US embassy cable - 05LIMA4008

UNCLAS SECTION 01 OF 02 LIMA 004008 
 
SIPDIS 
 
Dept for U/S Dobriansky 
OES for Foster 
Brasilia for Norman 
USDA/AS/FAA/Bailey and USDA/FAS/ITP/FSTSD/Brehm 
 
E.O. 12958: N/A 
TAGS: EAGR, EAID, KSCA, PREL, SOCI, KTDB, ECON, PE, UNGA 
SUBJECT: PERU AND AVIAN FLU -- OPPORTUNITY TO COLLABORATE 
 
REF: A) Lima 3924  (B) State 164134 (C) State 153802 
 
1.  Summary: The GOP is slowly progressing on its action 
plan to combat the Avian Flu threat, but the Health and 
Agriculture Ministries have insufficient resources to 
implement it.  Public health capacity is already stretched 
thinly across a wide range of needs.  Peru is at risk due to 
expanding commerce with Asia, an extensive poultry industry 
and its key position as a stopping point for north/south and 
east/west avian migration.  The U.S. Naval Medical 
Institute's presence in Peru can support aspects of planning 
for and responding to any epidemic in South America.  End 
Summary. 
 
PERU'S ACTION PLAN IN PROGRESS 
------------------------------ 
2. Peru has a small head start on handling the predicted 
high lethality Avian Flu epidemic.  No cases of Avian Flu 
have been reported in Peru, according to Vice Minister of 
Health, Jose Carlos del Carmen, in a September 9 meeting 
with ESTH officer that included the Ministry's entire Avian 
Flu team.  The Ministry of Health has recognized the threat 
for several years, del Carmen said, and began developing an 
action plan in 2003, accelerated after Ministry officials 
learned of several cases in Chile.  In 2004 the Health 
Ministry began a series of workshops targeted to various 
sectors of the economy -- the poultry industry, scientific 
researchers and the health care field. 
 
3.  After circulating Ref B invitation to join a U.S.- 
initiated Avian Flu partnership among the Health, Foreign 
and Agriculture ministries, Vice Minister del Carmen and 
Foreign Ministry Director for Social Issues, Maria Eugenia 
Echevarria, reported to ESTH office the GOP's enthusiasm for 
working with the U.S. on this issue (Ref A).  NMRCD director 
noted that the Health Minister has had a strong interest in 
cooperating with the U.S. on Avian Flu research and 
prevention since she assumed her position, an interest 
shared by her predecessor.  Echevarria said on September 9 
that President Toledo's staff is planning to brief Toledo 
extensively to prepare him for participating on this issue 
at UNGA. 
 
4.  The Health Ministry is almost finished with its master 
action plan to combat the Avian Flu threat.  The Ministry 
plans a final multi-sectoral workshop that would bring 
together University researchers, the poultry industry and 
clinical health care workers, but it lacks the resources to 
conduct the workshop.  An interagency action plan will then 
be based on the workshop results.  Dr. Raul Zegara, Director 
of Avian Flu and Newcastle's Disease programs at the 
Ministry of Agriculture's inspection service, SENASA, told 
ESTHoff that lessons learned from Peru's participation in 
the recent multi-nation Avian Flu outbreak simulation 
exercise in Argentina would be used to finalize the master 
action plan. 
 
CURRENT INSPECTIONS AND NEXT STEPS 
---------------------------------- 
5.  The Health Ministry's focus so far has been on 
laboratory investigation of Avian Flu.  Dr. Luis Suarez 
Ognio, the Health Ministry's director for Avian Flu issues, 
said that the next step in the Ministry's action plan 
involves linking clinical practice to existing research, as 
well as conducting an information campaign for the general 
public on signs of avian flu and how to prevent 
transmission.  Funds are lacking for both of these steps, 
Dr. Suarez said. 
 
6.  SENASA currently inspects poultry for signs of Avian 
Flu.  Dr. Zegara told ESTHoff on September 12 that since 
November of 2004 his agency has performed over 11,000 tests 
for Avian Flu, which SENASA has incorporated into its 
program for Newcastle's Disease testing.  In the next few 
days Zegara said he would orchestrate an official message to 
the OAS that Peru was free of Avian Flu.  SENASA existing 
inspections cover large poultry operations, small-scale 
poultry raising and house pets.  In November, in cooperation 
with GOP environmental agency INRENA, SENASA will begin 
inspecting migratory wild bird populations. 
 
PERU HIGH RISK FOR SPREAD OF AVIAN FLU 
-------------------------------------- 
7. The U.S. Naval Medical Research Center Detachment (NMRCD) 
has an extensive research program in Peru.  NMRCD Director 
confirmed Health Ministry officials' description of Peru as 
a prime risk for an Avian Flu outbreak.  Peru's coast is an 
important stop for migratory birds journeying between North 
and South America; there is also a significant migration 
pattern for birds between the coast and lowland jungle 
extending into Brazil and Bolivia. 
 
8.  The extensive poultry industry is another risk factor 
for Peru, coupled with the prevalence throughout the country 
of local markets that mix chicken, duck and other avian 
species.  Peru's chicken and duck industries are 
concentrated along its coast, near zones of North/South wild 
bird migrations. 
 
NMRCD AND USAID EFFORTS 
----------------------- 
9.  Peru is an ideal location for Avian Flu research and 
programs due to its risk factors and the existing presence 
of the NMRCD, with physicians and researchers in Lima's port 
of Callao and in the largest jungle metropolis, Iquitos. 
NMRCD staff participated in the GOP's first Avian Flu 
workshop in 2004.  NMRCD priorities have been Malaria, 
Dengue Fever and diarrheal diseases; NMRCD staff have a 
strong interest in Avian Flu programs but lack the resources 
to conduct Avian Flu research.  Agricultural Attache has an 
extensive network of contacts and cooperation in the poultry 
industry that could be enlisted to support a research 
effort. 
 
10. USAID/Washington's coordination of worldwide preparation 
for an epidemic has so far prioritized its Asian missions. 
USAID/Peru has limited resources to support public health 
planning and interventions related to an Avian Flu epidemic; 
efforts will focus on building capacity among health care 
providers, managers, and health communications specialists. 
 
11.  Points of Contact for followup at Embassy are ESTH 
Officer Hal Howard, (51-1) 618-2414, howardhh@state.gov and 
NMRCD Director for Infections Diseases CDR David Blazes, MD, 
(51-1) 618-2922, blazes@nmrcd.med.navy.mil.  POC for the GOP 
is Dr. Luis Suarez Ognio, Director General of Epidemiology, 
Ministry of Health, (51-1) 433-0081, lsuarez@oge.sld.pe; Dr. 
Suarez speaks English well. 
 
STRUBLE