NIGERIA AVIAN FLU U.S. RESPONSE

UNCLAS SECTION 01 OF 02 ABUJA 000404 SIPDIS SENSITIVE SIPDIS USDA FOR FAS/OSTA USDA ALSO FOR APHIS/JOSPEH ANNELLI E.O. 12958: N/A TAGS: TBIO KFLU EAID EAGR NI SUBJECT: NIGERIA AVIAN FLU U.S. RESPONSE ABUJA 00000404 001.2 OF 002 ¶1. (SBU) Summary: Although Nigeria is now better able to take samples and test reported outbreaks, most of the problems that have dogged the country in responding to AI persist. Surveillance remains very weak and urgently needs attention. Inter-ministerial cooperation is still a problem. The public is unconcerned about the threat, with business remaining brisk in markets hosting infected fowl. Both the GON and the UN institutions leading the response to AI lack the capacity on the ground to affect the situation. The Country teams believes the seriousness of the issues in Nigeria merit a sustained medium-term focus on improving surveillance through programs adequately and stably funded and directly managed by the USG. End Summary. U.S. Message -------------- ¶2. (SBU) The U.S. Government has provided a consistent message to the Government of Nigeria since Avian Flu was first confirmed in February 2006. First, surveillance is crucial to an effective response and strengthening both animal and human surveillance need to be top priorities. Secondly, they need to strengthen interagency coordination between the Ministries of Health, Agriculture and Information, and with state and local governments. Thirdly they need an adequate compensation policy that encourages farmers to report cases. Still Relevant Despite Some Progress -------------- ¶3. (SBU) This message continues to be relevant today. The Ministry of Agriculture has improved its capacity to collect samples, test them and announce results, and can often accomplish this chain in about three days. Surveillance remains passive, however, and depends on farmers voluntarily reporting cases, which many are reluctant to do. An EU-funded effort to jumpstart active surveillance is only now beginning to move into the field, several months behind schedule. On the human side, lab technicians can competently test samples if collected, but surveillance remains practically non-existent. In both cases, the ability to amount a sustainable response to outbreaks is lacking. Communication and cooperation between the relevant ministries, remains hit or miss. The Ministries of Health and Agriculture have been unable to cooperate in establishing a unified AI crisis center. This refusal of the Ministries to 
cooperate has impeded work of the USAID/FAO $1 million grant. The grant was awarded to FAO in November of 2006 but has not moved forward due to the Agriculture Ministry's refusal to share field information with FAO or other ministries. On the positive side, the Government this week announced a new compensation policy, which doubles the payment per bird, but problems such as slow payment, and payment only for birds culled could remain an issue. In addition, the public information campaign leaves much to be desired. Situation Today -------------- ¶4. (SBU) AI continues to be widespread in Nigeria and has now been confirmed in 21 states and the FCT. The Ministry of Agriculture reports that outbreaks have been reported on 600 farms over the year and have been confirmed on about 300. As noted, testing of reported outbreaks is improved. Active surveillance of farms was due to launch, at long last, this week and USAID staff this week are visiting some state offices, which we support directly, to see how things are going in the field. FAO had recommended 10 actions to be taken in response to the August outbreaks in Ogun and Lagos states. A review in January, showed that only one of the actions had been acted upon. On February 12, more than six weeks after the event, FAO checked the Lagos market where the human victim's family bought poultry. The market was operating normally, and a sickly chicken picked out by the team tested positive for H5N1. Unlike last year, the public report of a human case had little impact on the public's willingness to buy chicken, and GON authorities had not closed or cleaned the market as of February 19. ABUJA 00000404 002.2 OF 002 ¶5. (SBU) One issue is that the AI response is mainly in the hands of a small group of people. When international visiting teams arrive any activity to respond to AI stops as the GON team meets the visiting team. Team members also have traveled a great deal in the last year to various AI events or meetings, again halting decisions, and intra-government communication on AI. The working style of the UN agencies and some other visiting teams has contributed to this. UN Agencies Lack Capacity -------------- ¶6. (SBU) The UN Agencies designated to take the lead in coordinating the international response to AI, the WHO and the FAO, lack the capacity on the ground to carry out this task in Nigeria. Though the teams on the ground recognize this to some extent, and welcome USG support, their desire to be instep with the GON sometimes results in a tendency to gloss over key technical response issues. The UN agencies tend to put maintaining a good relationship with the GON above maintaining standards. As such, they have at times accepted and circulated inaccurate information about the situation in Nigeria and about the GON response. For example, an FAO team that visited Nigeria in late November then circulated a report supporting the GON contention that the AI problem was basically solved in Nigeria, although by then it was clear the problem was re-emerging. Likewise, there were press reports that WHO in Geneva announced that tests on the suspected human case in Lagos in January were negative, before the final tests were complete. This apparently was done on the basis of preliminary tests done without the proper reagents. Subsequent tests confirmed H5N1. The WHO initially touted the report of the human case as a success of their surveillance system, when in fact, it was an oil company contacted for Tamiflu that prompted the reporting of the case to the authorities. More Resources, More Control -------------- ¶7. (SBU) Nigeria has been identified, correctly in our view, as one of the countries for greatest concern for the potential development of a human pandemic. In the current situation, with AI becoming endemic in poultry, and with very weak surveillance, we are poorly equipped to identify and respond to any emerging problem. The issue is serious enough that it warrants committing real resources to the problem here. The Country Team believes that given these resources, there is much we could do directly to improve surveillance in both animals and humans, which is key to responding to any emerging problem. ¶8. (SBU) Neither the GON nor the UN agencies have the capacity to use significant amounts of USG resources effectively. Though we would still recommend providing some support to FAO and WHO, we would focus on directly managed USG programs that could strengthen surveillance and a more coherent, routine response. On the animal side, we would use contractors to provide expertise to the Ministry of Agriculture, at the state level and to poultry farmers. On the human side, WHO wants to depend on its IDSR system. IDSR is an important component of active surveillance, but has not to date been implemented effectively in Nigeria. Further, IDSR alone will not provide surveillance coverage broad enough to identify H5N1 at the community level in Nigeria. Using the platform already established through PEPFAR, polio, immunization and our other health programs we could improve human surveillance. To do so, however, we need sufficient, stable multi-year funding. CAMPBELL