UKRAINE: H1N1 UPDATE

UNCLAS SECTION 01 OF 02 KYIV 001990 SENSITIVE SIPDIS E.O. 12958: N/A TAGS: KIPR CDC SOCI PREL AMED CASC XH UP SUBJECT: UKRAINE: H1N1 UPDATE REF: A) KYIV 01893 B) KYIV 01911 KYIV 00001990 001.2 OF 002 SENSITIVE BUT UNCLASSIFIED, NOT FOR INTERNET DISTRIBUTION ¶1. (U) Summary. With the flu epidemic spreading across Ukraine, President Yushchenko and Prime Minister Tymoshenko continue to blame each other over the response to the outbreak. Yushchenko vowed on Wednesday to veto a bill, pushed through the Verkhovna Rada (Parliament) by Tymoshenko, that would direct the National Bank of Ukraine (NBU) to allocate UAH 1 billion ($125 million) to fight the flu. Yushchenko said such step would lead to further devaluation of the hryvnia and urged the government to use budget funds instead. Tymoshenko accused the President of undermining the government's efforts to successfully combat the outbreak and said he would "be responsible for every person who is ill today or dies." Against this backdrop, local health authorities are scrambling to bring the virus under control, procure and distribute medical supplies and equipment, and enact token measures like the mandatory wearing of surgical masks in some parts of the country. End Summary. FLU STATISTICS -------------- ¶2. (U) The Ministry of Health reported 239 deaths associated with influenza and acute respiratory viral infections in Ukraine as of November 12. H1N1 has been confirmed in 85 cases, including 16 cases which resulted in deaths. Eighteen regions, including the city of Kyiv and now oblasts in eastern Ukraine, reported epidemic-level outbreaks. An additional seven regions were nearing the epidemic threshold. ¶3. (U) There have been conflicting accounts about the spread of the virus. Some commentators reported that the outbreak has passed its peak and is on a decline while others warned that the virus is spreading. A WHO team, which has been in Ukraine since November 2 investigating the outbreak, characterized the outbreak as the first wave of a flu epidemic, with a second, longer wave likely to arrive later this winter. At the same time, the WHO team leader Jukka Pukkila warned, "it is extremely hard to foresee the further development of the epidemic in Ukraine, as in other countries of the world." FIGHT OVER MEASURES -------------- ¶4. (SBU) Ukraine's politicians continue using the flu outbreak to boost their own position and discredit their political opponents. In the latest public spat over the handling of the epidemic, Tymoshenko accused Yushchenko of sabotaging the government's effort to combat the flu, after the President vowed to veto a spending bill that would have forced the National Bank of Ukraine (NBU) to print money to finance anti-flu measures proposed by the government. "The President will be responsible for every person who is ill today or dies," Tymoshenko said. Yushchenko maintained his prerogative to veto the bill: "I will not be the author of such a policy. I don't need to be blackmailed." The President called Tymoshenko's policies excessive and said the adoption of the bill would lead to further deterioration of the economy and a weakening of the hryvnia. NBU executives stated that the central bank does not have the money to support any extra-budgetary measures (Ref B). ¶5. (U) Earlier in November, the government had said it would need UAH 3 billion ($375 million) to fight the flu. With its budget stretched and the President balking at the GOU's efforts to force the NBU to print money, serious questions have arisen about Tymoshenko's ability to pay for the planned measures. Her government had reportedly allocated UAH 50 million ($6.25 million) to prepare the country for the annual flu season and the potential outbreak of pandemic influenza. Since the 2009 flu epidemic was officially confirmed on October 30, the GOU managed to gather an additional UAH 500 million ($62.5 million) to fund procurements of the antiviral drug Tamiflu and other medicines. GOVERNMENT MEASURES -------------- ¶6. (SBU) Ukraine announced strict measures to combat the spread of the flu, including canceling schools and quarantining worst hit areas (Ref A). However, local interpretation of the measures seems to vary. In Kyiv, the Ministry of Culture ordered all theaters shut down but allowed other events, like the Champions League soccer match between Dynamo Kyiv and Inter Milan, to be played as scheduled. In some cities, local authorities have demanded that people wear surgical masks when in public, while other municipalities merely recommend the measure. UKRAINIAN "TAMIFLU" RUNS AFOUL OF PATENT LAW KYIV 00001990 002.2 OF 002 -------------- ¶7. (U) In one piece of good news, Zdorovya, a Kharkiv-based pharmaceutical company, announced on November 10 that it has begun producing Tamivir, a Ukrainian version of Tamiflu. This move could relieve pressure on the government's limited supply of antiviral drugs. However, the announcement was quickly followed by a complaint from Switzerland-based drug maker Roche that Zdorovya's production of Tamivir had violated international patent laws. Roche reportedly has patent coverage for Oseltamivir (Tamiflu) in Ukraine and has not given permission to Zdorovya to produce a generic version of the drug. COMMENT -------------- ¶8. (SBU) With a 2009 budget in severe deficit, Ukraine has few resources to fight the flu, particularly if the situation dramatically escalates. Furthermore, it is beset with complications resulting from the intense rivalry between Ukraine's authorities. It is unclear whether the government has a viable strategy for its own limited resources and those donated by international donors. The findings of the WHO team, which are expected shortly, could provide some clarity on policy steps and assistance priorities. PETTIT