US embassy cable - 05BANGKOK5626

C O N F I D E N T I A L SECTION 01 OF 03 BANGKOK 005626 
 
SIPDIS 
 
NOFORN 
 
E.O. 12958: DECL: 08/24/2015 
TAGS: EAGR, ECON, PGOV, PINR, SOCI, TBIO, TH 
SUBJECT: FLU PANDEMIC PREPAREDNESS: THAILAND 
 
REF: STATE 151549 
 
Classified By: DCM ALEX ARVIZU, REASON 1.4(D). 
 
 1. (C/NF) Summary: The responses below are in reply to 
questions contained in Reftel.  In general, Thailand is 
increasingly capable and increasingly transparent in 
detecting, reporting, and planning for and responding to 
avian influenza outbreaks in animals and humans.  Although 
Ministry of Public Health personnel would benefit from more 
intensive training in pandemic control measures and 
laboratory diagnostic methods, and the Department of 
Livestock Development would benefit from technical assistance 
to improve its information systems management infrastructure, 
Mission is confident that Thailand would respond rapidly, 
effectively, and transparently to contain any outbreak of 
avian influenza within its borders.  End summary. 
 
2. (C/NF) The following are Mission responses to questions 
contained in Reftel: 
 
Q. Where does preparing for an avian flu pandemic rank among 
government priorities?  Who and what would influence the 
country to give the issue a higher priority? 
 
A. This issue has the attention of the highest levels of the 
Thai government.  The Prime Minister has been directly 
involved in the response, and committees have been formed at 
various levels of the government to address the issue.  Fresh 
outbreaks among humans would likely raise it to the 
government's top priority. 
 
Q. Does the government have a strategy for preventing avian 
flu from becoming a pandemic and containing a pandemic once 
it occurs?  If the country has a strategy, how capable is it 
of implementing it? 
 
A. Thailand has developed and published a plan for both 
control of avian influenza in poultry and for a response to a 
human influenza pandemic.  These documents are publicly 
available in English and Thai languages.  Substantial 
resources have been committed to avian influenza containment 
and pandemic planning.  Within the limits of national 
resources, the Government of Thailand is capable of an 
effective response to a human influenza pandemic. 
 
Q. What measures has it taken to date to prepare for a 
pandemic (stockpiling antiviral medications, conducting 
surveillance, developing human vaccines, etc.)? 
 
A. The Government of Thailand now has a national stockpile of 
700,000 treatment courses of the antiviral drug oseltamivir. 
Surveillance and Rapid Response Teams (SRRT) have been 
trained and organized in every province of Thailand.  The 
National Institute of Health maintains a laboratory capable 
of processing large numbers of specimens and accurately 
identifying avian influenza in humans. 
 
Q. How capable is the country of detecting and responding to 
an outbreak, especially in rural areas? 
 
A. The Government of Thailand is capable of identifying 
clusters of two or more cases of avian influenza in a 
locality within a few days in most cases.  Isolated cases of 
human infections might go undetected. 
 
Q. How truthful will the government be in reporting the scope 
of any outbreak? 
A. It is possible that some under-reporting may take place 
(new outbreaks could have a ruinous effect on its poultry 
exports and its tourism industry).  Over the past 12-16 
months, however, the Government of Thailand has been 
increasingly transparent in reporting suspected and confirmed 
animal and human cases of avian influenza. 
Laboratory-confirmed human cases have been promptly reported 
to WHO.  Likewise, outbreaks of the infection in poultry have 
been promptly reported to the OIE. 
 
Q.  How willing and capable is the government of imposing 
quarantines and social distancing measures (closing schools, 
public gatherings, mass transit)? 
A. The Government of Thailand is willing and capable of 
establishing quarantine measures on its population if 
necessary.  Contingency plans for such measures have been 
established, and the Ministries of Defense, Transportation, 
and Education have been included in recent pandemic planning 
meetings. 
 
Q. What are the critical gaps that need to be filled in order 
to enhance the country's disease detection and outbreak 
response capabilities?  What is the country's greatest need 
from the US or other international organizations? 
 
A. Additional, more intensive training for Ministry of Public 
Health physicians and epidemiologists on avian influenza and 
pandemic control measures is needed.  On-site training for 
sophisticated molecular and serologic laboratory diagnostic 
methods is also needed.  Technical assistance to improve the 
information systems management infrastructure at the 
Department of Livestock Development would be useful. 
 
Q. Would government leaders be receptive to messages from US 
leaders through a bilateral approach, at a multilateral forum 
such as the UN or APEC, or through bilateral contacts with 
another country? 
 
A. Yes to all.  Thai leaders would be receptive to messages 
indicating a desire on the part of the US to support and 
collaborate on efforts to control avian influenza and plan 
for a human pandemic with technical assistance such as 
advanced training in laboratory diagnostics.  Thailand has 
assumed a regional leadership role on this issue and has the 
capability and willingness to function as a regional 
coordinator and partner for avian flu preparedness activities. 
 
Q. Who is the key "go-to" person or office for USG officials 
to interface with? 
 
A. Deputy Prime Minister Chaturon Chaisang and Dr. Supamitr 
Chunsutiwat at the Thailand Ministry of Public Health. 
 
Q. How well-informed is the population about the avian flu 
threat and about measures they should take to mitigate the 
threat? 
 
A. The Government of Thailand has undertaken measures to 
inform the public, including the distribution of printed 
media, radio, and television programs.  Outside of Thai 
farmers and others directly engaged in applying control 
measures to halt the avian/avian transmission of the virus, 
however, the general Thai population is not particularly 
well-informed about the avian flu threat.  In particular, the 
overall population knows little about the evidence of 
human-to-human transmission or the possibility of mutation 
that could launch a human pandemic.  The broader Thai public, 
therefore, has little knowledge about the potential 
epidemiological implications of avian influenza mutation, the 
need for rapid response to contain the spread of 
human-to-human transmission, or the public health measures 
required as part of that response.  A recent US CDC study in 
Nakhon Province in Northeast Thailand suggested that the 
population there is informed regarding risk factors for avian 
influenza infection, but that more work remains to effect 
real behavioral changes. 
 
Q. Is the host country already working with any international 
organizations or other countries on the avian flu issue?  Are 
government leaders likely to ask for assistance from the US 
or other countries? 
 
A. The Government of Thailand has met with numerous political 
representatives and maintains collaborative relationships 
with technical experts from several regional countries 
affected by avian influenza.  The Government of Thailand has 
asked for technical assistance from the US CDC in the past. 
The US CDC continues to actively collaborate on the issue, 
particularly by improving surveillance and laboratory 
diagnostic capacity.  The Government of Thailand is not 
likely to ask for direct financial aid to address this issue, 
but welcomes technical cooperation and assistance at 
different levels. 
 
Q. Would its military enforce quarantines? 
 
A. Yes, in addition to local police forces. 
 
Q. What would it want from the US in return for its request 
efforts? 
 
A. The Government of Thailand would appreciate political 
support and technical assistance from the US to establish and 
maintain a regional stockpile of antiviral drugs and personal 
protective equipment. 
 
Q. What mechanisms are available for providing additional 
information to the population, particularly in rural areas, 
and how effective are these measures? 
 
A. National radio and broadcast television are the only media 
to reach all parts of Thailand, and even that extensive 
broadcast range includes small populations whose 
comprehension of spoken Thai language is minimal.  Because 
all national broadcast radio and TV are government-owned or 
affiliated, the Royal Thai Government could quickly 
disseminate emergency information via these national media 
with a good prospect of reaching a substantial proportion of 
the population within as little as 48 hours.  Many local 
villages also employ loudspeaker systems to deliver messages 
to the public.  As always, the clarity of the message and the 
speed with which the Royal Thai Government embraced the need 
to communicate it would determine the success in any 
emergency information campaign. 
ARVIZU