AI Update: Guangdong Authorities Coming Clean?

UNCLAS SECTION 01 OF 03 GUANGZHOU 009084

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SUBJECT: AI Update: Guangdong Authorities Coming Clean?

Ref: A) GUANGZHOU 6294, B) GUANGZHOU 8517

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1. SUMMARY: Guangdong provincial health and veterinary
officials are showing increased levels of openness and
cooperation. On March 29, officials hosted a private
information meeting for Guangzhou foreign consulates about
the March 2 human avian influenza (AI) death and subsequent
health policies. The initiative to hold such an event and
Chinese inter-agency cooperation are both good signs.
However, questions remain about the general AI threat level
and potential future transparency. END SUMMARY.

Meet the Press: Cantonese Style
--------------

2. On March 2, Guangdong province had its first confirmed
human AI death (reftel A). On March 4, Guangzhou Consulates
learned about the case. On March 29, Guangdong officials
hosted a private "press conference" for the Guangzhou
foreign consulates. The event was unique in terms of the
attempt at openness and inter-agency cooperation among
Chinese government officials. The event also builds on
previous breakthroughs by Post, namely a March 23 planning
meeting for a possible digital video conference (DVC)
between Guangdong health and agricultural officials and
relevant U.S. medical officials housed at Embassy Bangkok
(reftel B). The March 29 special meeting included officials
from the Guangdong Veterinary Station of Epidemic Prevention
and Supervision, the Guangdong Health Department, and the
Guangdong Center of Disease Control (CDC). Officials from
about half of Guangzhou's 23 consulates were in attendance.


3. The Guangdong officials conveyed that they are taking
the recent human death case very seriously and seeking to
improve their policies. Officials are working in six
different ways to improve Guangdong's prevention and
response mechanisms, including:

1. Alerting and information abilities

2. Technical and personnel capabilities

3. Vaccination storage materials and implementation

4. Cooperation with all relevant departments

5. Cooperation with other regions (i.e., Hong Kong, Macau)

6. Public awareness

Background on Guangdong Poultry and Human Threat
-------------- ---

4. Mr. Yu Yedong of the Guangdong Veterinary Station began
the meeting describing Guangdong's potential source for AI
and the government reaction before and after the March 2
human case. Guangdong is China's largest source of poultry.
In 2005 the province was estimated to have 1.36 billion
poultry, or approximately one bird for each PRC citizen,
accounting for 52.3 percent of China's overall poultry
population.


5. Yu next described the events surrounding Guangdong's
only confirmed human AI death. On March 2, a 30-year old
Guangzhou native (surnamed Lao) died (reftel A). On March
4, two national laboratories independently confirmed the
case was AI and the Ministry of Health announced the results
to the provincial authorities. On March 3, the provincial
health authorities enacted their contingency plan to contain
AI. All close contacts of Mr. Lao (124 people) were
quarantined, and special hospitals in Guangdong were put on
"tier-three alert". On March 6, Hong Kong and Macau health
experts met with equivalent Guangdong officials. Throughout
the ordeal, World Health Organization officials were never
contacted. The tier-three alert level was recalled on March

14.

Scorecard of Guangdong Implementation Success
--------------

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6. The Guangdong officials described in some detail how
they are improving policies in the six aforementioned areas.
1) Alert and information abilities: Since 2004, Guangdong
Party Secretary Zhang Dejiang and Guangdong Governor Huang
Huahua have placed Guangdong on "high alert" and asked all
departments to implement relevant measures at the three main
levels of governance: provincial, municipal and county. In
October 2005, Guangdong began creating 43 provincial
monitoring stations, which provide advance information on
the AI situation. (When asked by PolOff about the
capabilities of these stations, the officials provided only
a limited answer. In terms of staffing, some stations like
Guangzhou have 130 staff, Shenzhen has around 60. Other
cities have only 10-20 people and in the countryside the
stations are even smaller.).


7. 2) Technical and personnel materials: Last year the
province invested 200 million RMB ($250,000) in AI programs
and this year has already spent 8.5 million RMB ($1.06
million) on vaccination programs. Additionally, health
officials have received special training on how to manage AI
cases.


8. 3) Vaccination storage materials and implementation:
Over 1.2 billion poultry have been vaccinated (98 percent of
the province's poultry) using a domestic Chinese
vaccination. Last year the veterinary department took
190,000 blood samples and found their vaccination to be 95
percent effective. After 14 days the birds develop a strong
immunity to the disease. Emergency materials for health
personnel have also increased, including increasing stocks
of Tamiflu.


9. 4) Cooperation with all relevant agencies: The
government has increased exchanges with other departments,
including broadening cooperation with the Department of
Education; Department of Transportation; Department of
Forestry (to collect dead birds for lab tests) and the South
China Endangered Species Center (to monitor migratory
birds).


10. 5) Cooperation with other regions: Guangdong CDC and
public health officials have had multiple meetings with Hong
Kong and Macanese officials on how to handle a public health
emergency.


11. 6) Public Awareness: The Guangdong government has
increased the amount of public "propaganda". There have
been more television interviews with doctors than during
SARS, and AI informational signs now hang in most hospitals
and medical centers.

Whodunnit?: Mr. Lao's Death Remains A Mystery
-------------- -

12. Guangdong has over half of China's poultry population
and one confirmed human case, yet no confirmed poultry
deaths in the past two years. The burning question at the
meeting was: "What was the source of the human death?" The
officials said they still do not know the source but assumed
it came from one of the 12 marketplaces in which Lao had
spent significant time. Though Yu of the Veterinary Station
believed both future poultry outbreaks and repeated human
infections were possible, he ruled out human-to-human
outbreaks in the short term.

Transparency Issues
--------------

13. PolOff asked specifically about the rules of reporting
suspected and confirmed AI cases. All final confirmation of
AI cases remains with the Ministry of Health in Beijing,
requiring two separate labs to confirm a death. Information
of an AI death can only be released to the public after this
confirmation. However, Guangdong authorities may release
information on any suspected cases when they choose. The
Guangdong officials agreed to consider sending information

GUANGZHOU 00009084 003 OF 003


via e-mail instead of the slower diplomatic note process.
The former method was used during some of the worst days of
SARS. (In the recent human AI case, Lao was suspected of
having AI on March 2, but the information was not released
until March 4).

Comment: Improvement and Continuing Problems
--------------


14. The unspoken message from this special meeting was
obvious: Guangdong does not want another SARS. It is
believed Guangzhou city was the source of the SARS outbreak,
during which the provincial government was criticized for
apathy, cover-up and economic downturn. At the moment, it
is unclear whether the increased transparency resulted from
foreign or domestic pressure. In terms of influencing the
Guangdong medical response, Post will continue to increase
contact with officials through methods such as the planned
digital video conference. However, because of their access
to internal Guangdong meetings, Hong Kong officials also
remain an important conduit for expressing U.S. concern.
Overall, Guangdong officials should be praised for hosting
the meeting and working with other government departments.
However, they still seem reluctant to inform the public of
suspected cases and working with outside groups such as the
WHO and USG.

DONG