Embassy AI Task Force Meets With Diplomatic Community,

UNCLAS AMMAN 001276 SIPDIS STATE PASS USAID FOR GLOBAL HEALTH/K HILL, D CARROLL USDA FOR APHIS STATE FOR M/MED DASHO DR. TRIPLET GENEVA FOR WHO REPRESENTATIVE ROME PASS US MISSION FAO NEA FOR RA/LAWSON SIPDIS SENSITIVE E.O. 12958: N/A TAGS: TBIO KFLU XF JO SUBJECT: Embassy AI Task Force Meets With Diplomatic Community, Jordanian Officials REF: Amman 1036 ¶1. (SBU) Summary: Embassy Amman's Avian Influenza (AI) Task Force met with representatives from other embassies, Amman-based UN organizations, and Government of Jordan (GoJ) officials on March 7 to share information on avian flu preparedness. The GoJ is focusing now on pandemic preparedness, and is confident they can manage the types and numbers of cases that might emerge at the current stage of the disease. The GOJ reported that they are cooperating with Israel and the Palestinian Authority on AI. Agriculture officials and poultry industry representatives are worried about backyard flocks, not industrial producers. End Summary. -------------- Current Status of Avian Flu -------------- ¶2. (U) Dr. Russ Gerber, Centers for Disease Control (CDC) Resident Advisor in Jordan, opened the meeting with an overview of the avian influenza situation. WHO categorizes AI as phase "3" on its 1-6 pandemic alert scale, meaning there is little to no human-to-human transmission. Dr. Gerber said that avian flu has spread widely in poultry and wild birds, but there have been only 277 confirmed human cases of AI since 2003, of which 167 have been fatal. He said Egypt is emerging as a country of concern and that avian flu in birds has recently been found in Kuwait. In 2007, confirmed H5N1 avian flu human cases have been found in China, Laos, Indonesia, Egypt, and Nigeria, but there has been no sustained human-to-human transmission. -------------- Government Preparing for Worst Case -------------- ¶3. (U) Dr. Neyla Gargouri Darwaza, Head of Surveillance at the Jordanian Ministry of Health, said the Minister of Health chairs an interagency avian flu steering committee at the ministerial level. There is also an interagency technical committee on avian flu that includes university, industry and professional representatives. The technical committee meets monthly. The GoJ continues to update regularly an avian influenza preparedness plan that was first printed in September 2005. Dr. Darwaza stated that Jordan has 3 million Tamiflu capsules, enough for 300,000 treatments. She added that Jordan has done case management training and outbreak training, and has received valuable commodity support from USAID (see para 11). ¶4. (SBU) Dr. Adel Belbessi, Director of Disease Control at the Jordanian Ministry of Health, said that the GOJ is not afraid of the current stage (Phase 3),but fears the next stages where the disease would become pandemic. He confirmed that Jordan has not had any case of avian flu in humans, except one incident last year with an Egyptian worker who had the disease prior to coming to Jordan. Jordan has PCR testing capability and has established a biosafety level "3" laboratory, with the assistance of the USG's NAMRU-3 in Cairo. He added that sharing samples, e.g. with NAMRU-3, is "not a problem." ¶5. (U) The Ministry of Health Disease Control Directorate posts information on avian flu and other diseases on its website at http://www.dcd.gov.jo/Eindex.asp. -------------- - Regional Cooperation with Israel, Palestinians -------------- - ¶6. (SBU) Dr. Belbesi said the GOJ has had no direct contact with Syria on avian flu. However, the GOJ has been in touch with the WHO and Gulf countries, as well as the Palestinian Authority and Israel, with whom they recently met. Jordan, Israel and the Palestinians have been working together on AI with the assistance of the NGO "Nuclear Threat Initiative" and a $1 million World Bank grant, he said. Their common goal is to develop a regional "plan of attack" in the event of a pandemic. This collaboration will run another 18 months, Belbessi said. -------------- Jordan's Public Outreach Plan -------------- ¶7. (U) Dr. Darwaza informed the group that the Ministry of Health (MOH) has utilized a USAID-funded program with Johns Hopkins University on health communication. The MOH has developed a comprehensive multi-media communication strategy for avian flu which targets the general public. The goal is to minimize risk through behavior change and to build awareness. -------------- Ministry of Agriculture -------------- ¶8. (U) Dr. Hisham Al-Maaytah, Director of the Veterinary Lab at the Ministry of Agriculture (MOA) said that the Ministry has three labs (north, south and central Jordan),with PCR capability at the central lab. MOA collaborates with other reference labs, such as NAMRU-3 in Cairo and an international lab in Italy. There are animal health surveillance teams in each governorate. Nationwide, they visit 10% of all farms per month and collect 750 samples a month. Processing these samples imposes a significant burden on the laboratories. He mentioned later in the meeting that the logistics, communication and transportation for the surveillance impose significant costs on the MOA. ¶9. (U) MOA has sent staff to Italy for advanced training in avian flu. The MOA is also conducting drills to train their staff, as well as staff of other ministries, to deal with AI. They have already done drills in Mafraq and Zarqa (see reftel) and will hold a third drill in Tafila (in southern Jordan - date TBD). -------------- Compensation Fund - Focus is Backyard Flocks -------------- ¶10. (U) Dr. Al-Maaytah noted that 60-70% of the birds have been vaccinated so far, and the MOA will vaccinate all local birds in "backyard" flocks. Dr. Ayman Al-Salti, Head of the Poultry Division at the MOA, said that there is a fund available to compensate farmers if their flocks are culled because of H5N1. The culling around Ajloun following the March 2006 case in turkeys was 100% compensated, as was subsequent preventive culling in the Jordan Valley. The fund is not large (about $1.7 million),he said, because the risk of H5N1 is biggest for small, backyard flocks, not large commercial flocks which are isolated from wild birds and outside contact. Jordan has few backyard flocks (about 100,000 birds) compared to Egypt, he said. The Royal Society for the Conservation of Nature has banned most hunting in Jordan and is collecting dead wild birds for testing. -------------- USAID Assistance -------------- ¶11. (U) Dr. Salwa Qteit (USAID Development Assistant Specialist, Population and Health Section) gave an overview of the supplies and equipment that USAID/Jordan is giving to MOH. The assistance includes Personal Protective Equipment (PPEs) and lab and surveillance kits. Four thousand PPEs have been received, and another 4,000 sets are expected. Dr. Qteit said that USAID/Jordan has trained Ministry of Health and Ministry of Agriculture experts on the use of PPEs and sampling kits. USAID will soon provide additional technical assistance to the GOJ for an evaluation of the GOJ pandemic preparedness plan related to training. -------------- WHO Office Role and Activities -------------- ¶12. (U) World Health Organization (WHO) Representative Dr. Hashim Al-Zain said WHO held the first meeting of its Influenza Pandemic Task Force in September 2006, and it should be fully up to speed by June 2007. The Task Force categorizes and evaluates AI data. It found that there is no need to change the present phase "3" level of pandemic alert. It has started a project to define best practices for timely sharing of influenza virus samples and information on genetic sequences. Dr. Al-Zein said WHO has issued a 2006-2007 strategic action plan for pandemic influenza, and has developed information management systems to assist with tracking case-contact interactions. WHO has sent nine missions to locations of confirmed outbreaks, sent 30 assessment teams to various locations around the world, and managed 45 reports of possible outbreaks. ¶13. (U) WHO received a donation of three million doses of the antiviral agent Tamiflu from Roche for stockpiling at six WHO regional offices. The stockpiles are reserved for use by WHO for a rapid response and containment operation in the event of pandemic influenza. Dr. Al-Zein also mentioned that there are protocols to guide rapid interventions in the event of the emergence of an influenza pandemic. Avian flu investigation kits for rapid field investigation of suspected outbreaks are being dispatched to 116 WHO country offices. WHO is assessing preparedness in each country and provides generic guidance to its Member States on national pandemic flu preparedness plans, as well as technical assistance to countries with limited resources. He said 178 countries have AI preparedness plans. ¶14. (U) The Food and Agriculture Organization (FAO) has a modest $320,000 regional program to help with Personal Protective Equipment and surveillance systems. -------------- U.S. Embassy Preparations -------------- ¶15. (U) ECON Couns briefed the participants on Embassy preparations, particularly the creation of an Avian Influenza Task Force and "tripwires" to assist with contingency planning. The Embassy is emphasizing two things: basic knowledge about H5N1, and practical preparedness measures related to health and hygiene such as the ability to "shelter in place." He confirmed that there is no double standard or "inside" information: the same information is available to the American citizen community and all Embassy staff. The Embassy has a warden system to contact American citizens. Noting the huge economic impacts of a pandemic and the uncertainty of air transport, ECON/C said that "shelter in place" may be the best option during a pandemic. ¶16. (U) Dr. Belbessi from the Ministry of Health noted concern over air transport during a pandemic, and said that Jordan would follow WHO recommendations with respect to quarantines and border controls. He said that WHO was promoting the use of non-pharmaceutical controls (non-drug measures such as restrictions on movement and large gatherings) to control a pandemic. -------------- Meeting Outcomes -------------- ¶17. (U) Several participants noted the value of cooperation within Jordan among embassies, UN organizations and the Government of Jordan. Meeting minutes and a list of participants were distributed electronically to all participants following the meeting. -------------- Participants -------------- ¶18. (U) In addition to local USG entities (State, AID, CDC, Peace Corps),representatives from the embassies of Australia, Canada, Egypt, Israel, the Netherlands, and the EU attended the meeting, as did representatives from Jordan's Ministries of Health and Agriculture, the WHO, the FAO, and Jordan's Quality Poultry Producers Union. HALE