BORDER PROVINCE WITH CHINA: HEALTH, ENVIRONMENTAL CONCERNS

UNCLAS SECTION 01 OF 04 HANOI 000398 SIPDIS SENSITIVE SIPDIS STATE FOR EAP/MLS, EAP/EP, INR, OES/STC, OES/IHA, MED, OGAC STATE PASS TO USAID FOR ANE AND GH DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (STERN) HHS/OSSI/DSI PASS TO OGHA (WSTIEGER/LVALDEZ/CHICKEY/DMILLER) AND FIC/NIH (RGLASS) AND DIV-FLU (COX/MOHEN) USAID FOR ANE (CJENNINGS, MWARD) AND GH (KYAMASHITA, KHILL) CDC FOR COGH (SBLOUNT),CCID (SREDD) AND GAP (BIRX, SIMONDS) USDA PASS TO APHIS, FAS (OSTA AND OCRA),FSIS BANGKOK FOR RMO, CDC (MALISON),USAID (MACARTHUR/MBRADY/CBOWES) BANGKOK FOR APHIS (NCARDENAS),REO (JWALLER) BEIJING FOR HHS HEALTH ATTACHE (BROSS) PHNOM PENH FOR CDC INFLUENZA COORDINATOR(BBRADY) ROME FOR FAO VIENTIANE FOR CDC INFLUENZA COORDINATOR (ACORWIN) E.O. 12958: N/A TAGS: TBIO AMED EAGR PINR KFLU VM SUBJECT: BORDER PROVINCE WITH CHINA: HEALTH, ENVIRONMENTAL CONCERNS REF: A) 06 HANOI 630 B) HANOI 90 HANOI 00000398 001.2 OF 004 ¶1. (SBU) Summary: A small, mountainous province bordering China, Lang Son's location is both a blessing and a curse. Its four border gates with Vietnam's huge neighbor to the north have encouraged trade and development, leading to increased economic growth. However, local authorities also blame its close proximity to China for several health and environmental problems, including the threat of avian influenza outbreaks from chickens smuggled across the border, high rates of HIV/AIDS due to the easy availability of cheap narcotics, and silent forests robbed of wildlife sent to feed Chinese appetites for exotic animals. Though local officials denied extensive smuggling at the border posts, we observed huge stocks of counterfeit electronics and apparel in local markets. End Summary. Lang Son is Growing -------------- ¶2. (U) Late last month, ESTH personnel visited Lan Son province, Vietnam's province bordering China's Guangdong province. In a March 31 meeting with ESTH Officer and ESTH Assistant, Lan Son provincial officials reported strong economic growth for the province; 10.4 percent from 2001-05, followed by 10.3 percent in 2006, and 11.6 percent in 2007. Traditionally dependent on forestry and agriculture, industry/construction and trade/services increasingly play a large role in provincial development, with both seeing double-digit expansion over the past few years. Lang Son has yet to attract significant foreign direct investment, instead relying on local exploitation of its natural resources, including iron, bauxite, and limestone, together with agricultural and forestry processing, and limited manufacturing and assembly of mechanical products. In 2007, total trade equaled USD 985 million, most of which passed into or out of China. Officials worry about Lang Son's ability to sustain its growth, given its limited infrastructure and few competitive goods, but hope to continue the province's transition from agriculture to industry. Lack of Infrastructure Limits Public Health Improvements -------------- ¶3. (U) Local officials proudly note that every village in the province has a public health clinic, 70 percent of which are staffed by doctors. Over 300,000 underprivileged residents have access to health insurance and the province has a solid record of response to disease outbreaks. At the same time, only 79 percent of people in Lang Son meet national health care standards. The province's four hospitals lack necessary equipment (only 40-50 percent of required equipment per Ministry of Health lists) and have little funding for improvements and no money for new facilities. Health officials stated that a major outbreak could overwhelm their limited capacity. Avian Influenza Preparations -------------- HANOI 00000398 002.2 OF 004 ¶4. (SBU) Though Lang Son has only suffered one animal outbreak (in February 2004) and has yet to report a human infection, animal and human health officials highlighted their preparatory efforts. A provincial steering committee, including human and animal health experts, guides policy, which includes response plans down to the village level for possible human victims. In 2007, officials carried out a province-wide training exercise to improve capabilities to respond to human infections. As a high-priorty border province, Lang Son actively participates in the GVN animal vaccination program, with over 2.6 million vaccinations administered in 2007. Per local officials, Lang Son used nearly seven tons of sterilization liquid in 2007. Human health officials closely monitor the border gates for persons possibly suffering from influenza, tuberculosis or HIV/AIDS (note: the international border post at Dong Dang recently received a thermal imaging device to detect high temperatures in persons entering Vietnam). Border officials have the ability to separate suspected infected persons and reported one instance in which an individual was quarantined and then sent to the National Institute of Infectious and Tropical Diseases for further testing. Long Border With China Tempts Smugglers . . . -------------- ¶5. (U) Lang Son's over 200 kilometer border with China contains two international border crossings, two national border gates (where local Chinese and Vietnamese can cross without formal documentation) and numerous paths in the mountainous and well-forested areas where smugglers can bring goods back and forth across the frontier. National and provincial authorities do not have the resources to police the border beyond the formally recognized border posts. . . . Leading to Large Numbers of Illicit Chickens -------------- -------------- ¶6. (SBU) In a sense, Lang Son is a victim of the success of Vietnam's efforts to combat AI. According to local health officials, over the past five years, Vietnam has culled 60 million poultry, which has caused sharp increases in prices. Sensing a market opportunity, smugglers quickly moved to spirit Chinese chickens, a similar breed to their more expensive Vietnamese counterparts, across the border (Ref A). Though local customs officials denied that any birds made it through the border gates, all local officials acknowledged wide-spread smuggling across the thousands of local crossing points. Though much of the smuggling remains disorganized and small-scale, the overall numbers are quite large. In 2007, customs and market control officials seized 160 tons of illicit poultry (mostly live) and 300,000 eggs. In the first three months of 2008, they have confiscated 82 tons of poultry and 30,000 eggs - which all agreed represented a fraction of the total numbers crossing the border. Other border provinces, particularly Quang Ninh to the east, have also reported poultry seizures. . . . And an Increased Threat of Avian Influenza -------------- --- HANOI 00000398 003.2 OF 004 ¶7. (U) Aside from economic impacts, Lang Son fears smuggled chickens may spread AI. An EU/Japanese-funded project to increase Vietnamese testing capacity has yielded chilling results - 28 out of the first 115 samples in 2008 tested positive for H5N1 (Note: the Department of Animal Health in Hanoi confirmed positive results for H5N1 in its tests of samples from Lang Son in 2007 and 2008, though its numbers varied somewhat from those provided by the officials in Lang Son). And these birds are not simply destined for local tables, many find their way to markets and restaurants throughout northern Vietnam, including Hanoi. Though Lang Son cooperates with other provinces, it does not have the resources to interdict shipments into or out of its borders. Little Cooperation with China on Smuggling or AI -------------- --- ¶8. (SBU) Despite the magnitude of the issue, Vietnam and China have few cooperative efforts to monitor or stop chicken smuggling. In fact, according to Lang Son market control officials, China does not consider the practice to be illegal and so provides no assistance to Vietnamese attempts to patrol the border. Lang Son animal health officials do not communicate with their Chinese counterparts and so do not know when or if animal outbreaks occur across the frontier. Human health officials would notify Chinese health officials if they detected a human infection at the border, but would not provide direct notification of other cases, instead reporting to the Ministry of Health, which would then notify international authorities. These officials assumed the Chinese followed the same practice. Addressing HIV/AIDS -------------- ¶9. (SBU) Lang Son reported its first HIV/AIDS infection in 1993 with rapidly increasing numbers throughout the decade -- approximately 200 new patients discovered annually. As of 2007, Lang Son had 2,674 cumulative cases, with 1,440 fatalities. Most victims are men between the ages of 20 to 39, primarly intraveneous drug users (IDUs). Lang Son city and two districts bordering China provided the most cases, most likely due to easy access to drugs in those areas. (Note: HIV/AIDS officials stated that Lang Son and Guangxi authorities met annually to discuss prevention efforts, the next meeting to take place in June 2008). Though Lang Son remains one of the most heavily impacted provinces in Vietnam, its relative ranking has steadily dropped from the fourth most cases in 2004 to the tenth most in 2007. Officials credited assistance from the Ford Foundation for successful intraventions (including a clean needle and free condom program) that significantly reduced the percentage of IDUs infected with HIV/AIDS, from 46 percent prior to the program's initiation to only 27 percent within 36 months. While pleased with this success, HIV/AIDS responders noted that infections have increased in other groups, particularly among women married to male IDUs and, to a more limited extent, among commercial sex workers. To that end, the province intended to increase its destigmatization programs to better integrate family members of HANOI 00000398 004.2 OF 004 HIV/AIDS victims into society. Lang Son's Silent Forests -------------- ¶10. (SBU) Lang Son forest protection officials stated that the illegal wildlife and timber trade flowed one way - into China. They reported little wildlife smuggling directly from Lang Son, but only because Lang Son's forests had already been emptied of endangered wildlife in the 1990s. Now, Lang Son serves primarily as a way station for birds, monkeys, and snakes from other provinces and abroad as they head to Chinese markets (with some animals detoured to local dining establishments). Though the province has instituted propaganda campaigns, high demand (and high prices) in China ensure a steady supply. Lang Son has 300,000 hectares of forest, an attractive target for illegal logging - both for domestic and international consumption. In 2007, the Forest Protection Department confiscated over 10,000 pieces of rare wood, a drop in the bucket in the total trade. Counterfeit Goods Easy to Find in Local Markets -------------- -- ¶11. (SBU) In meetings in the provincial capital and at two border gates, customs officials consistently stated that no smuggling of any kind took place at any of the border gates, reiterating a message delivered to Embassy Econoff earlier this year (ref B). However, 200 meters from the Tan Thanh domestic border gate, a large and well-organized shopping-mall style market contained dozens of stalls selling a full range of counterfeit electronic goods and apparel. "IPod nanos" sold for 300,000 dong (approximately USD 20), while consumers could browse amongst several semi-familiar brands, including "Pannusonic" and "Addidas." Notably, even Chinese brands suffered, with several obviously fake Chinese DVD players for sale. Michalak