LEADING AVIAN INFLUENZA EXPERT, DR. DAVID SWAYNE, VISITS

UNCLAS SECTION 01 OF 03 CAIRO 002835 SIPDIS SENSITIVE SIPDIS E.O. 12958: N/A TAGS: TBIO KSCA KFLU EAGR PGOV EG SUBJECT: LEADING AVIAN INFLUENZA EXPERT, DR. DAVID SWAYNE, VISITS EGYPT; USAID PROGRAM UPDATE. REF: CAIRO 2686 SENSITIVE BUT UNCLASSFIED. PLEASE HANDLE ACCORDINGLY. ¶1. (SBU) SUMMARY: Dr. David Swayne, Director of the Southeast Poultry Research Lab and leading expert on Avian Influenza (AI),met with the week of August 26 with Government of Egypt (GOE), non-government organization (NGO) and private sector poultry entities. USAID approved USD 8.2 million in funding under its USD 24 million, three year AI program, on September 11. The United Nations Food and Agriculture Organization (FAO) and the General Organization of Veterinary Service (GOVS) continue to work together, having resolved a number of disagreements on elements of the program. According to World Health Organization (WHO) statistics, Egypt accounts for 30 percent of the world's human AI cases thus far in 2007. END SUMMARY. -------------- Dr. Swayne's Visit -------------- ¶2. (U) During his August 25-31 visit Dr. Swayne met a wide variety of AI stakeholders and toured domestic poultry farms. In a meeting with Minister of Agriculture and Land Reclamation (MALR) Ahmed Abazza, Dr. Swayne stressed the need for a strategic, comprehensive vaccination program including high quality vaccines, targeting high risk areas as well as education and behavior change campaigns in the backyard sector. Abazza agreed on the need for behavioral changes among local poultry farmers as misinformation and mistrust continues to hinder the vaccination program. Abazza wants to raise awareness without creating panic, but noted the difficulty in changing behavior given that "thousands [of people] die everyday of other serious things." ¶3. (U) Dr. Swayne also discussed vaccination strategies with Dr. Mona Aly, Director of the Central Lab for Quality Control of Poultry Production (CLQPP),and her team. CLQPP tests all potentially infected domestic birds for the AI virus in Egypt. He also addressed over 150 officials from various government and non-government agencies directly involved in Egypt's effort to combat AI at the Ministry of Agriculture. -------------- Dr. Swayne's Conclusions -------------- ¶4. (U) At the end of his visit, Dr. Swayne recommended to GOE and NGO stakeholders: 1) a vaccine strategy that includes high quality vaccine, 2) a stable cold chain and risk analysis for where, when 
and how often to administer vaccines and 3) a broad surveillance network with a central hub for data collection to coordinate containment and treatment efforts is vital. Currently, Egypt imports 19 different vaccines of varying quality. Dr. Swayne recommended each vaccine be tested and regulated by GOE before use in the country. ¶5. (U) Dr. Swayne considers backyard farms, where prevention and containment efforts are co-dependent upon GOE efforts and private citizen cooperation, Egypt's biggest challenge. To promote citizen participation, Dr. Swayne recommended a system to reward farmers bringing in birds for vaccinations with free vitamins for the birds or other incentives. He also suggested GOE study ways to encourage the purchase of vaccinated birds. Dr. Swayne also noted that, contrary to press accounts attributing Egypt's AI problems to migratory bird, AI transmission from wild, migratory birds to backyard poultry is rare. -------------- - Frank Discussion Or Friction Between Partners? -------------- - ¶6. (SBU) Although the USAID Detailed Implementation Plan (DIP) process continues to make progress, some obstacles remain. Two primary recipients, FAO and GOVS, have finally agreed on CAIRO 00002835 002 OF 003 implementation strategy priorities after intense discussions. At an August 29 DIP meeting, FAO team leader Rob de Rooij commented that "GOVS is less concerned about the cold chain than FAO. We must still come to an agreement on this." ¶7. (U) GOVS representative, Dr. Saber Abdel Aziz, however insists that an effective cold chain exists throughout Egypt, and that poultry in 65 percent of households have been vaccinated (representing 55 - 60 million birds). He noted that in August, there were only three cases of AI in backyard sector birds, crediting the vaccination program. He blamed problems with the program on the fact that some households are too remote to have easy access to vaccinations, and that some flock owners refuse the vaccine or hide their birds out of fear that visiting vets may cull rather than vaccinate. (There is no compensation program for backyard flock culling.) Counter to Abdel Aziz's claims of an effective vaccination program, FAO staff recently found an unrefrigerated truck full of vaccine sitting outside, in the August heat, in the GOVS parking lot. NAMRU-3 field samples have also shown contradictory results in birds that GOVS had supposedly vaccinated. Also, although NAMRU-3 has confirmed the presence of a new H7 strain on AI in migratory ducks from Eastern Europe, NAMRU-3 noted H7 is historically common among ducks. If this becomes endemic, current vaccines geared towards the H5N1 strain will not be effective and a new vaccine will be required. ¶8. (SBU) Despite GOVS requests for USAID funds for poultry vaccine purchases, the FAO view prevailed that the money should go toward effective cold chain and data systems that allow fact-based decisions on vaccine deployment. Major planned expenditures include training for 1600 field veterinarians, data managers and for surveillance capabilities. FAO will focus on establishing an effective cold chain, data collection equipment (i.e. handheld GPS enabled devices) and poultry sample collection equipment and training. ¶9. (U) The process of developing plans and budgets culminated in September 9-11 meetings attended by both USG and GOE agencies concerned. USAID has approved, based on the conclusions of the meetings, USD 8.2 million to fund the first year of activities under the three year, USD 24 million program. -------------- To BSL 3 or Not To BSL 3 -------------- ¶10. (SBU) Currently NAMRU-3 is the only Bio Safety Level 3 (BSL 3) laboratory in Egypt. Dr. Mona Aly, Director of CLQCPP, has asked USAID for funding to build a BSL 3 lab in the new AI lab scheduled for construction next to her current lab. USAID and NAMRU-3 are concerned that these facilities will be very expensive to build and maintain, and believe that the initial focus of the USAID program should be directed at surveillance and response. NAMRU-3 staff did propose joint experiments and training at their BSL 3 lab with Dr. Aly and her staff. As additional labs in Egypt have also expressed desires to upgrade to BSL 3, APHIS proposed a consultant to review the BSL 3 issue. -------------- Comment -------------- ¶11. (SBU) According to the WHO, Egypt accounts for 30 percent of the world's human AI cases in 2007. Other top countries include Indonesia (47 percent),Viet Nam (7 percent),and China (3 percent). GOVS is the critical link in combating AI in Egypt, but they continue to deal with management and organizational weaknesses. USAID is funding FAO efforts to improve GOVS capacity in order to reduce virus load in backyard sector flocks. FAO also continues to promote a shift in GOVS priorities. Post supports FAO's priorities of establishing a cold chain and strengthening surveillance, and has confidence in FAO's ability to target the top priorities, despite continuing friction between FAO and GOVS. CAIRO 00002835 003 OF 003 Ricciardone