AVIAN INFLUENZA UPDATE - SPORADIC ANIMAL OUTBREAKS

UNCLAS SECTION 01 OF 04 HANOI 000725 SIPDIS SIPDIS STATE FOR EAP/MLS, EAP/EP, INR, OES/STC, OES/IHA, MED STATE PASS TO USAID FOR ANE AND GH STATE PASS TO HHS/OGHA (STIEGER, BELL AND BHAT) STATE PASS TO CDC (COX AND MOHEN) USDA PASS TO APHIS DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (STERN) BANGKOK FOR RMO, CDC, USAID (MACARTHUR AND BRADY) ROME FOR FAO E.O. 12958: N/A TAGS: TBIO KFLU AMED AMGT CASC EAGR PINR SOCI VM SUBJECT: AVIAN INFLUENZA UPDATE - SPORADIC ANIMAL OUTBREAKS CONTINUE HANOI 00000725 001.2 OF 004 SENSITIVE BUT UNCLASSIFIED REF: ¶1. (U) Summary: Since mid-February, sporadic outbreaks of H5N1 avian influenza (AI) have occurred in isolated poultry flocks. The outbreaks have been readily controlled by the Government of Vietnam (GVN). No human cases were found. Local media reports that the 2007 poultry vaccination program is behind schedule. The Minister of Health (MOH) confirmed that the GVN will cooperate with international organizations and other governments in sharing information. News of USG expected FY2007 AI funding for Vietnam is mixed, with increased funding for USAID but decreased funding for CDC programs in country. End Summary. ¶2. (U) There have been no reported confirmed cases of H5N1 AI in humans since November 2005. CONTINUING ANIMAL OUTBREAKS -------------- ¶3. (U) Sporadic isolated poultry AI outbreaks continue to occur following GVN's mid-February declaration that Vietnam is AI-free. They have occurred in several provinces in southern delta and northern regions. These outbreaks have involved unvaccinated hatchling populations, mostly duck flocks. Involved provinces include Ha Tay and Hanoi in the northern region and Vihn Long, Can Tho, and Ca Mau provinces in the southern region. Animal health authorities quickly confirmed the presence of the virus, culled the affected flocks, and bolstered local prevention and control efforts. ¶4. (U) Comment: The current wave of poultry outbreaks from December 2006 through the present has affected 11 provinces and about 100,000 birds have been culled. In the two previous waves (5 months from December 2004 to April 2005, and 3 months from October to December 2005) there were more provinces effected (36 and 18) and more birds reported culled (1,800,000 and 4,000,000). Therefore, by comparison, the current wave of outbreaks is relatively minor. Further, the current wave has been restricted almost entirely to unvaccinated hatchlings, mostly duck flocks, and has not appreciably spread to mature or vaccinated ducks or chickens. The downward trend parallels persistent and aggressive control activity by the GVN and support from international donors. ¶5. (U) The National Steering Board for the Prevention and Fight against AI in Humans requested that localities reinforce their preventive measures against AI in both poultry and humans. Related agencies are required to work closely at border checkpoints to promptly detect suspected cases. Fifteen provincial and municipal television stations broadcasted AI awareness programming and the GVN plans to air radio versions of the program in 10 ethnic minority languages. ¶6. (U) Local media reports that the 2007 poultry vaccination program is behind schedule. Only seven provinces, including Hanoi, have completed first round vaccinations. Thirty-four of Vietnam's 64 provinces and cities are preparing to vaccinate more than 47 million birds. In previous years, the GVN purchased low-cost poultry HANOI 00000725 002.2 OF 004 vaccines from Chinese suppliers. Le Minh Sat, Deputy Director of the Science and Technology Department of the Ministry of Science and Technology (MOST),reported to national media that Vietnam expects to start domestic vaccine production this September. MOST is expected to complete project evaluations later this month. ¶7. (SBU) In a meeting with FAO, MARD Minister Phat has mentioned that the efficacy of the vaccines in fowl has declined and in his view a greater capacity for sequencing and possibly vaccine production is needed. He said that two years ago the imported Chinese vaccine was 80 pecent effective; last year 67 percent, and currently it is only 60 percent. In-country and regional experts have said that this is consistent with the larger picture that Vietnam needs to move beyond emergency measures and look at more internal capacity development. ¶8. (U) While speaking at a pandemic influenza planning conference in Hanoi on April 6, Minister of Health Tran Thi Trung Chien said that Vietnam is mobilizing all available resources to combat AI in humans, including stockpiling medications and working to improve public awareness. The Minister affirmed that the country would strengthen coordination among ministries and increase the first responder capacity. She also pledged to fully cooperate and share information with international organizations and governments combating AI. Dr. Nguyen Huy Nga, Director of the Vietnamese Administration for Preventive Medicine (VAPM),MOH, reported to local media that Vietnam has an ample supply of Tamiflu (oseltamivir phosphate) to combat outbreaks of AI in humans. Vietnam will receive around 71,000 doses of Tamiflu out of the 500,000 doses that the Japanese Government pledged to give to Southeast Asian countries. ¶9. (SBU) USAID's Regional Mission organized an AI partners' meeting in Bangkok on April 3 and 4. Dr. Dennis Carroll, Director of USAID's Avian and Pandemic Influenza Response Unit, noted that when USAID support for AI programs began in 2006, AI activity was reported in six countries. Today it is present in 56. He highlighted the progress being made in Vietnam, Thailand, and Indonesia but cautioned all participants that a regional epidemic would still inflict heavy casualties and cause a breakdown in local food supplies. Vietnam actions set an example of what the other countries will have to do. In this regard, USAID already has been funding government delegations from Sri Lanka and Egypt to come to Hanoi to share best practices of their Vietnamese counterparts. 10.(SBU) With respect to FY2007 funding, USD 161 million has been programmed in the last 18 months with approximately 46 million of that going to AI programs in Southeast Asia. For this year, should the AI supplemental for USAID presently before Congress be approved, he expected a similar amount to be made available to support activities in Southeast Asia. Given the progress to date, there should be, however, a shift from quote emergency unquote assistance to more medium term strategies. He estimates, pending the Congressional appropriations, that the individual country level for Vietnam should be in the range of USD 5 to 8 million and that will be channeled through USAID (note: this range represents a possible increase). In designing our activities, the country team will be looking maintaining our support for the current government strategy that we and other donors subscribe to while simultaneously assisting HANOI 00000725 003.2 OF 004 MARD and MOH to begin transitioning to more medium term strategies for the control of the H5N1 virus. ¶11. (U) The GVN has approved the first year of a 5-year USD 1.15 million cooperative agreement with the U.S. Centers for Disease Control and Prevention (CDC) on the Control and Prevention of AI in Humans (2007-2012). This is the last step leading to VAPM, MOH, utilization of FY2006 funds. This broad project encompasses activities on the human side under all three Presidential pillars: preparedness and communication; surveillance and detection; and response and containment. ¶12. (SBU) Given overall funding constraints, CDC Atlanta has appraised CDC-Vietnam that cooperative agreements previously funded from an emergency supplemental source will experience an approximate 50 percent budget reduction in FY2007. This is expected to decrease the cooperative agreement funding with VAPM from USD 1.3 million to USD 525,000. Discussion with the MOH has begun around modifications of plans; activities are expected to be curtailed. ¶13. (U) USAID is providing USD 45,000 for the NGO Agronomes and Veterinaires Sans Frontieres (AVFS) to maintain its AI prevention work in Vietnam. The Phase II project will be continue to work in coordination with MARD, provincial animal health departments, and private partners such as Pfizer Animal Health, Synbiotics, Evialis, Cargill, and Pronconco. The project will train first responders on outbreak investigation, epidemiology, and safe poultry handling. ¶14. (U) On April 17, USAID and HHS held the USG AI Coordination Meeting with USG-funded implementing NGOs and contractors. The meeting looked at past USAID-funded programming and participants discussed areas for improvement including more in-depth program evaluation, a focus on program sustainability, increasing communication between animal health and human health agencies, increasing the beneficiary pool to include groups (e.g., poultry transporters and slaughters) and increasing programs geographic coverage. ¶15. (U) On April 12, the State Bank of Vietnam (SBV) and the World Bank (WB) signed a USD 38 million loan to fund an AI prevention and control project, allowing the implementation of the Avian Influenza Emergency Recovery Project. The International Development Association, the entity within the World Bank Group which provides concessional funds for low-income countries, will finance the project at USD 20 million. The EU and Japan will fund USD 15 million with the GVN providing the additional USD 3 million. The project is broken into five components: a) AI Control and Eradication in the Agricultural Sector; b) Influenza Prevention and Pandemic Preparedness in the Health Sector; c) Integration and Coordination; d) Results Monitoring and Evaluation; and e) Project Management. The provinces receiving support include Lang Son, Ha Tay, Thai Binh, Thanh Hoa, Ha Tinh, Thua Thien-Hue, Binh Dinh, Tay Ninh, Long An, Tien Giang, and Dong Thap, which have all been hit by animal AI outbreaks. ¶16. (U) Dr. Nguyen Huy Nga, Director of VAPM, MOH, was reported to say that there is a sufficient amount of Tamiflu stored for the fight against the deadly H5N1 virus in Vietnam. Vietnam will receive around 71,000 doses of Tamiflu out of the 500,000 doses that HANOI 00000725 004.2 OF 004 the Japanese Government pledged to give to Southeast Asian countries. ¶17. (U) USAID held 2-day training-of-trainers workshops for human and animal health workers on the use of personal protective equipment (PPE) and decontamination kits in Hanoi on April 12 and 13, and in Ho Chi Minh City on April 16 and 17. Participants learned about safe work practices for gathering samples and preparing them for shipment to reference laboratories. The training augments the March 2006 provision of PPE equipment and decontamination kits. ¶18. (SBU) Comment: The GVN continues to effectively control sporadic outbreaks, while investing in improving capacity to prevent and respond. Putting funds in place and beginning expenditure takes time. Overall, bilateral USG funding for AI programs is relatively low compared with the total for multilateral joint UNDP and WB projects. Coordination, especially in the provision of technical assistance, is critical to best leverage USG investment. End Comment. ALOISI