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