CUTS TO LATVIAN HEALTH SYSTEM LOWERS H1N1 READINESS

UNCLAS RIGA 000521 SIPDIS E.O. 12958: N/A TAGS: TBIO PGOV SOCI AMED CASC LG SUBJECT: CUTS TO LATVIAN HEALTH SYSTEM LOWERS H1N1 READINESS SENSITIVE BUT UNCLASSIFIED ¶1. (SBU) Summary: Cuts to the Health Ministry's budget have weakened Latvia's ability to respond to an unlikely but possible H1N1 outbreak. Latvia cannot afford H1N1 vaccines and has fewer resources to combat an outbreak. So far the virus does not appear to be widespread in Latvia. End Summary. Weakened Health System ¶2. (U) As a result of the economic crisis, the GOL has cut the Health Ministry's budget by 21% in 2009. Under current plans, the budget will be further reduced by another 11% in 2010. This returns the budget to roughly the nominal level of 2006. The Health Ministry provides the vast majority of health care in Latvia. Sources roughly estimate that only about 5% to 6% of official health care expenditures are from private sources. Low H1N1 Readiness ¶3. (SBU) The economic crisis and the accompanying budget cuts are having a direct and negative effect on Latvia's preparations for a possible H1N1 outbreak. Health Ministry officials say that Latvia cannot afford H1N1 vaccines this winter. According to the WHO, vaccines cost $2.50 to $20 per dose, depending on a country's ability to pay. Latvia has a pandemic flu preparedness plan drawn up in 2006, but has not updated the plan to reflect the current budgetary situation. ¶4. (SBU) Latvia and other EU countries are currently negotiating a joint H1N1 vaccine purchase contract with drug manufacturers. The contract will grant Latvia an option to purchase vaccines in the future at the negotiated price. Latvia does not plan to exercise this option unless the situation deteriorates. Latvian officials are unsure about what level of pandemic would trigger a purchase and would need to ask the parliament for more money to do so, but said they would be ready to act when needed. Latvia has no current plans to stockpile anti-viral drugs. ¶5. (U) It is unlikely that H1N1 vaccines will be made available to private purchasers in Latvia through official sources. The Health Ministry said that drug manufacturers in Europe are filling government orders first and do not expect to have enough vaccines to sell to private individuals. Fortunately, the H1N1 virus does not appear to be widespread in Latvia. The Latvian Infectious Disease Center has identified only 30 H1N1 cases since the virus began, and most cases have been mild. The Center acknowledges that the actual number of cases may be somewhat higher due to underreporting. ¶6. (U) The Center estimates that in a worst case scenario up to 35% of Latvia's population could contract influenza, both seasonal and H1N1 flu, this winter. In that scenario, an outbreak could kill 2,000 to 4,000 people and hospitalize up to 16,000 people, in excess of bed capacity.