AVIAN INFLUENZA IN AZERBAIJAN: NEED FOR MORE

C O N F I D E N T I A L SECTION 01 OF 02 BAKU 000377

SIPDIS

SIPDIS

DEPT FOR EUR/CARC AND EUR/PGI, ALSO OES
DEPT PLEASE PASS USAID FOR GLOBAL HEALTH MURRAY TROSTLE
ANKARA FOR AGRICULTURAL COUNSELOR
ROME FOR FAO REPRESENTATIVE
GENEVA FOR HEALTH ATTACHE
TBILISI FOR USAID

E.O. 12958: DECL: 03/07/2016
TAGS: ECON EAID PGOV PREL EAGR KFLU CASC AJ
SUBJECT: AVIAN INFLUENZA IN AZERBAIJAN: NEED FOR MORE
INTERNATIONAL EXPERTS ON THE GROUND

REF: A. BAKU 356


B. BAKU 329 AND PREVIOUS

Classified By: AMBASSADOR RENO L. HARNISH III; REASONS 1.4 (B,D)


1. (C) SUMMARY AND ACTION REQUEST: Despite significant and
prolonged intervention by Post, the GOAJ continues to react
poorly to the threat of avian influenza. The GOAJ's
extremely poor veterinary response appears to have largely
destroyed the commercial poultry industry, in addition to an
unknown number of domestic birds. Post is also aware of as
many as 14 suspicious human illness cases within the past
week, including three deaths, but lacks information necessary
for a diagnosis. Post believes that the visits of several
assessment teams, including a very effective USG team, over
the past two months have left a clear picture of the GOAJ's
policy and laboratory capabilities. However, based on our
experience and the present situation, Post has little
confidence in the GOAJ's ability to engage in the basic,
field-level operations needed to manage this crisis. What
has been successful to date has been direct involvement by
visiting experts and U.S. Embassy staff to encourage positive
action, and to gain knowledge at the source. Post requests
Department's immediate engagement with FAO, WHO, and other
international donors aimed in the first instance at getting
WHO and FAO to establish a robust and permanent presence on
the ground, as well as supporting the fielding of multiple
teams of experts to Azerbaijan for field-level work. We also
welcome, and strongly encourage, continued technical-level
visits by American experts on both the veterinary and human
health aspects of this issue. In our view, only field teams
and hands-on support and guidance will provide the
information needed to ensure an appropriate response. END
SUMMARY AND ACTION REQUEST.

Transparency Appalling
--------------


2. (C) Since October 2005, Post has repeatedly engaged the
GOAJ, at every level from laboratory technicians to President
Aliyev, seeking rapid action on avian influenza. Instead, we
have found the going very slow. Only through direct and
forceful intervention by Post were we able to send avian
samples to the internationally recognized laboratory at
Weybridge, UK, on February 6. When the GOAJ would not
contact the lab directly, Post was forced to act as
intermediary, delivering word to the GOAJ that H5N1 was
confirmed in Azerbaijan. Rather than act prudentially, as
many other countries have done, the GOAJ has done practically
nothing to contain the spread of the virus. In fact, the
GOAJ's ineptitude has almost certainly allowed the virus to
spread to many regions in the country and into the commercial
poultry industry. Even now, the vet authorities often
misinform the public.


3. (C) The past week has seen human health issues move to the
fore. As we have pressed our case at increasingly senior
levels of government, all of whom have assured us the GOAJ is
taking active measures, local press reported suspicious human
illnesses, raising the possibility of human H5N1 infection.
In total, Post has now counted as many as 14 separate cases
of suspicious respiratory illness in which patients have been
hospitalized. All the cases are from the same village in
rural Azerbaijan; all are relatives. Three of these 14
patients have died. As reported to Embassy medical
personnel, who examined two of the patients at the hospital
March 6, symptoms in all cases are at least partially
consistent with avian influenza. Only analysis of samples by
an internationally-recognized reference laboratory, such as
at Mill Hill in the UK, will give a clear answer. Rather
than a focused message to the public, the press is now awash
in contradictory reports, nearly all of which cite Health
Ministry officials. A USAID prepared public service
announcement, which was distributed to Azerbaijani television
stations, is the most widely disseminated accurate public
information on AI currently available. We have also
distributed thousands of pamphlets in Azerbaijani about AI
through the Ministry of Education, and directly to farmers

BAKU 00000377 002 OF 002


and other groups.

GOAJ Field Efforts Lacking
--------------


4. (C) In both the veterinary and human health areas, the
GOAJ's attempts at surveillance and monitoring have been
sorely lacking. For example, the GOAJ still lacks any plans
for active surveillance of poultry. Since the February 6
sample shipment facilitated by the Embassy, the Vet Service
has sent samples to an OIE lab only once. This latest batch
of 12 samples arrived in the UK on March 7. In the interim,
well over 100,000 poultry died in various commercial
operations. In human health, while the GOAJ has taken
samples from the patients referenced above, it has yet to
send samples for WHO lab testing. Instead, the GOAJ
continues to trust in equipment and testing that the
international community -- including USG experts -- has
flagged repeatedly to the GOAJ as deficient for identifying
H5N1.


5. (C) Through the efforts of Post's medical team, Post has
more information on the suspect human cases than virtually
any other group in Azerbaijan. Yet, based on the information
we have, we cannot ascertain whether the suspect human cases
are H5N1 avian influenza. As of March 9, the GOAJ has sent
no samples to a WHO reference lab. Sadly, Post is once again
in the position of refereeing the WHO's unprepared and
ineffectual attempts to send samples. Given the GOAJ's lack
of ability to carry out rigorous veterinary and
epidemiological investigation in the field, only multiple
teams of experts in both of these areas can give the
international community the information we need to meet this
challenge head-on.

ACTION REQUEST: More International Experts on the Ground
-------------- --------------


6. (C) We expected that once avian influenza was identified
in Azerbaijan, WHO and FAO would establish a significant
presence on the ground and lead the international response.
This has not happened. It is telling that even with hundreds
of thousands of poultry dying and humans taking ill under
suspicious circumstances, FAO has no permanent presence
(expert or otherwise). WHO has no permanent country
representative in Azerbaijan. We would appreciate
Department's continued pressure on WHO and FAO to field
robust permanent teams to Azerbaijan that can both act at the
technical level as well as engage directly with the GOAJ at
the senior level.


7. (C) Separately, what is needed now are international teams
of veterinary and health professionals, from international
organizations, the donor community, and the USG, to deploy to
the regions operationally. These teams should assist the
GOAJ in direct operational ways, such as sample collection
and shipment, culling, or epidemiological research. We would
welcome and strongly encourage continued technical-level
visits by American experts on both the veterinary and human
health aspects of the issue, and appreciate the support
received to date. A strong international expert presence on
the ground is the best contribution we can make to improving
GOAJ management of the avian influenza problem here.
HARNISH