Identifier
Created
Classification
Origin
06KINSHASA357
2006-03-03 11:59:00
UNCLASSIFIED
Embassy Kinshasa
Cable title:
DRC: AVIAN INFLUENZA UPDATE
how-toVZCZCXRO6687 RR RUEHDU RUEHGI RUEHJO RUEHMR DE RUEHKI #0357/01 0621159 ZNR UUUUU ZZH R 031159Z MAR 06 FM AMEMBASSY KINSHASA TO RUEHC/SECSTATE WASHDC 3308 INFO RUEHXR/RWANDA COLLECTIVE RUCNSAD/SOUTHERN AFRICAN DEVELOPMENT COMMUNITY RUEAUSA/DEPT OF HHS WASHDC
UNCLAS SECTION 01 OF 03 KINSHASA 000357
SIPDIS
SIPDIS
DEPT ALSO PASS USAID FOR AID/W/AFR MHARVEY AND KODONNELL
HHS FOR AVIAN FLU OFFICER
E.O. 12958: N/A
TAGS: TBIO KFLU EAID EAGR ECON SENV SOCI CG
AVIAN FLU
SUBJECT: DRC: AVIAN INFLUENZA UPDATE
REF: KINSHASA 1939
UNCLAS SECTION 01 OF 03 KINSHASA 000357
SIPDIS
SIPDIS
DEPT ALSO PASS USAID FOR AID/W/AFR MHARVEY AND KODONNELL
HHS FOR AVIAN FLU OFFICER
E.O. 12958: N/A
TAGS: TBIO KFLU EAID EAGR ECON SENV SOCI CG
AVIAN FLU
SUBJECT: DRC: AVIAN INFLUENZA UPDATE
REF: KINSHASA 1939
1. (U) Summary. The GDRC Avian Influenza Commission,
composed of representatives from the Ministries of
Agriculture, Health, External Commerce, and Environment,
released the DRC Country Contingency Plan (CCP) on February
24. The CCP seeks over USD 16M to prepare for and respond
to the anticipated arrival of Highly Pathogenic Avian
Influenza (HPAI) in the DRC. The pre-pandemic phase
focuses on surveillance, equipment, and training; the
approach/onset phase focuses on containment to slow
transmission; and the declared pandemic phase includes
case-tracking and treatment. The plan highlights the DRC's
lack of capacity to monitor, detect, and respond to HPAI,
and notes that conditions in the DRC are conducive to rapid
bird-to-bird, bird-to-human, and possibly human-to-human
transmission of the virus, once introduced. In a related
development, a report out of south-central DRC says that
migratory swallows, coming from European countries where
confirmed cases of HPAI exist, are being captured and
consumed in the DRC. End summary.
--------------
DRC Avian Flu Commission
--------------
2. (U) The GDRC created an Avian Flu Commission (AIC) in
late 2005, chaired by the Minister of Agriculture and
composed of representatives from the Ministries of Health
(Directorates of Disease Prevention and Border Health,
National Institute of Bio-medical Research),Agriculture
(Directorate of Animal Production and Health, Veterinary
Laboratory of Kinshasa),External Commerce (Congolese
Office of Control and its laboratory),and Environment
(Directorate for the Protection of Flora and Fauna,
National Institute for the Conservation of Nature). The
Commission resolved to reinforce the number of sanitary
inspectors and police at all official border crossings and
to strengthen sanitary measures on commercial poultry farms
while monitoring those farms for signs of Highly Pathogenic
Avian Influenza (HPAI). The Ministry of Agriculture was
charged with the monitoring, detection, and diagnosis of
HPAI in the DRC. The Commission charged the Ministry of
Environment with the issue of migratory bird transmission
of HPAI. The plan was to work with the World Organization
for Animal Health (OIE) and the World Health Organization
(WHO) to identify and respond to suspected bird and human
cases of the disease.
--------------
The DRC Country Contingency Plan
--------------
3. (U) On February 25, the AIC released its Country
Contingency Plan (CCP) at a ceremony attended by high-level
representatives from donor countries, the UN Mission to the
DRC (MONUC),the World Bank, FAO, UNICEF, WHO, and other UN
agencies. The meeting was co-chaired by the Ministries of
Agriculture, Health, and External Commerce. The CCP points
out that the DRC lies along the path of many migratory bird
species that come to Africa during the northern hemisphere
winter in Europe and Asia, including many countries with
HPAI. It estimates that there are over 20 million poultry
(mostly chickens, but also ducks, turkeys, geese, and
guinea fowl) in the DRC, 80 percent of which are
free-range. The document notes that many Congolese live in
close proximity with their poultry, sometimes in the same
house, and that this, combined with general lack of
sanitation, could result in easy bird-to-bird,
bird-to-human, and human-to-human transmission.
--------------
Health Sector Capacity
--------------
4. (U) In principle, the DRC is covered by 515 health
zones, each with a central office, a referral hospital, and
health centers. The CCP notes, however, that the majority
of these health zones do not have the capacity to provide
even primary health care services. Since 2000, with the
start-up of the nationwide polio eradication program, a
surveillance system has been in place that can alert
authorities to outbreaks of certain infectious diseases.
The CCP reports that there is also a viable system for the
collection and transport of medical samples, but that DRC
medical laboratories are not capable of testing for the
HPAI virus strains. The DRC, a post-conflict country, has
KINSHASA 00000357 002 OF 003
poor health infrastructure in general, little or no medical
resources of its own, and is almost entirely dependent upon
outside assistance for provision of health care services.
--------------
Agriculture and Environment
--------------
5. (U) The Ministry of Agriculture Directorate of Animal
Production and Health, according to the CCP, suffers from
insufficient personnel, logistical support, communication,
and general capacity, especially at border posts far from
large towns and cities. The CCP is pessimistic that
Ministry of Agriculture personnel would be able to monitor,
detect, or react to the appearance of HPAI in the DRC. The
report concedes that the two functioning veterinary labs in
Kinshasa and Lubumbashi have no ability to determine
whether the H5N1 variety of HPAI is present in suspected
samples. The CCP says that an E.U.-funded entity called the
Pan-African Program for the Control of Epizootic Diseases
(PACE),concerned mainly with cattle diseases such as
rinderpest, might provide some monitoring and detection of
HPAI in the DRC. The report also cites the Environment
Ministry's National Institute for the Conservation of
Nature as a possible monitor for wild bird transmission of
HPAI, but only in the small number of wildlife reserves and
protected areas in the DRC. The CCP notes that an informal
radio network of GDRC ministries, NGOs, and UN agencies
across the DRC could be called upon to provide nationwide
emergency communication, even down to the village level.
--------------
Phase One: Pre-Pandemic
--------------
6. (U) The CCP divides the national approach to a possible
HPAI pandemic into three phases: pre-pandemic,
approach/onset of the pandemic, and a declared pandemic.
The pre-pandemic phase is defined as the period during
which there is the possibility of animal infection with the
associated risk of transmission to humans. Beginning
March 2006, the CCP lays out immediate objectives and
indicators, designates which GDRC ministry or international
partner will be responsible for each program activity, and
indicates the timeline for each activity. The total budget
for the pre-pandemic phase, from March through end April,
is USD 13,720,000. Strategies include better communication;
better monitoring of animal and human health; compensation
for affected farmers; training for monitors and first
responders; placement of equipment for rapid detection,
transport, and analysis; and determination of needs for
medicines and other treatments.
--------------
Phase Two: Approach/Onset of Pandemic
--------------
7. (U) The CCP approach/onset phase of the pandemic is
defined as the period when human infections by HPAI are
first noted in a localized area of infection, possibly with
limited human-to-human transmission. The specific CCP
objective of this phase is stopping or slowing the
transmission of the disease in humans. Strategies include
heightened surveillance for animal and human cases; support
for prevention, treatment, and care of emergent cases; and
provision of protective equipment to technical and at-risk
personnel. This phase is budgeted at USD 1,857,700 and was
left open as a period of indeterminate length, depending
upon the evolution of the epidemic.
--------------
Phase Three: Declared Pandemic
--------------
8. (U) The final phase of the CCP, during which
human-to-human transmission is confirmed and the already
large number of human cases continues to rise, aims to
reduce morbidity, mortality, and "social disorganization,"
while the DRC supports research activity aimed at ending
the pandemic. Strategies include heightened animal and
human surveillance; increased prevention efforts; support
for care and research; and follow-up and evaluation. This
phase, with no timeline indicated, is budgeted for USD
433,500. The total budget for the three phases is USD
16,011,200.
--------------
KINSHASA 00000357 003 OF 003
Ministry of Agriculture: Little Capacity
--------------
9. (U) EconCouns met with the Ministry of Agriculture
Secretary General Hubert Ali, a doctor of veterinary
SIPDIS
medicine. Ali confirmed that the two functioning
veterinary laboratories in the DRC, in Kinshasa and
Lubumbashi, are not equipped to detect flu viruses of the
highly pathogenic H5N1 variety. As in Nigeria, samples
would have to be flown to a laboratory outside the DRC, and
it would be days before the results were known. Ali
admitted that preventing the entry of and detecting any
outbreak of HPAI in the DRC would be extremely difficult,
given the size of the country (DRC is approximately the
size of the U.S. east of the Mississippi River) and the
thousands of miles of land borders with its nine
neighboring countries. PACE (see para 5),he said, has
hundreds of personnel in the DRC, including in the Bas
Congo, Bandundu, and Equateur provinces that border on
Congo Brazzaville. PACE radio and internet connections
might allow for news of rural poultry or wild bird die-offs
to be transmitted quickly to Kinshasa. Ali, however,
pointed out that Congolese villagers would be very reticent
to report poultry die-offs and would be even more resistant
to the voluntary culling of backyard flocks.
--------------
Migratory Birds in Southwestern DRC
--------------
10. (U) MONUC reported on February 24 that a joint OIE/WHO
team traveled to Eastern Kasai province in mid-February
in response to reports that banded migratory birds were in
this area of south-central DRC, near the Angolan border.
The team located and identified the remains of eight birds
classified as swallows, all of which had carried bands
identifying their points of origin in Europe. Four had
been banded in Hungary, two in Germany, one in Poland, and
one at the British Museum in London. All eight had
apparently fallen prey to a common practice: during peak
migration months (October through January, also a local
"hungry season"),hunters place glue on branches where the
birds roost at night. Unable to fly away the next morning,
the birds are collected by hand and consumed by local
villagers. The researchers were only able to retrieve the
information contained on the bands, since the villagers
believe that the bands themselves contain some magic power.
There was no indication that any of the hundreds of
swallows captured and consumed had died en route or been
sickly. Post has no information about whether there were
plans to test swallows or their remains for HPAI. The
team's WHO physician found that infectious respiratory
diseases were second only to malaria as the most common
ailment in local health centers.
11. (U) Comment. The GDRC has been proactive on HPAI,
given the potential here for the transmission and
socioeconomic consequences of HPAI. The DRC has previous
experience in dealing with outbreaks of Ebola and Marburg
virus. DRC was one of the first sub-Saharan African
countries to ban poultry products from countries with
confirmed HPAI (reftel). Poultry imports are now banned
from nearly 30 countries with the recent addition of
Nigeria, Italy, France, Germany, and Niger. The DRC
Country Contingency Plan is complete and well-thought-out,
but also completely dependent upon outside resources that
may not be forthcoming. The CCP budget declines
significantly from phase to phase when it should actually
increase, since tracking and treatment are more expensive
than standard surveillance. The size of the country, its
porous borders, the dependence of many of its citizens on
backyard poultry flocks, and the inability of GDRC
authorities to detect the arrival of HPAI may conspire to
prevent a timely response and allow the virus to spread
unchecked across the country. GDRC compensation for culled
poultry and/or a nationwide poultry vaccination campaign
are not realistic options. The best approach to avoid
socioeconomic disaster and a possible human pandemic will
be to engage all possible entities, governmental and
non-governmental, in an HPAI monitoring/detection campaign,
limit the geographical spread of the virus after it is
detected, and emphasize appropriate measures to prevent
bird-to-human and human-to-human transmission. End
comment.
DOUGHERTY
SIPDIS
SIPDIS
DEPT ALSO PASS USAID FOR AID/W/AFR MHARVEY AND KODONNELL
HHS FOR AVIAN FLU OFFICER
E.O. 12958: N/A
TAGS: TBIO KFLU EAID EAGR ECON SENV SOCI CG
AVIAN FLU
SUBJECT: DRC: AVIAN INFLUENZA UPDATE
REF: KINSHASA 1939
1. (U) Summary. The GDRC Avian Influenza Commission,
composed of representatives from the Ministries of
Agriculture, Health, External Commerce, and Environment,
released the DRC Country Contingency Plan (CCP) on February
24. The CCP seeks over USD 16M to prepare for and respond
to the anticipated arrival of Highly Pathogenic Avian
Influenza (HPAI) in the DRC. The pre-pandemic phase
focuses on surveillance, equipment, and training; the
approach/onset phase focuses on containment to slow
transmission; and the declared pandemic phase includes
case-tracking and treatment. The plan highlights the DRC's
lack of capacity to monitor, detect, and respond to HPAI,
and notes that conditions in the DRC are conducive to rapid
bird-to-bird, bird-to-human, and possibly human-to-human
transmission of the virus, once introduced. In a related
development, a report out of south-central DRC says that
migratory swallows, coming from European countries where
confirmed cases of HPAI exist, are being captured and
consumed in the DRC. End summary.
--------------
DRC Avian Flu Commission
--------------
2. (U) The GDRC created an Avian Flu Commission (AIC) in
late 2005, chaired by the Minister of Agriculture and
composed of representatives from the Ministries of Health
(Directorates of Disease Prevention and Border Health,
National Institute of Bio-medical Research),Agriculture
(Directorate of Animal Production and Health, Veterinary
Laboratory of Kinshasa),External Commerce (Congolese
Office of Control and its laboratory),and Environment
(Directorate for the Protection of Flora and Fauna,
National Institute for the Conservation of Nature). The
Commission resolved to reinforce the number of sanitary
inspectors and police at all official border crossings and
to strengthen sanitary measures on commercial poultry farms
while monitoring those farms for signs of Highly Pathogenic
Avian Influenza (HPAI). The Ministry of Agriculture was
charged with the monitoring, detection, and diagnosis of
HPAI in the DRC. The Commission charged the Ministry of
Environment with the issue of migratory bird transmission
of HPAI. The plan was to work with the World Organization
for Animal Health (OIE) and the World Health Organization
(WHO) to identify and respond to suspected bird and human
cases of the disease.
--------------
The DRC Country Contingency Plan
--------------
3. (U) On February 25, the AIC released its Country
Contingency Plan (CCP) at a ceremony attended by high-level
representatives from donor countries, the UN Mission to the
DRC (MONUC),the World Bank, FAO, UNICEF, WHO, and other UN
agencies. The meeting was co-chaired by the Ministries of
Agriculture, Health, and External Commerce. The CCP points
out that the DRC lies along the path of many migratory bird
species that come to Africa during the northern hemisphere
winter in Europe and Asia, including many countries with
HPAI. It estimates that there are over 20 million poultry
(mostly chickens, but also ducks, turkeys, geese, and
guinea fowl) in the DRC, 80 percent of which are
free-range. The document notes that many Congolese live in
close proximity with their poultry, sometimes in the same
house, and that this, combined with general lack of
sanitation, could result in easy bird-to-bird,
bird-to-human, and human-to-human transmission.
--------------
Health Sector Capacity
--------------
4. (U) In principle, the DRC is covered by 515 health
zones, each with a central office, a referral hospital, and
health centers. The CCP notes, however, that the majority
of these health zones do not have the capacity to provide
even primary health care services. Since 2000, with the
start-up of the nationwide polio eradication program, a
surveillance system has been in place that can alert
authorities to outbreaks of certain infectious diseases.
The CCP reports that there is also a viable system for the
collection and transport of medical samples, but that DRC
medical laboratories are not capable of testing for the
HPAI virus strains. The DRC, a post-conflict country, has
KINSHASA 00000357 002 OF 003
poor health infrastructure in general, little or no medical
resources of its own, and is almost entirely dependent upon
outside assistance for provision of health care services.
--------------
Agriculture and Environment
--------------
5. (U) The Ministry of Agriculture Directorate of Animal
Production and Health, according to the CCP, suffers from
insufficient personnel, logistical support, communication,
and general capacity, especially at border posts far from
large towns and cities. The CCP is pessimistic that
Ministry of Agriculture personnel would be able to monitor,
detect, or react to the appearance of HPAI in the DRC. The
report concedes that the two functioning veterinary labs in
Kinshasa and Lubumbashi have no ability to determine
whether the H5N1 variety of HPAI is present in suspected
samples. The CCP says that an E.U.-funded entity called the
Pan-African Program for the Control of Epizootic Diseases
(PACE),concerned mainly with cattle diseases such as
rinderpest, might provide some monitoring and detection of
HPAI in the DRC. The report also cites the Environment
Ministry's National Institute for the Conservation of
Nature as a possible monitor for wild bird transmission of
HPAI, but only in the small number of wildlife reserves and
protected areas in the DRC. The CCP notes that an informal
radio network of GDRC ministries, NGOs, and UN agencies
across the DRC could be called upon to provide nationwide
emergency communication, even down to the village level.
--------------
Phase One: Pre-Pandemic
--------------
6. (U) The CCP divides the national approach to a possible
HPAI pandemic into three phases: pre-pandemic,
approach/onset of the pandemic, and a declared pandemic.
The pre-pandemic phase is defined as the period during
which there is the possibility of animal infection with the
associated risk of transmission to humans. Beginning
March 2006, the CCP lays out immediate objectives and
indicators, designates which GDRC ministry or international
partner will be responsible for each program activity, and
indicates the timeline for each activity. The total budget
for the pre-pandemic phase, from March through end April,
is USD 13,720,000. Strategies include better communication;
better monitoring of animal and human health; compensation
for affected farmers; training for monitors and first
responders; placement of equipment for rapid detection,
transport, and analysis; and determination of needs for
medicines and other treatments.
--------------
Phase Two: Approach/Onset of Pandemic
--------------
7. (U) The CCP approach/onset phase of the pandemic is
defined as the period when human infections by HPAI are
first noted in a localized area of infection, possibly with
limited human-to-human transmission. The specific CCP
objective of this phase is stopping or slowing the
transmission of the disease in humans. Strategies include
heightened surveillance for animal and human cases; support
for prevention, treatment, and care of emergent cases; and
provision of protective equipment to technical and at-risk
personnel. This phase is budgeted at USD 1,857,700 and was
left open as a period of indeterminate length, depending
upon the evolution of the epidemic.
--------------
Phase Three: Declared Pandemic
--------------
8. (U) The final phase of the CCP, during which
human-to-human transmission is confirmed and the already
large number of human cases continues to rise, aims to
reduce morbidity, mortality, and "social disorganization,"
while the DRC supports research activity aimed at ending
the pandemic. Strategies include heightened animal and
human surveillance; increased prevention efforts; support
for care and research; and follow-up and evaluation. This
phase, with no timeline indicated, is budgeted for USD
433,500. The total budget for the three phases is USD
16,011,200.
--------------
KINSHASA 00000357 003 OF 003
Ministry of Agriculture: Little Capacity
--------------
9. (U) EconCouns met with the Ministry of Agriculture
Secretary General Hubert Ali, a doctor of veterinary
SIPDIS
medicine. Ali confirmed that the two functioning
veterinary laboratories in the DRC, in Kinshasa and
Lubumbashi, are not equipped to detect flu viruses of the
highly pathogenic H5N1 variety. As in Nigeria, samples
would have to be flown to a laboratory outside the DRC, and
it would be days before the results were known. Ali
admitted that preventing the entry of and detecting any
outbreak of HPAI in the DRC would be extremely difficult,
given the size of the country (DRC is approximately the
size of the U.S. east of the Mississippi River) and the
thousands of miles of land borders with its nine
neighboring countries. PACE (see para 5),he said, has
hundreds of personnel in the DRC, including in the Bas
Congo, Bandundu, and Equateur provinces that border on
Congo Brazzaville. PACE radio and internet connections
might allow for news of rural poultry or wild bird die-offs
to be transmitted quickly to Kinshasa. Ali, however,
pointed out that Congolese villagers would be very reticent
to report poultry die-offs and would be even more resistant
to the voluntary culling of backyard flocks.
--------------
Migratory Birds in Southwestern DRC
--------------
10. (U) MONUC reported on February 24 that a joint OIE/WHO
team traveled to Eastern Kasai province in mid-February
in response to reports that banded migratory birds were in
this area of south-central DRC, near the Angolan border.
The team located and identified the remains of eight birds
classified as swallows, all of which had carried bands
identifying their points of origin in Europe. Four had
been banded in Hungary, two in Germany, one in Poland, and
one at the British Museum in London. All eight had
apparently fallen prey to a common practice: during peak
migration months (October through January, also a local
"hungry season"),hunters place glue on branches where the
birds roost at night. Unable to fly away the next morning,
the birds are collected by hand and consumed by local
villagers. The researchers were only able to retrieve the
information contained on the bands, since the villagers
believe that the bands themselves contain some magic power.
There was no indication that any of the hundreds of
swallows captured and consumed had died en route or been
sickly. Post has no information about whether there were
plans to test swallows or their remains for HPAI. The
team's WHO physician found that infectious respiratory
diseases were second only to malaria as the most common
ailment in local health centers.
11. (U) Comment. The GDRC has been proactive on HPAI,
given the potential here for the transmission and
socioeconomic consequences of HPAI. The DRC has previous
experience in dealing with outbreaks of Ebola and Marburg
virus. DRC was one of the first sub-Saharan African
countries to ban poultry products from countries with
confirmed HPAI (reftel). Poultry imports are now banned
from nearly 30 countries with the recent addition of
Nigeria, Italy, France, Germany, and Niger. The DRC
Country Contingency Plan is complete and well-thought-out,
but also completely dependent upon outside resources that
may not be forthcoming. The CCP budget declines
significantly from phase to phase when it should actually
increase, since tracking and treatment are more expensive
than standard surveillance. The size of the country, its
porous borders, the dependence of many of its citizens on
backyard poultry flocks, and the inability of GDRC
authorities to detect the arrival of HPAI may conspire to
prevent a timely response and allow the virus to spread
unchecked across the country. GDRC compensation for culled
poultry and/or a nationwide poultry vaccination campaign
are not realistic options. The best approach to avoid
socioeconomic disaster and a possible human pandemic will
be to engage all possible entities, governmental and
non-governmental, in an HPAI monitoring/detection campaign,
limit the geographical spread of the virus after it is
detected, and emphasize appropriate measures to prevent
bird-to-human and human-to-human transmission. End
comment.
DOUGHERTY