AI CONSIDERED UNDETECTED IN NEPAL

UNCLAS SECTION 01 OF 02 KATHMANDU 001488 SIPDIS SIPDIS E.O. 12958: N/A TAGS: TBIO CASC KFLU AID SOCI WHO NP SUBJECT: AI CONSIDERED UNDETECTED IN NEPAL Summary -------------- ¶1. At an August 2 meeting of Post's avian influenza (AI) working group, Dr. Zandra Andre from USAID's Health and Child Survival Fellows Program briefed post on the spread of AI in South Asia and the level of Nepal's preparedness. With reported outbreaks in India, Burma, and Bangladesh, Nepal was now considered an "un-detected out break" country. USAID was exploring the possibility of expanding the individual country programs in Nepal, Bangladesh and India into a regional program. Nepal's ability to respond to an outbreak was questionable. Dr. Andre noted that there was low awareness of AI in Nepal, which deterred early detection; long and inadequate response times; little awareness of bio-safety issues; and inadequate capacity to mitigate the affects of an AI outbreak. While the World Bank has committed 18 million dollars to an AI project in Nepal, it would take at least six months for the project to begin. Dr. Andre stressed that Nepal did not have that much time and that work needed to begin now. Nepal Considered an Un-Detected Outbreak Country -------------- --- ¶2. At an August 2 meeting of Post's avian influenza (AI) working group, Dr. Zandra Andre from USAID's Health and Child Survival Fellows Program briefed post on the spread of AI in South Asia. She stated that, with reported outbreaks in India, Burma and Bangladesh, Nepal was now considered an "un-detected outbreak" country. Since March 2007, there have been on-going outbreaks in Bangladesh affecting 17 out of 64 districts, and last month, India reported an outbreak in the district of Manipur. Dr. Andre is based in the USAID Global Health Office Avian Influenza Unit and was on TDY in Bangledesh. She visited Nepal for one week to make an initial assessment of the country's ability to detect and respond to an outbreak. Dr. Andre explained that the AI program in Nepal was currently focused on the Terai and other border areas with China and India, but she emphasized that USAID was exploring the possibility of expanding the individual country programs in Nepal, Bangladesh and India into a regional program. She stressed that a regional program would facilitate a much more effective response to the spread of the virus. Awareness Critical -------------- ¶3. Dr. Andre stated that, with AI, there were five areas that the Center for Disease Control focused on, including planning and preparedness, early surveillance, response, recovery and communication. At this time, she explained, the main concern in Nepal was information sharing. She emphasized that a public awareness campaign was considered critical as the successful detection and containment of the disease would depend largely on reporting from communities. Dr. Andre also noted that it was important to consider the contribution of wild birds. There was large populations of wild birds in the Sunsari and Saptari Districts and, Dr. Andre emphasized, surveillance needed to be established in these areas where there was a major risk of transmission from wild birds to domestic fowl such as ducks and chickens. Detection, Prevention and Mitigation - Cause For Concern -------------- -------------- ¶4. Dr. Andre stated that the Government of Nepal's (GON) detection capabilities were a cause for concern. Dr. Andre explained that a country should be able to respond to a reported outbreak within 48 hours. In Nepal, it currently took 72 hours just to get sample test results. It would take many more days to stage an appropriate response. Rapid response testing kits needed to be distributed throughout the country. USAID had provided some kits, but they had not yet been distributed into the field. Dr. Andre also noted concern about the GON's ability to mitigate the affects of an outbreak on the poultry industry, which makes up four percent of the economy. Virus Won't Wait for the World Bank Project to Get Underway KATHMANDU 00001488 002 OF 002 -------------- -------------- ¶5. The USD 18 million World Bank AI project was moving very slowly, according to Dr. Andre. She warned that it could likely take six months for the World Bank project to get started, and the disease would not wait that long. USAID had USD 750,000 and, working with its partners - Winrock, the Food and Agriculture Organization (FAO) and the World Health Organization (WHO) - was seeking to build local capacity, as well as begin critical initiatives, many of which could be turned over to the World Bank later. Nepal needed technical assistance now. In addition, Dr. Andre highlighted the need for compensation to farmers for culled fowl. Farmers would only be willing to report suspected outbreaks if they knew they would be compensated for their birds. Comment -------------- ¶6. If AI is already in Nepal, detection efforts need to be stepped up immediately. Post strongly supports the expansion of the USAID country specific AI programs into a larger regional project that can respond more effectively to the present risk. Existing resources need to be used carefully to support detection and prevention efforts. Taking action now could be essential in preventing a crisis in the near term. HUGINS