US embassy cable - 05SINGAPORE2524

C O N F I D E N T I A L SECTION 01 OF 03 SINGAPORE 002524 
 
SIPDIS 
 
NOFORN 
 
CIA FOR NATIONAL INTELLIGENCE COUNCIL NIO/EA 
 
E.O. 12958: DECL: 08/08/2015 
TAGS: PINR, SOCI, TBIO, ECON, KHIV, EAGR, ETRD, SN 
SUBJECT: FLU PANDEMIC PREPAREDNESS -- SINGAPORE INPUT 
 
REF: A. STATE 151549 
 
     B. SINGAPORE 1311 
 
Classified By: Management Counselor Karen Stanton, 
reason 1.4 (d) 
 
1. (U) SUMMARY.  Post is satisfied that the Government of 
Singapore (GOS) would rapidly respond to halt the spread of 
an influenza pandemic within Singapore.  The Singapore 
Ministry of Health (MOH) has developed an "Influenza Pandemic 
Readiness and Response Plan" that is available for public 
viewing at www.moh.gov.sg.  Post has an inter-agency Avian 
Influenza Taskforce to monitor the spread of avian influenza 
and coordinate planning for our preparedness and response. 
END SUMMARY. 
 
2. (C/NF) The following answers correspond to reftel A 
questions in para 2: 
 
-- Where does preparing for an avian flu pandemic rank among 
government priorities? 
The GOS considers prevention of an avian influenza (AI) 
outbreak among its highest public health priorities.  It has 
developed a detailed readiness and response plan and has 
published it on the MOH website (www.moh.gov.sg).  It reacts 
instantly and forcefully to any threat of AI as, for example, 
when it stopped all imports of chickens and eggs from 
Malaysia when AI was detected at farms there last year. 
Since Singapore imports almost all of its food, such actions 
have grave consequences.  The Government also conducted an 
"operational readiness" drill to test its ability to react to 
a bird flu outbreak in which it actually destroyed 5,000 
healthy chickens. 
 
-- Who and what would most influence the country to give the 
issue a higher priority? 
As stated above, the GOS is already at an extremely high 
state of readiness.  The MOH plan defines a scale of 
increasing alert levels and the triggers for each of those 
levels.  Increases in priority will take effect under 
occurrences such as: evidence that the disease is spreading 
via human-to-human respiratory infection; significant spread 
of the disease in other Asian regions; or, suspected case(s) 
of Avian Flu within Singapore or border regions in Malaysia 
or Indonesia. 
 
-- Does the government have a strategy for containing the 
pandemic? 
The MOH plan assumes that, with vigilant screening of the 
local bird population, any outbreak of AI in human beings in 
Singapore would be imported.  The plan describes a strategy 
to "establish an effective surveillance system to detect the 
importation of a novel influenza virus, mitigate the 
consequences when the first pandemic wave hits and then race 
to achieve national immunity when a vaccine becomes 
available." 
 
-- If the country has a strategy, how capable is it of 
implementing it? 
Most capable.  As demonstrated by its effective and efficient 
response during the 2003 severe acute respiratory syndrome 
(SARS) outbreak, the GOS is extremely effective at managing a 
communicable disease outbreak.  Lessons learned from SARS 
have further improved preparedness and response capability. 
 
-- What measures has it taken to date to prepare for the 
pandemic (stockpiling antiviral medications, conducting 
surveillance, developing human vaccines, etc.)? 
The GOS is stocking 200,000 doses of the antiviral drug 
Tamiflu, enough for five percent of its 4.2 million 
population.  Surveillance is on-going. 
 
-- How capable is Singapore of detecting and responding to an 
outbreak, especially in rural areas? 
Singapore, only 25 miles across, is a highly developed, 
urbanized, and well-organized country.  Scientists at the 
Genome Institute of Singapore recently developed a 
commercially available H5N1 Diagnostic Kit which can detect 
genes specific to H5N1 in under four hours. 
-- How truthful will the government be in reporting the scope 
of any outbreak? 
SARS showed the Singapore authorities were very transparent 
and frank when faced with a problem like this.  They also 
have retroactively seen that this approach set them apart in 
a positive way from other affected countries, and so would be 
likely to take a similar approach. 
 
-- How willing and capable is the government of imposing 
quarantines and social distancing measures? 
The government is willing and capable.  Quarantine and 
control mechanisms are in place, and the GOS used those 
mechanisms effectively during the SARS outbreak.  A detailed 
description of these plans may be found on the MOH website. 
 
-- What are the critical gaps that need to be filled in order 
to enhance the country's disease detection and outbreak 
response capabilities? 
None. 
 
-- What is the country's greatest need from the US or 
international organizations? 
Singapore is very self-sufficient and likely would be in a 
support, rather than supported role, vis-a-vis countries in 
the region. 
 
-- Would government leaders be receptive to messages from US 
leaders at APEC or other settings or would they prefer a 
multilateral approach or bilateral contacts with another 
country? 
The GOS would be receptive to messages through either 
channel.  We already have a bilateral mechanism in place, the 
U.S.-Singapore Regional Emerging Diseases Intervention (REDI) 
Center, which could become multilateral if we chose. 
 
-- Who is the key "go-to" person or office for USG officials 
to interface with? 
The Ministry of Health is the lead agency.  In the event of 
an outbreak, a variety of crisis management groups would be 
convened in various agencies, with the MOH group in the lead. 
 Again, details are on the MOH website.  Embassy Singapore 
has regular and cooperative contacts with these officials, as 
does the CDC. 
 
-- How well informed is the population about the avian flu 
threat and about measures they should take to mitigate the 
threat? 
In addition to the information available on the web, local 
media regularly report on AI and other disease prevention 
campaigns.  The public is generally well-educated and 
receptive to these efforts, much as they were during the SARS 
outbreak. 
 
3.  (C/NF) The following answers correspond to reftel A 
questions in para 3: 
 
-- Is the host country working with any international 
organizations or other countries on the avian flu issue? 
The GOS is already working closely with the WHO and CDC to 
share information and develop preparations. 
 
-- Are government leaders likely to ask for assistance from 
the United States or other countries? 
The close coordination already in evidence would continue at 
an even greater level.  Singapore may very likely be in the 
position of providing assistance and expertise to the United 
States and countries in the region. 
 
-- Would its military enforce quarantines? 
Quarantines would be enforced by civilian agencies.  It is 
unlikely that military support would be required. 
 
-- What would it want from the United States in return for 
its efforts? 
Singapore expects to be a partner in professional exchanges 
with United States experts.  In the case of SARS, CDC and 
other United States agencies studied Singapore's response as 
a possible model for us and others.  Singapore is likely to 
request antiviral vaccines. 
 
-- What mechanisms are available for providing additional 
information to the population, particularly in rural areas 
and how effective are these measures? 
Singapore has a very effective and pervasive state 
information dissemination system. 
 
LAVIN