TECHNOCRATS WILLING TO ENGAGE ON AVIAN INFLUENZA

C O N F I D E N T I A L SECTION 01 OF 03 RANGOON 000124 SIPDIS SIPDIS STATE FOR EAP/MLS; PACOM FOR FPA; USDA FOR FAS, APHIS E.O. 12958: DECL: 12/07/2015 TAGS: EAGR EAID AMED PGOV PREL SOCI TBIO KFLU BM SUBJECT: TECHNOCRATS WILLING TO ENGAGE ON AVIAN INFLUENZA REF: RANGOON 1257 RANGOON 00000124 001.2 OF 003 Classified By: Econoff TLManlowe for Reasons 1.4 (b,d) ¶1. (C) Summary: The first visit of USAID's Regional Infectious Diseases Advisor based in Bangkok, prompted a rare level of access and engagement by GOB counterparts. Eager for information as well as support, experts at the Ministries of Health and, especially, Livestock and Fisheries discussed weaknesses in Burma's preparedness to cope with an Avian Influenza (AI) outbreak, focusing on surveillance, lab capabilities, disease response and public awareness. Although GOB officials expressed a firm grasp of what is necessary to create a response to the threat of AI, they admitted that a lack of political buy-in by the regional military commanders could create obstacles to effective implementation of their plans. The USAID Advisor encouraged GOB officials to consult more closely with UN agencies, particularly WHO, UNICEF and FAO, and he encouraged the UN offices to coordinate AI assistance, following other models in the region. U.S. assistance would be most welcome. Post recommends broadcasting short-wave radio AI awareness programs and supporting UN technical assistance and training programs in country or in the region. End Summary. UN Engagement Ramping Up -------------- ¶2. (SBU) During his January 18-20 visit to Rangoon, Dr. John MacArthur, USAID Regional Infectious Diseases Advisor, met with representatives from FAO, WHO, UNICEF, the Ministry of Health (MOH) and the Ministry of Livestock and Fisheries (MLF). WHO Representative Dr. Adik Wibowo expressed eagerness to collaborate closely with the USG, and that she would coordinate with WHO and USAID Bangkok offices for assistance and training. She noted that no bilateral donors were contributing to improve Burma's ability to detect an outbreak. Dr. Wibowo said that WHO in Rangoon was beginning to work closely with the GOB on AI and had advised the inter-ministerial committee that drafted Burma's national AI plan. She said a WHO AI expert team is currently in country looking at labs, disease control, and surveillance. This team would brief the GOB committee on its findings. She invited Dr. MacArthur to attend the monthly AI committee meetings in Rangoon, which he agreed to do. ¶3. (SBU) UNICEF officials briefed Dr. MacArthur about the inclusion of AI precautions in their communication programs on hygiene. They also noted that, because of a perceived negative impact on poultry sales, commercial chicken producers had influenced a high level official to withdraw informational TV spots. Public service announcements at cinemas and on the radio continue. FAO assistant representative Saw Ler Wah said that FAO had not assisted in preparing Burma's AI contingency plan, although it offered technical assistance. The GOB considers itself a "non-affected country," however, and it had declined FAO's offers. Dr. MacArthur encouraged UN representatives to coordinate their activities closely, as other UN teams have done in the region. GOB Experts Engage -------------- ¶4. (SBU) At a meeting attended by expert level officials, Dr. Tin Win Maung, Director General of MOH's Department of Health said that the Department trains health workers on AI. At the township level, local military commanders chair monthly Health Committee meetings that address general health issues. The commander has ultimate authority for any actions in his respective area, so all activities conducted by any ministry require his approval. This would include notifying central authorities about a suspected AI case. The DG described the GOB response to a case of suspected bird flu in Kengtung in eastern Shan State (reftel). The GOB closed the school and RANGOON 00000124 002.2 OF 003 market, ordered villagers to stay inside, and sent specimens to a lab in Thailand for tests, through WHO. The results came back negative for AI, but the process took at least seven days from detection to confirmed results. This time lag is a big problem, GOB officials admitted, and they acknowledged the need for better lab facilities in country. Rangoon will host an ASEAN Health Ministers meeting in June, and a possible theme will be "ASEAN: Unity in Health Emergencies," the DG said. ¶5. (SBU) The Ministry of Livestock and Fisheries put together a three day itinerary for Dr. MacArthur, including visits to labs, markets, and farms, as well as meetings with senior level officials, some of whom had just returned from the Beijing donor conference on AI. U Maung Maung Nyunt, Director General of the Livestock Breeding and Veterinary Department, hosted an early Saturday morning meeting with senior experts, immediately upon his return from the conference. He said that Burma follows FAO and OIE regulations and is using the World Bank model to develop its response to AI. ¶6. (SBU) DG Maung Maung Nyunt described the situation in Burma and his ministry's efforts on AI. The Ministry wants to put posters in all 80,000 Burmese villages, but only had the money to print 1,000. His officials also designed an informational booklet for township authorities. The DG described some active surveillance, including testing 1,500 random samples from birds in sanctuaries, farms and markets. Maung Maung Nyunt also noted that efforts at the township level and below depend upon the local commander's support. ¶7. (C) At all of Dr. MacArthur's meetings officials willingly shared information about the Burmese response to the AI threat. The GOB and UN representatives agreed on priority areas that must be addressed: surveillance capability for identification and communication, strengthening labs to be able to identify the H5N1 strain, equipping the hospitals that will treat suspected cases, and implementing a broad public awareness campaign. Officials were eager to discuss the disease, the medical response, the county's existing response system and weaknesses, activities of other nations in the region, regional cooperation and possible assistance from UN agencies and donors. Only when the discussions turned to efforts to engage the senior military leadership did officials turn vague. Comment: Technocrats on Board, Senior Generals Lagging -------------- -------------- ¶8. (C) Dr. MacArthur's first visit revealed several facets of the GOB's position on AI. The enthusiasm and frankness that greeted his visit is uncharacteristic of our normal dealings with the government. The first indication of the GOB's interest was Dr. MacArthur's multiple-entry visa, rarely given to TDY visitors. In all discussions, GOB officials were open, inquisitive, and informative. UN interlocutors said they had similar experiences in their meetings with the GOB on AI. The Livestock DG told us they know Burma has no defense from the disease spreading from neighboring countries and that, "the Prime Minster is afraid that AI will wipe out many of our citizens." ¶9. (C) Despite the GOB's realization, at the technical level, of the AI threat, political obstacles remain. No one we spoke to could say that the senior military leaders supported, with words or resources, activities on AI. The Prime Minister is widely regarded as powerless. The DGs at both ministries also noted that local military commanders could stymie any of the AI activities. To support the efforts of those working to address AI in this difficult environment, Dr. MacArthur discussed potential areas for USG assistance with the Charge. We recommend funding short-wave radio public awareness campaigns and supporting the technical RANGOON 00000124 003.2 OF 003 assistance and training efforts of WHO and FAO. End comment. ¶10. (U) Dr. MacArthur did not have the opportunity to clear this message. VILLAROSA