KUWAIT PREPARES FOR AVIAN INFLUENZA PANDEMIC

C O N F I D E N T I A L SECTION 01 OF 02 KUWAIT 004466 SIPDIS SENSITIVE SIPDIS E.O. 12958: DECL: 11/15/2011 TAGS: AMED CASC KSCA SENV TBIO KU SUBJECT: KUWAIT PREPARES FOR AVIAN INFLUENZA PANDEMIC REF: A. 05 KUWAIT 4673 ¶B. 05 KUWAIT 4755 ¶C. 05 KUWAIT 4516 ¶D. KUWAIT 563 Classified By: CDA Matt Tueller for reasons 1.4 (b) and (d). ¶1. (SBU) SUMMARY. On November 15, Econoff and Medoff met separately with Director of Public Health Dr. Rashed Al-Owaish and his deputy Dr. Mussab Al-Saleh, and with Director of Animal Health Dr. Farida Al-Mulla to discuss the GOK's preparations for a possible outbreak of Avian Influenza (AI). The GOK has developed and circulated case definitions and treatment protocols based on World Health Organization (WHO) guidance to all public and private hospitals, and currently has sufficient stocks of Tamiflu to treat 1 million people (10 million doses),along with doses of Relenza for 100,000 people. Al-Owaish said Kuwait will follow WHO guidance on treatment and will only use its Tamilfu for treatment, not as a prophylactic (except for healthcare workers). Al-Owaish said Kuwait's AI ministerial committee, headed by the Ministry of Health, is finalizing a comprehensive plan to cover the responsibilities and jurisdictions of GOK ministries in a pandemic, but is facing resistance from the Interior Ministry over subordinating its Civil Defense Department to MOH authority. ¶2. (SBU) Al-Mulla said her department is continuing the practices developed in 2005 (Refs A & B) to inspect bird markets, farms, and coastal areas for signs of AI. She said she is receiving good budgetary support from the Ministry of Finance and has better resources to conduct inspections as compared to last year. Animal Health inspectors are conducting regular inspections of Kuwait commercial poultry operations, and will only provide vaccines to commercial operators after an inspection is completed. Al-Mulla said the GOK has purchased the H5N1 vaccine for poultry, but only plans to use it in the case of a local AI outbreak. Surprisingly, Al-Mulla did not raise concerns over U.S. military vehicle traffic entering Kuwait from Iraq, although this was a major issue during the winter of 2005/2006. END SUMMARY. AI Plan Coming Together, Interior Ministry Balks -------------- --- ¶3. (SBU) On November 15, Econoff and Medoff met with Direction of Public Health Dr. Rashed Al-Owaish and his deputy Dr. Mussab Al-Saleh. The Directorate of Public Health is part of the Ministry of Health (MOH). Al-Owaish said the GOK's ministerial committee, chaired by the Minister of Health, is finalizing a comprehensive plan to respond to a possible AI outbreak, including case definitions and treatment protocols that have already been distributed to all public and private hospitals. Part of the plan involves delineating the roles and jurisdictions of each GOK ministry, but Al-Saleh said the Ministry of Interior, which sees its Civil Defense Department as leading any crisis-response effort, has balked at MOH authority. The roles of the various ministries will be on the committee's agenda for its next meeting during the week of November 20. Under the ministerial committee, Al-Owaish said there are two sub-committees - one addressing medical issues and one working on non-medical (logistics and resources) issues - which are using WHO guidance in developing their plans. Tamiflu Only For Treatment -------------- ¶4. (C) Al-Saleh said the MOH purchased 200,000 doses of the influenza vaccine (up from 40,000 doses in 2005),and has made them widely available. The GOK has secured sufficient Tamiflu for 1 million persons (10 million doses),and has decided to use the drug only for treatment, not for prophylaxis (except for healthcare workers). The GOK also has 100,000 doses of Relenza on hand. In order to monitor distribution and appropriate usage, the MOH will only allow Tamiflu to be distributed at government hospitals. Al-Saleh also said the GOK has reserved some of its Tamiflu stocks for distribution to "VIPs," and that the decisions surrounding these "VIP stocks" would be made by the Amir. Al-Saleh said the VIPs could include the Embassy personnel of "the U.S., U.K., and others" in the event that "we really need your help." Animal Health Inspections Continue -------------- ¶5. (SBU) Econoff and Medoff also met on November 15 with Dr. Farida Al-Mulla, Director of Animal Health at the Public Authority for Agriculture and Fish Resources (PAAAFR). KUWAIT 00004466 002 OF 002 Al-Mulla said there are 7 PAAAFR teams conducting regular inspections of bird markets, poultry farms, and coastal areas. These inspections follow the same protocols the PAAAFR developed in 2005 (Refs A & B),which were very effective. Al-Mulla said she is getting good budgetary support, including more vehicles, from the Ministry of Finance which has made inspections more efficient. At commercial poultry farms, PAAAFR inspectors are withholding vaccinations for the birds until the farms pass a biosecurity inspection. The GOK has purchased the H5N1 vaccine for poultry, but because of limited stocks does not plan to inoculate all birds. Instead, in the event of an outbreak of AI among poultry, the PAAAFR will order the destruction of all birds within a 3km radius of the outbreak site, and use the H5N1 vaccine of all poultry within a 10km radius to contain the outbreak. No Concern (Yet) Over Border Traffic -------------- ¶6. (SBU) To Econoff's surprise, Al-Mulla did not express concerns over U.S. military vehicle traffic entering Kuwait from Iraq. In the winter of 2005/2006, Al-Mulla and the PAAAFR expressed serious concerns about the AI virus being brought into Kuwait on the tires of these vehicles, and requested that substantial measures be taken to decontaminate these vehicles. (See Ref D for a summary of GOK concerns and USG responses.) Instead, Al-Mulla's worries centered on appropriate quarantine procedures at Kuwait ports of entry, and on the quality of the PAAAFR's laboratory work. ********************************************* * For more reporting from Embassy Kuwait, visit: http://www.state.sgov.gov/p/nea/kuwait/?cable s Visit Kuwait's Classified Website: http://www.state.sgov.gov/p/nea/kuwait/ ********************************************* * Tueller