TFFLU01: MAURITANIA NOT PREPARED FOR H1N1 INFLUENZA

C O N F I D E N T I A L NOUAKCHOTT 000364 E.O. 12958: DECL: 05/31/2019 TAGS: AEMR ASEC AMED CASC KFLO MARR PREL PINR AMGT KFLU, TF, MR SUBJECT: TFFLU01: MAURITANIA NOT PREPARED FOR H1N1 INFLUENZA Classified By: Ambassador Mark Boulware for reasons 1.4 (b) and (d). ¶1. (SBU) Summary: Although there have been no reported cases of H1N1 influenza in Mauritania, authorities are not prepared for an outbreak should ONE occur. The Government of the Islamic Republic of Mauritania (GIRM) had no Tamiflu on hand until the World HEALTH Organization recently provided it with 4000 doses. This stockpile is still far short of the 10,000 to 15,000 doses that it should have in stock. The GIRM needs to do much more to increase surveillance, public awareness, and training for HEALTH professionals. While the GIRM does have a plan to address avian flu that could be modified and implemented to address H1N1 flu, it has not done so due to a lack of funding. End Summary. ¶2. (U) Mauritania is not prepared for an H1N1 influenza outbreak. The government had no Tamiflu on hand until it recently obtained 4000 doses from the World HEALTH Organization (WHO). Nevertheless, its recently acquired stock is well below the estimated 10,000 to 15,000 doses that experts believe it should have on hand. In addition, Mauritania does not have any laboratories capable of testing for the H1N1 influenza virus. If there was a suspected case, samples would have to be sent to Dakar or Algiers for testing, delaying verification of potential cases of H1N1 flu. ¶3. (SBU) EconOff met with Dr. Yacoub Ould Ahmedou, an infectious disease expert with the World HEALTH Organization (WHO). Ahmedou said that ONE of the most significant problems in Mauritania is a lack of information and public awareness. Many, including trained HEALTH professionals, incorrectly believe that Mauritania is protected from an H1N1 influenza outbreak because it is a Muslim country and accordingly Mauritanians are not allowed to keep pigs. In addition, if there were an influenza outbreak, it would be difficult to contain quickly because the general population lacks information about flu symptoms and what to do if they suspect someone of being infected. ¶4. (SBU) The WHO is working closely with Mauritanian authorities to try to help them prepare for an influenza outbreak. However, Ahmedou was critical of the regime's actions to date. He said that Mauritanian authorities have been doing what they can do for free but have not done anything yet that requires financing. For example, the Ministry of HEALTH has been airing public awareness announcements on state-run radio and television, which it can do at almost no cost. However, Ahmedou said that what the government really needs to do is to equip, train and follow-up with HEALTH professionals, which it has not done. In addition, it has not taken any measures to increase surveillance to monitor any potential outbreaks. He also stated that ONE or two hospitals need to be identified and prepared to treat patients who do contract the H1N1 influenza virus in order to isolate the virus and not spread it to other people. ¶5. (SBU) According to Ahmedou, the biggest problem is a lack of financial resources. Mauritania developed a comprehensive plan to address avian influenza several years ago. Ahmedou said that it needs to be looked at again, amended if necessary to address H1N1 influenza, and then implemented. However, there is no financing available to implement it. The Ministry of HEALTH did not set aside any money in its annual budget to address influenza or other pandemic diseases. Mauritanian authorities have not been able to provide additional funds to the Ministry of HEALTH for this purpose. Ahmedou concluded that it comes down to making a political decision to devote financial resources to be able to prepare Mauritania for an influenza outbreak. ¶6. (C) Ahmedou was critical of how Mauritanian HEALTH officials were prioritizing spending relating to H1N1 influenza. He said that most placed the acquisition of an infrared thermal scanner for the airport as the top priority. While the authorities could get a lot of publicity by acquiring a scanner, Ahmedou said that it would not be the best use of resources. He explained that most people enter Mauritania at land borders and the same amount of money would be much better spent training HEALTH professionals. Unable to actually obtain the funds to purchase a thermal scanner, authorities are now using a temple thermometer on all arriving passengers at Nouakchott Airport, but its effectiveness in preventing the spread of H1N1 influenza is limited. ¶7. (C) Comment: While Mauritania has so far been spared from an outbreak of H1N1 influenza, it is not prepared should ONE occur. Given that Mauritania has an extremely poor and underdeveloped healthcare system and does not have the financial resources to prepare for an outbreak of H1N1 influenza, authorities would have difficulty responding to any suspected or identified cases. For the time being, authorities continue to rely on Mauritania's relative isolation and hope that it alone will be sufficient to protect the country from an outbreak. While a relatively small amount of money could go a long way in preparing the country for an influenza outbreak, the fact that authorities have not devoted any resources to doing so is yet another indication of the very tenuous state of the regime's finances. End comment. BOULWARE