIED. HANDLE ACCORDINGLY.


1. (SBU) Summary: Embassy Amman's Avian Flu Task Force met
with representatives from other embassies, Amman-based UN
organizations and the Government of Jordan (GoJ) on March 2,
2006 to share information on avian flu preparedness. All
participants are following similar lines of action:
stocking Tamiflu, tracking the progress of avian flu,
informing their staff and community, and evaluating
contingency plans for staff drawdowns. WHO representative
said that Jordan is among the best-prepared countries in the
region. The GoJ reported minimal contact with the
Government of Syria on avian flu, despite overtures. End
Summary.


2. (U) The following minutes were developed from the
discussion at the meeting, and were distributed on March 14
to all participants and to Embassy Amman's Avian Flu Task
Force. All information below was current as of early March;
some may now be incomplete (e.g., AI outbreak in Israel) or
otherwise OBE'd.

BEGIN MINUTES OF MARCH 2 MEETING:

-------------- --------------
Current Status of Avian Flu in Birds and in Animals
-------------- --------------


3. (SBU) Dr. Scott Kennedy (U.S. Regional Medical Officer)
gave an overview of the avian influenza outbreak. There
have been 169 human cases, with a mortality rate of nearly
50%. H5N1 avian flu has been found in 28 countries,
including human cases in nearby Turkey and Iraq. The
potential for a major pandemic is increasingly real, but
there has been no sustained human-to-human transmission to
date. H5N1 in birds is almost inevitable in Jordan, he
said, but the GoJ is doing a great job in preparing, a
sentiment echoed by Dr. M.Z. Ali Khan of WHO. Little is
known about avian flu preparedness in Syria, which is a
major concern. Dr. Adel Belbessi, Director of Disease
Control at the Jordanian Ministry of Health, said Jordan
has almost no contact with Syria on avian flu, despite
requests to Syria for cooperation. His contacts with the

Palestinian Authority and Israel are much better.


4. (U) Dr. Kennedy noted concern over secondary infections
from bacterial pneumonia following an avian flu outbreak,
and suggested that organizations and governments purchase
appropriate vaccines, which have a long shelf life.


5. (U) Dr. Neyla Gargouri Darwaza, Head of Surveillance,
Jordanian Ministry of Health, said that a vaccine for human
H5N1 is unlikely to be available in time for an outbreak.
Dr. Kennedy said that H5N1 vaccine research is promising,
and resulting vaccines may offer at least partial
protection.

--------------
U.S. Embassy Preparations
--------------


6. (U) The American Embassy has created an Avian Influenza

Task Force and has generated "tripwires" to assist with
contingency planning. The embassy needs to determine what
it can do and what is beyond its control. Good planning may
help to delay and contain the onset of pandemic flu, which
would be a major benefit. More cases mean a higher chance
of reassortment and an easily transmissible version.


7. (U) The U.S. Embassy is emphasizing two things: basic
knowledge about H5N1, and practical preparedness measures
related to health and hygiene. There is no double standard
or "inside" information: the same information is available
to the American citizen community and the Embassy staff.
Self-quarantining, with adequate food, supplies and
water, is an effective countermeasure, although there are
security concerns about that policy. People should also
have a long-term supply of their personal medications. A
community-wide response is needed.
The Embassy has contingency plans for reducing staff, but no
one knows whether commercial air transportation will be
possible in an outbreak.

-------------- --------------
Jordan's Actions on Avian Flu Prevention and Preparedness
-------------- --------------


8. (U) Dr. Salwa Qteit (USAID Development Assistant
Specialist, Population and Health Section) gave an overview
of avian flu preparations by the Government of Jordan (GoJ).
Jordan has been preparing seriously for avian flu. It has
an interagency avian flu steering committee at the minister
level that is chaired by the Prime Minister. There is also
an interagency technical committee on avian flu, chaired by
the Minister of Health. The GoJ has developed an avian
influenza preparedness plan. The first version was printed
in September 2005 and it has been updated regularly since
then. The GOJ has allocated JD 6 million to implement that
plan, which addresses interagency coordination,
responsibilities, health services, treatment, equipment,
outreach and education.


9. (U) Dr. Belbessi acknowledged that the lack of funds to
compensate farmers whose flocks would have to be destroyed
because of H5N1 is a major issue. Funds have been
requested. The Royal Society for the
Conservation of Nature has banned hunting in Jordan and is
collecting dead wild birds for testing by appropriate
laboratories.


10. (U) The Ministry of Health has six epidemiologists
trained by the U.S. Centers for Disease Control's Field
Epidemiology Training Program (FETP). Those six people
supervise 18 district-level surveillance teams. The
Ministry of Health has 16 labs across the country with two
trained persons per lab. Those labs can do a rapid test for
H5N1 in 15 minutes. Three labs (Ministry of Health, Jordan
University of Science and Technology - JUST, Ministry of
Agriculture) can do Polymerase Chain Reaction (PCR) tests,
which are used as the definitive test, required before the
GoJ will confirm presence of H5N1. If the PCR test is
positive, the lab will send a sample to the U.S. Embassy's
Naval Medical Research Unit (NAMRU-3) in Cairo. The
Ministry of Health has designated a point-of-contact at each
hospital to be the focal point for avian flu information and
programs.


11. (U) The Ministry of Agriculture has three labs (north,
central, south). There are animal health surveillance teams

in each governorate, and they collect 750 samples a month.
Processing these samples imposes a significant burden on the
laboratories. MOA has sent staff to Italy for advanced
training in avian flu.


12. (U) The Ministry of Health has allocated JD 3.7 million
for purchase of Tamiflu. They have 50,600 courses of
Tamiflu in stock now. Another 250,000 courses will be
delivered in August 2006. Dr. Belbessi said that the
Ministry of Health asked for JD 10 million and was given JD
6 million. Of this amount, the Ministry of Health was
allocated JD 5 million and the Ministry of Agriculture JD 1
million. In addition to the JD 3.7 million for Tamiflu, the
Ministry of Health spent JD 1 million to purchase personal
protective equipment. Most of the rest has been spent on
training, he said. The Ministry has adequate supplies for
now, but both staff and materials would be in short supply
during an outbreak. The Food and Agriculture Organization
has ordered additional PCR testing kits for Jordan, but Dr.
Belbessi was not sure of the quantity.


13. (U) Dr. Belbessi said that the Ministry of Health and
the Ministry of Agriculture are planning an on-the-ground
simulation exercise on avian flu response. This will be
announced.


14. (U) Dr. Naffa (WHO) said that a committee is evaluating
all of Jordan's health labs and that a report will be out
soon. There has also been a program to identify all of
Jordan's medical assets, both human and physical resources.

--------------
Jordan's Public Outreach Plan
--------------


15. (U) Dr. Qteit said that the Ministry of Health has a
USAID-funded program with Johns Hopkins University on health
communication, and they are working on avian flu. The main
goals of the program are fear alleviation, and building
awareness among professional groups and the public. The
project has disseminated health tips to TV and newspapers,
provided background material for journalists, had panel
discussions, established hotlines and provided material for
television broadcasts. Dr. Belbesi clarified that the broad
outlines of the public education campaign are done, but it
is not yet finalized. The goal is to reach the public to
minimize risk and dangers. Dr. Darwaza said that the
preparedness plan is divided into two sections, pre-pandemic
and pandemic, and that they are still working on the section
for pre-pandemic communication.

--------------
Rumors
--------------


16. (U) In response to a question about rumored H5N1
outbreaks, Dr. Belbessi said categorically that there have
been no confirmed H5N1 cases in birds or people in Jordan.
He assured that Jordan would transparently inform the media
of any cases. Dr. Darwaza said there was recent culling for
Newcastle disease, perhaps giving rise to the rumors.
Routine testing of dead birds may also create rumors.

--------------
WHO Office Role and Activities
--------------


17. (U) Acting WHO Representative Dr. M. Z. Ali Khan said
that WHO is the lead on avian flu for the UN Country Team.
There is a UN Country Plan for avian flu in Jordan that is
based on WHO's global plan that focuses on staff and
families. Vaccines, drugs and protective equipment are
available for staff. Dr. Sana Naffa, UNAIDS Country
Officer, WHO is the focal point. WHO's role in Jordan is to
strengthen the capacity of the Jordanian health sector on
avian flu, in coordination with the Ministry of Health and
the Ministry of Agriculture. WHO publishes bulletins on
avian flu. WHO has avian flu teams in Geneva and Cairo that
can be mobilized to respond to outbreaks. WHO Geneva has a
stockpile of Tamiflu that can be used to address "hot
spots." Both WHO Geneva and WHO Cairo have avian flu
websites.


18. (U) WHO had an avian flu mission to Jordan on February
6-10, and the findings are being finalized. Jordan can
prepare a proposal to the WHO's Cairo office for further
assistance. WHO works with the Food and Agriculture
Organization (FAO) and the World Animal Health Organization
(OIE) on a joint avian flu task force. WHO is assessing
preparedness in each country.

--------------
Preparedness at Other Embassies
--------------


19. (U) Mr. Frederic Bontemps (First Secretary, French
Embassy) said that France has a national plan that includes
overseas citizens. His embassy has passed information on
avian flu to the French community in Jordan. The French
Embassy has an avian flu hotline, and a procedure in place
for providing Tamiflu to French citizens and embassy staff
and their families who request it from the Embassy's
stockpile.


20. (U) Ms. Angelina Eichhorst (EU Mission Public Health
Advisor) said that the European Delegation has Tamiflu
available for its local and expatriate staff. The EU is
prepared to assist countries on avian flu projects, but has
not received any proposals from Jordan. Specific proposals
for assistance from the EU are welcome. The EU is
contributing to the World Bank's Trust Fund for avian
influenza. Dr. Darwaza said that Jordan is working on a
proposal to the World Bank to assist with Jordan's needs.


21. (U) Ms. Alison Banks (Management Officer, UK Embassy)
said that the UK Embassy has a Jordan contingency plan that
was developed from a template sent from London and which
follows the WHO model. Staff and dependents have been
inoculated for flu. When the WHO alert level on avian flu
reaches four, the Embassy will begin repatriating staff.


22. (U) Ms. Roz McKenzie (Second Secretary, Australian
Embassy) said that Australian Embassy preparations were
similar to those of the UK Embassy. There are no local
stockpiles of drugs or protective equipment; stockpiles are
kept in Australia and will be sent on an as-needed basis
around the world.

--------------
Status of Poultry Imports
--------------


23. (U) The EU's Ms. Eichhorst asked about the status of
poultry imports and whether there was a total ban. Embassy


Econ Counselor Richard Eason said he believed that a total
ban was applied initially, and that since then, exceptions
have been made to allow imports from areas free of avian
flu.

--------------
Outcomes
--------------


24. (U) Several participants noted the value of cooperation
within Jordan between embassies, UN organizations and the
Government of Jordan. Dr.
Kennedy suggested that a regional conference in Amman would
be particularly useful.


25. (U) Meeting minutes and a list of participants were
distributed to everyone who was at the meeting.

--------------
Participants
--------------


26. (U) Delegation of the European Union (Mr. Michel Laloge
and Ms. Angelina Eichhorst; Second Secretary, Embassy of
Australia (Ms. Roz McKenzie); First Secretary, Embassy of
France (Mr. Frederic Bontems); Management Officer, Embassy
of the United Kingdom (Ms. Alison Banks); Embassy of the
United States (Mr. Richard Eason, Economic Counselor, Mr.
Dan Goodspeed, Consul General, Dr. Scott Kennedy, Regional
Medical Office, Dr. Salwa Qteit, US AID Development
Assistant Specialist, Ms. Rana Safadi, Regional Environment
Office, Mr. Jock Whittlesey, Regional Environment Office,
Mr. Bill Densmore, Regional Security Office, Ms. Alison
Kilani, Regional Medical Office, Ms. Jenny Gilbert, Regional
Medical Office, Ms. Laurene Abu Anza, Peace Corps, Mr. Samir
Dahshan, Peace Corps); Government of Jordan (Dr. Adel
Belbessi and Dr. Neyla Gargouri Darwaza); World Health
Organization (Dr. M. Z. Ali Khan and Dr. Sana Naffa).

HALE