UNCLAS SECTION 01 OF 02 ROME 000762

SIPDIS

DEPT FOR OES/IHA (DR. DSINGER/RSDALEY), EUR/WE
DHHS FOR OGHA (STEIGER/BUDASHEWITZ)
FAS FOR ITP/MACKE/THOMAS, CMP/DLP/WETZEL/CLERKIN, FAS/BLEGGI
FAS PASS FSIS AND APHIS
CDC FOR DR. DBELL
HOMELAND SECURITY FOR OIA
USEU BRUSSELS PASS APHIS/FERNANDEZ
MILAN PLEASE PASS TO TURIN OFFICE

E.O. 12958: N/A
TAGS: TBIO EAGR KFLU SENV ECON PREL KSCA IT AVIAN INFLUENZA
SUBJECT: ITALIAN AVIAN/PANDEMIC INFLUENZA PLAN ADOPTED

REFTELS: (A) ROME 000510, (B) 05 ROME 4188, (C) 05 Rome

4113


1. SUMMARY: Ref C reported on a draft version of Italy's
avian/pandemic influenza preparedness plan. The final
version of the plan was adopted by the Council of the State
and Regions on February 9, 2006. The National Plan for
Preparedness and Response to Pandemic Influenza is now
available in Italian on the Health Ministry's Center for
Disease Control internet web site at:
(http://www.ccm.ministerosalute.it/imgs/C_17_ pubblicazioni_5
01_allegato.pdf. The final version, which is much less
detailed than the earlier draft (Ref C), updates and
replaces the 2002 version. The final version enumerates
guidelines for the operational plans to be prepared by each
Italian region, with input from all institutions with
responsibilities during a pandemic. The GOI intends to
update the plan on a regular basis, as the regional plans
are completed. END SUMMARY.

PLAN'S MAIN OBJECTIVES
--------------


2. Preparing for an influenza pandemic is a top priority
for the Government of Italy, and the GOI is working with
many partners, including the United States, to enhance
global capacity to respond. Italian medical science,
veterinary services, and public health infrastructure are
capable of timely and effective disease detection and
outbreak response. The plan's main objective is to increase
preparedness at both national and local levels, in order to:

-- Improve epidemiological and virological surveillance to
quickly identify flu cases caused by new viral sub-types and
immediately recognize the onset of a pandemic.
-- Guarantee access to medical treatment in order to

minimize transmission and limit mortality.
-- Reduce the impact on social services and maintain
essential services.
-- Provide adequate training to medical responders.
-- Establish mechanisms for immediately channeling updated
information to decision.makers, the health system, and the
public.
-- Monitor continuously the efficacy of actions taken.

COUNCIL OF MINISTERS TAKES OVER FROM HEALTH MINISTRY WHEN
WHO DECLARES PANDEMIC ALERT.
-------------- --------------


3. The plan adopts the WHO's six phases and levels of
pandemic alert, and provides for specific actions to be
taken during each phase/level. When the WHO Director
General declares the current phase of alert, the Health
Minister provides the information to the public. The
Ministry of Health and its operational branch, the CCM,
("Centro Nazionale per la Prevenzione ed il Controllo delle
Malattie" - the Italian CDC), will be responsible for
planning, carrying out, and monitoring pandemic-related
activities. The CCM has formed a Strategy Committee, which
includes the Health Minister, the Regions, the Civil
Protection Department, and the Defense Ministry. The CCM is
supported by universities, animal health institutes, and
public, private, and military hospitals all over Italy.
Local actions, determined and coordinated by the CCM, will
be overseen by the Regions through their own operational
bodies.


4. As each pandemic phase is declared, the Health Ministry
will reach agreement with the Regions on health care
actions, and with other ministries on all necessary non-
health actions, including making international agreements.
Health care measures will be available to everyone in Italy,
as well as to personnel at Italian embassies in affected
countries.


5. When the WHO declares the maximum level of pandemic
alert (phase 6), the Ministry of Health/CCM will cede
decision-making authority to the Council of Ministers and
the Prime Minister, who will declare a state of emergency
and activate the Civil Protection Department.

ACTIONS TO DATE
--------------


6. Reftels outlined GOI actions already taken in the areas
of public health and veterinary prevention, i.e., increased
surveillance and augmented veterinary forces. On public
health, the GOI has purchased four million doses of
antivirals, which will be stockpiled by the end of 2006.
The drugs will be distributed to the Italian regions, which
will be responsible for administering them immediately in
case of a pandemic.


7. Vaccination and Antivirals. The GOI has signed
contracts with drug companies for vaccine production. The
vaccine will be administered to six categories of
individuals by priority (health care providers first and
healthy adults last). The plan does not give details on
expenditures; but on September 2, 2005 (Ref C), the Health
Ministry announced that Italy had paid five million euros in
pre-emption rights to purchase 36 million doses of vaccine
and 1.5 million euros for antivirals.

NEXT STEPS
--------------


8. The CCM will prepare national guidelines for actions
included in the plan that have not yet been completed, and
will include them as technical annexes. Many of the actions
have already been started (see paragraph 6 and reftels).
Operational effectiveness will be tested in national and
local exercises, which will include all authorities and
health and emergency professionals with responsibilities
during a pandemic.

COMMENT
--------------


9. The final version of the National Plan is much less
detailed than the draft of November 30, 2005, which was
furnished in confidence to the Embassy (Ref C). The final
version does not spell out specifics, but instead sets out
broad guidelines and areas of national/local responsibility.
Though final, the plan appears to be a "work in progress"
that we expect will evolve as the European region and the
rest of the world respond to the evolving avian influenza
situation. END COMMENT.
SPOGLI