AI Task Force Meets With Diplomatic Community,

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