US embassy cable - 05HANOI2372

UNCLAS SECTION 01 OF 02 HANOI 002372 
 
SIPDIS 
 
FOR NIO/EA, STATE FOR EAP/BCLTV 
 
E.O. 12958: N/A 
TAGS: CASC, PINR, SOCI, VM, AFLU 
SUBJECT: VIETNAM AVIAN INFLUENZA PREPAREDENESS 
 
 
SENSITIVE - DO NOT POST ON THE INTERNET 
 
REF: State 153483 
 
1. (SBU) Mission Vietnam is reporting on the Government of 
Vietnam's (GVN) Avian Influenza (AI) Preparedness 
capabilities and our answers are keyed to reftel 
questionnaire. 
 
-- While preparing for an AI pandemic is a significant 
concern, it is not currently the GVN's top priority.  The 
GVN is focused on joining the World Trade Organization; APEC 
2006 Planning and Preparation; preparing the GVN's 2006-2010 
Five Year Plan and for the Party Plenum.  The Prime Minister 
would have the influence to raise AI to a higher priority. 
 
-- The GVN is currently working on developing an AI strategy 
and preparedness plan for preventing AI from becoming a 
pandemic.  Until the plan is fully vetted and shared, Post 
is unable to determine the GVN's capability to implement it. 
Early indications from the United Nations technical team 
assisting the GVN is that the plan under review is a good 
first draft. 
 
-- The GVN has no stockpile of antiviral medications, but 
the Ministry of Health (MOH) is developing a surveillance 
system with assistance from U.S. Department of Health and 
Human Services (HHS).  The MOH also has an ongoing program 
to develop an AI human vaccine, again with assistance from 
WHO and HHS. 
 
-- Surveillance of poultry is improving, but there is a 
shortage of trained personnel.  The GVN admits that it needs 
outside assistance to detect and respond to an outbreak, 
whether in poultry or humans.  In some cases, it may take up 
to a week before a rural based AI patient comes to a 
hospital for treatment. 
 
-- The experience with SARS has shown the GVN the value of 
transparency.  The GVN is more forthcoming with information 
now than it has been in the past.  We expect that this trend 
will continue, especially concerning AI-related cases in 
country.  However, the reports about the epidemiology of the 
cases are still sketchy.  In addition, leery of adverse 
international press coverage, the GVN tightly restricts 
dissemination of preliminary information on possible human 
AI cases. 
 
-- The Government is capable of imposing quarantines and 
social distancing measures in an extreme emergency, but 
would resist doing so as long as possible.  Security 
services have shown themselves capable of carrying out major 
crowd control measures in urban areas, including denying 
access to large sections of urban areas.  They would be able 
to apply these measures in a quarantine or social distancing 
scenario.  Of greater concern would be the speed which the 
GVN acted to carry out these measures.  Vietnam has a 
consensus-based power structure that requires substantial 
consultation before reaching any important conclusion.  We 
are not convinced that the GVN could act quickly on a mass 
scale even in the event of a time-sensitive emergency. 
 
-- Training, consultations, funding for public education, 
antiviral and personal protective equipment are gaps that 
need to be filled in order to enhance Vietnam's disease 
detection capability.  In addition, the GVN is in the pilot 
stages of its poultry vaccination program which will cost 
about USD 44 million over the next few months.  For 
additional information, please refer to the HHS/USAID/USDA 
Assessment Plan. 
 
-- GVN leaders would be most receptive to a discreet 
approach from the USG bilaterally that minimized Vietnam's 
loss of face and allowed Vietnam to frame any possible 
decision as proactive and not based on foreign pressure. 
Reinforcing the message discreetly through similar 
approaches from other governments - especially including 
ASEAN neighbors and other Asian countries - would also be 
effective.  We believe that that the GVN would be very 
receptive to assistance, especially on the poultry 
management side, if this could be provided in a timely 
manner.  The GVN has agreed, in principle, to join the 
International Partnership on Avian and Pandemic Influenza 
Partnership. 
 
-- Thus far, neither Prime Minister Phan Van Khai nor any of 
his three deputies has publicly assumed control over the 
issue.  We believe that standing Deputy Prime Minister 
Nguyen Tan Dung is normally in charge of the GVN response. 
GVN interagency coordination is weak and the ministries are 
"stovepiped."  USG officials would contact the Ministry of 
Health (MOH) and Ministry of Agriculture and Rural 
Development (MARD) for human health and animal health 
inquiries, respectively.  Leadership in MARD is generally 
viewed as effective and focused.  MARD Minister Cao Duc Phat 
has been tasked with coordinating the GVN to meet the AI 
threat.  Post also works closely with and through 
multilateral organizations such as the Hanoi offices of the 
World Health Organization (WHO), U.N. Food and Agriculture 
Organization (FAO), and United Nations Development Program. 
HHS is in the process of seconding an influenza expert to 
WHO/Hanoi.  The expected date of arrival is unknown.  HHS 
has announced a position for a Public Health Advisor to work 
with the Heath Attache to facilitate distribution and 
disbursement of funds for AI assistance to country.  USDA is 
in the process of identifying a poultry AI expert to work 
closely with MARD on the vaccination program and other 
remedial measures. 
 
-- AI has been in the media and has been clearly identified 
as the cause of a number of deaths around the country. 
Occasionally, the GVN issues directives on measures which 
should be taken to avoid the threat.  The GVN has requested 
assistance to develop information materials and campaigns to 
train farmers and health care works about AI prevention. 
Non-governmental organizations are working in selected 
provinces to train human and animal health workers about AI 
prevention.  Most observers agree that a lack of 
understanding of basic AI issues remains acute especially in 
rural areas. 
 
2. (SBU) Additional questions: 
 
-- The GVN is already working with many multilateral 
organizations such as WHO, FAO and UNDP and has requested 
and invited international donors to provide AI-related 
assistance. 
 
-- The People's Army of Vietnam (PAVN) would have 
responsibility to support and possibly enforce health 
restrictions, or medical quarantines in reaction to AI 
crisis developments, especially in the rural and border 
areas.  In rural areas, PAVN forces provide much of the 
basic health support and also implement some national 
programs in those remote areas.  In urban areas and along 
major national road networks, police and related security 
forces most often are the forces that administer traffic 
control and commerce monitoring.  Control of health 
restrictions would likely be delegated to those (police and 
security) forces, together with quarantine service officers. 
Local corruption and availability of off-road or secondary 
routes would diminish the effectiveness of all national 
efforts by military or security forces to control or 
quarantine crisis situations. 
 
-- Vietnam desperately needs international assistance to 
counter the AI threat to its animals and people.  We do not 
see any real possibility that the GVN would impose a quid- 
pro-quo for accepting U.S. help. 
 
-- There are no formal mechanisms, per se, for providing 
additional information to the population.  It should be 
noted, however, that even in local villages and communes, 
the Vietnamese population is relatively literate and many 
people watch GVN television, listen to GVN radio, and read 
GVN newspapers everyday.  While the GVN and Communist Party 
of Vietnam have well established communications networks 
even in rural areas, it is not clear that these have been 
activated on AI. 
 
MARINE