AFGHAN SUPPORT FOR NEW DEHLI AVIAN FLU CONFERENCE AND

UNCLAS SECTION 01 OF 02 KABUL 003983 SIPDIS DEPT FOR SCA/A AND THE AVIAN INFLUENZA ACTION GROUP (G-AIAG), ISLAMABAD FOR USDA SIPDIS E.O. 12958 N/A TAGS: ESTH AIAG PGOV PREL EAGR SENV AF SUBJECT: AFGHAN SUPPORT FOR NEW DEHLI AVIAN FLU CONFERENCE AND PREPARATIONS IN COMBATING POSSIBLE AVIAN FLU OUTBREAK REF: STATE 159330 -------------- Summary -------------- ¶1. (U) Embassy confirmed Afghan attendance at the New Delhi Avian and Pandemic Influenza Conference (reftel). Afghan Ministry of Agriculture Ubaidulla Ramin and Minister of Public Health Dr. Sayed Mohammad Amin Fatimi are scheduled to attend the conference, along with four others including their respective avian flu coordinators, Dr. Azizullah Osmani (Agriculture) and Dr. Jawad Mofleh (Public Health). However, the applicants do not yet have Indian visas and hope to receive them shortly. ¶2. (U) The Embassy continues to work closely with Afghanistan authorities and locally-based international health organizations to monitor events and offer assistance in combating avian flu; in the past three weeks, both the Embassy and Afghanistan-based US Department of Defense (DoD) elements, namely, Combined Security Transition Command - Afghanistan (CSTC-A) in Kabul and Combined Joint Task Force - 82 (CJTF-82) at Bagram Air Field, have held civil-military coordination workshops. Avian flu monitoring is currently through the Disease Early Warning System (DEWS),funded by USAID and implemented through the Afghanistan Ministry of Public Health (MoPH). The system is designed to detect any suspected outbreak of influenza like illness (ILI case definition - fever of 38 degrees Celsius, cough, sore throat and dyspnea) in the country. MoPH and the Ministry of Agriculture, Irrigation and Livestock (MAIL) respond to reports of avian flu with Rapid Response Teams that are currently located in 12 of 34 provinces (Bamyan, Helmand, Kabul, Kandahar, Kapisa, Khost, Kunar, Laghman, Nangarhar, Paktia, Paktika and Zabul). These nine member teams consist of Public Health and Agricultural officials and are charged with surveillance of zoonotic diseases, fever monitoring, and with raising awareness in the affected communities. Per diem and transportation costs are covered by the U.S. Center for Disease Control (CDC). USAID is funding the World Health Organization, which supports the training of these teams. Training is conducted by the Afghanistan Public Health Institute and WHO technical staff. ¶3. (U) Afghanistan continues to make significant progress in the development of avian flu strategies and plans, primarily through the efforts of the Ministry of Public Health and the Ministry of Agriculture and Livestock, with the assistance of the Food and Agriculture Organization (FAO),UNICEF, the World Bank, the World Health Organization and USAID/USDA. A NAMRU-3 (U.S. Naval Medical Research Unit-3) sponsored laboratory in Kabul has significantly improved Afghan ability to test for HPAI (H5N1) in animals and humans. USAID Kabul resources continue to strengthen Afghan surveillance systems, particularly timely sample collection and reporting. ¶4. (U) Last year H5N1 was confirmed in Afghanistan in March, 2006 and also earlier this year in February, 2007. Following the confirmation of these cases, the Afghan Ministries of Agriculture and Public Health took appropriate measures, including the culling of infected domestic poultry. The major pattern of bird deaths/infections in Afghanistan appears to be primarily centered on live bird markets, as "backyard farming" is the country's primary method of poultry production. A large portion of the Afghan population raises chickens in their backyards to supplement diet and to provide a small source of income. To date, no human cases have been reported but there remains a high probability of eventual animal to human transmission because of poor living conditions and sanitation, high rates of morbidity and mortality, and close human contact with animals/birds. A lack of infection control procedures in limited provincial health facilities would complicate the appropriate treatment and control for any human case of H5N1. ¶5. (U) Further testing did not/not confirm October 2007 initial reports of the H5N1 strain of avian flu in Kandahar province. However, given the security situation in the provinces with the suspected cases, future monitoring and preventive efforts will be difficult. MOPH Avian Influenza Coordinator Dr. Mofleh has noted severe challenges with limited access for governmental Rapid Response Teams as local leaders could not guarantee security. In place of the teams, the IRoA trained locals to conduct sampling and fever monitoring, but did not expect much efficacy from such efforts. The Ministry is concerned that using Afghan, U.S. or International Security Assistance Forces (ISAF) military force protection and military public health resources in security-challenged areas would further hinder its future public health efforts among the local population, but realizes that such resources may have to be used to prevent a wider public health KABUL 00003983 002 OF 002 threat in the safe areas. November 24 discussions with the Afghan Military, as well as ISAF and U.S. resources are a step towards devolvement of an appropriate security assistance plan if needed. DELL