TURKEY AVIAN INFLUENZA: TURKEY AS MODEL FOR REGION

UNCLAS SECTION 01 OF 04 ANKARA 000341

SIPDIS

USAID FOR TROSTLE, BLANCHET AND CARROLL
HHS FOR WSTEIGER/PBUDASHEWITZ
FAS FOR ITP/MACKE/THOMAS, CMP/DLP/WETZEL, FAS/JDEVER
FAS PASS FSIS AND APHIS
VIENNA PASS APHIS
BRUSSELS PASS APHIS/FERNANDEZ
GENEVA PASS HEALTH ATTACHE
ROME FOR US MISSION TO FAO

SIPDIS

E.O. 12958:N/A
TAGS: TBIO AMED EAID CASC SENV EAGR KPAO TU KFLU
SUBJECT: TURKEY AVIAN INFLUENZA: TURKEY AS MODEL FOR REGION

REF: A. ANKARA 263


B. ANKARA 134 AND PREVIOUS

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1. SUMMARY: The USG AI Delegation that recently visited
Turkey, as well as international organizations on the scene,
applaud Turkey's robust and transparent response to recent
AI animal and human outbreaks, including good cooperation
with international actors. They cite Turkey's response as a
regional and global model, particularly as the international
effort moves to scientific investigation of the Turkey
experience. The World Bank is coordinating international
support for increasing surveillance capacity. The GOT and
IOs hope for a USG contribution to this support. Ambassador
attended an international coordination meeting, aimed to
target next steps. End Summary.

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Situation-Background
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2. Turkey first experienced an avian influenza outbreak in
poultry in western Turkey in October that was subsequently
declared contained after culling in surrounding commercial
operations. Later waves of backyard fowl cases were
identified first in eastern Turkey, but spread to many
different provinces. In late December, the virus jumped
from infected domestic birds to people, eventually infecting
21 cases confirmed by the GOT. Four of these persons died,
all children who helped tend rural backyard poultry.
Immediately after the outbreak, there were some delays in
coordinating a GOT response that was exacerbated by a
weeklong religious holiday, but the crisis now appears to be
abating. Both human cases and poultry cases are now under
control. Over 1.5 million fowl have been culled, and the
GOT has implemented an intensive public education program.


3. An 11-member, multi-agency USG Delegation traveled to
Ankara and eastern Turkey January 16-22 to assess the
situation and make recommendations for USG support. The
team traveled on to the Caucasus and the Ukraine to assess
conditions and to share lessons learned from the Turkey
experience.

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International Partner Coordination - WHO, FAO, UNICEF
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4. UNDP ResRep Jakob Simonsen organized a meeting on

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January 27 of AI international actors, including the
Ambassador, aimed to determine next steps in Turkey and
coordinate assistance. All organization reps emphasized
that the GOT's response had been open, quick, efficient, and
supportive of field investigation and research. WHO Turkey
Rep Luigi Migliorini stressed that the situation in Turkey
was calming down -- with no new human cases reported,
allowing the WHO teams in Ankara and Van to finish their
outbreak investigations. He noted that the WHO DG would
travel to Turkey during the week of January 30.


5. FAO Turkey Rep Abdellatif Tabet echoed his positive view
of Turkey's actions, but noted the initial delay by the GOT
in identifying and responding to waves of animal outbreaks;
i.e., the GOT did not quickly control transport of people
and animals. He tallied 40 confirmed outbreaks in poultry
and 80-90 suspected. The FAO rep called for increased
capacity in Turkey for early detection and early
investigations, including increased laboratory and human
capacity. Noting the risk of transmission via bird
migration, he raised potential movement of birds to/from
Russia and the Red Sea. The FAO has sent a team to the
Adana region of Turkey, believing that cold weather in other
parts of the country will force migratory birds into
marshlands near Adana.


6. UNICEF Turkey Edmond McCloughney observed that media
saturation during the outbreaks helped the GOT succeed in
getting the right messages through to the public,
particularly that children were at risk. He said that
UNICEF's efforts - working with the MOH - were now focused
on more concise, punchy messages, working through Ministries
of Education and Interior to filter down to local levels.
The UNICEF Rep announced a Feb 6-7 Regional AI communication
conference in Geneva to focus on communication lessons from
Asia.

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USG Avian Influenza Team
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7. Ambassador explained that the USG AI team had not
returned to Ankara for a de-brief, because it had traveled
directly on to the Ukraine to continue its mission after the
Caucasus (Jan 23-27). He described the team's mission:

a) Gain first-hand information and assessment
b) Make specific recommendations for USG support

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c) Focus on regional approach, using Turkey as a model
d) Identify lessons for future application - regionally and
globally.


8. Responding to GOT and IO concerns of likely unreported
outbreaks in neighboring countries, Ambassador stressed the
importance of regional efforts, building on exporting the
Turkey model for response. Asked about U.S. assistance to
Turkey, Ambassador said the AI team would make
recommendations, but noted that a particularly large effort
may not be likely. Instead, Ambassador stated that USG
contributions could be best leveraged in the Caucasus where
there was a significant USAID mission presence and we could
help authorities get ahead of potential outbreaks. He
expressed hope that WHO, FAO, and others were in contact
with Iran, Syria, and Iraq (the first two raising
difficulties for the USG in making contacts).


9. The EC Rep announced approval for a fast-track 10
million euro project for Turkey (8.5 million euros out of EU
accession funds, rather than Beijing commitments, and 1.5
million euros in counterpart Turkish contributions),which
would target animal laboratory upgrades and associated
equipment, training, and rapid testing capacity. In
describing the recent visit of EC Health Commissioner
Kyprianou, the EC rep noted that his message was the need
for Turkey and the international community to not let their
guard down. The EC Rep stated that a one-week expert
mission would remain in Turkey.


10. The World Bank Rep described the provisional $16
million loan package being developed, which is intended to
be complemented by the EC grant (and hopefully a USAID
and/or other USG grant contribution). The loan/grant
package would target human, animal, and communication
components, including compensation and laboratory capacity.


11. While applauding Turkey's response and openness, IO
Reps warn the GOT to expect incremental AI cases in Turkey
and adjoining countries. Moreover, there is an expectation
that movements of birds in the spring may continue to fan
potential spread of the disease in the Middle East, Africa,
and elsewhere.


12. In closing, the UNDP ResRep acknowledged the general
praise of GOT efforts, but highlighted the lack of an "AI
Czar" or centralized focal point in the GOT. Despite
creation of a structure under the Prime Ministry, in effect

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there were still parallel crisis coordination centers at the
MOH and MOAGR. (The EC Rep corroborated the issue, noting
that the EC team was unable to organize a joint press
meeting.) The WB Rep pointed out that there was a National
Zoonotic Committee for coordinating scientific
investigation, with a revolving head. All the IO reps
looked forward to illumination of mechanisms for utilization
of the mix of loans and grants pledged at Beijing.

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Comment:
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13. While we await the AI team's recommendations, post
believes the U.S. should be responsive in supporting
Turkey's AI response capacity, as well as promoting it as a
regional model. The GOT has asked for support for
increasing and improving surveillance training/capacity,
communication, culling incineration, and laboratory
capacity. The U.S. could also provide technical assistance
in developing Turkey's crisis coordination and response
capability.
Wilson