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

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Summary
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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