US embassy cable - 05RANGOON1157

C O N F I D E N T I A L SECTION 01 OF 02 RANGOON 001157 
 
SIPDIS 
 
STATE FOR EAP/MLS; PACOM FOR FPA 
 
E.O. 12958: DECL: 10/05/2015 
TAGS: PINR, SOCI, PGOV, PHUM, EAID, EAGR, BM, Avian Influenza 
SUBJECT: BURMA ILL-PREPARED FOR AVIAN INFLUENZA OUTBREAK 
 
REF: RANGOON 1036 AND PREVIOUS 
 
Classified By: Pol/Econ Chief, W. Patrick Murphy for Reasons 1.4 (b,d) 
 
1. (C) Summary:  Representatives in Burma of the World Health 
Organization (WHO) and the Food and Agriculture Organization 
(FAO) assess that the GOB is aware of a potential Avian 
Influenza threat in Burma and has some sort of a national 
preparedness plan.  The WHO and FAO representatives note, 
however, that Burma lacks resources, training, and testing 
capacity to cope with public health emergencies and suggest 
that senior Burmese military officials are likely to try to 
suppress news of an AI outbreak.  A major poultry producer 
believes that GOB shortcomings are partially a result of a 
lack of resources, but more importantly reflect the regime's 
proclivity to withhold negative news.  We do not see many 
encouraging signs that the regime's senior leaders will act 
any more quickly with the AI threat than they have with other 
ongoing health crises.  End Summary. 
 
WHO AND FAO: THE GOB'S MANY SHORTCOMINGS 
---------------------------------------- 
 
2. (SBU) The Charge met on October 4 with Professor Adik 
Wibowo, WHO Representative to Burma.  Other WHO officials 
attending the meeting were Dr. Hans Kluge (TB and HIV 
Adviser), Dr. Stefania Pace-Shanklin (WHO's local expert on 
Avian Influenza), and P.P. Singh, program officer.  The WHO 
officials said that the Health Ministry takes the threat of 
Avian Influenza (AI) very seriously and has prepared a draft 
national preparedness plan.  High level concern, however, 
does not change the fact that Burma's hospitals have very 
limited facilities, lack the Tamiflu vaccine, and do not have 
the resources to obtain medicines and other supplies 
necessary to deal with an AI outbreak. 
 
3. (C) Dr. Pace-Shanklin elaborated that although the GOB is 
aware of the AI threat, Burmese laboratories lack the 
training and equipment to test for AI strains.  For instance, 
they lack the reagents required for testing.  WHO could 
supply the reagents, but the country's only two labs capable 
of testing first need substantial investment in equipment and 
training.  WHO has a budget for such training, Dr. 
Pace-Shanklin said, and has begun bringing consultants to 
Burma for this purpose. 
 
4. (C) In response to the Charge's question whether the GOB 
has the capacity to detect potential AI outbreaks, Dr. 
Pace-Shanklin explained that the Ministry of Health (MOH) has 
a surveillance system, but it is barely adequate.  The more 
vexing issue is whether GOB health authorities would be 
permitted to report publicly any AI findings.  MOH field 
offices seeking to report an AI case, for example, must 
obtain permission first from the local military commander, 
who in turn could prohibit further dissemination.  Professor 
Wibowo opined that the international community needs to 
develop better relations with the MOH in order to learn 
through informal channels, as well, of likely outbreaks. 
 
5. (C) In a separate meeting with the Charge on October 5, 
FAO's Burma Representative, Tang Zhenping, affirmed that the 
Ministry of Livestock, Breeding, and Fisheries is aware of 
the seriousness of the AI threat and has increased its 
monitoring.  He expressed the view that disease outbreaks in 
animals would likely be reported back to the capital, because 
such cases would not involve humans and therefore would not 
be as sensitive.  Although the FAO has provided some 
AI-related training and assistance, Tang said he doubted that 
the Ministry had any ability to monitor or control beyond the 
country's "very few" industrial-scale poultry operations. 
The Ministry, he added, has no effective network to reach the 
vast majority of small household poultry operations scattered 
throughout the country. 
 
PRIVATE SECTOR VIEW: EQUALLY DISCOURAGING 
----------------------------------------- 
 
6. (SBU) On October 4, Embassy Rangoon hosted a briefing for 
the mission's AI task force by representatives from JAPFA 
(Maykka Industries Limited), an Indonesian-Burmese joint 
venture that is Burma's second largest poultry producer (the 
largest is a Thai-Burmese joint venture).  JAPFA has an 
annual production volume of over 10 million chickens, 
produced for the domestic market only.  Company veterinarians 
described their rigorous standards for preventing AI and 
other diseases from infecting their bird populations, but 
acknowledged that the standard is a company and 
industry-driven one, not one encouraged or imposed by the 
GOB.  The company also has broad protocols for stemming the 
spread of infection should an outbreak occur, including 
isolation of bird populations and self-culling.  The company 
vets noted that the most accurate methods and facilities for 
testing, however, do not exist in Burma; samples must be sent 
outside the country to be tested for AI. 
 
7. (C) JAPFA reps told us in confidence that their regular 
interaction with the GOB--primarily at the Ministry of 
Livestock--revealed that officials are generally aware of the 
AI threat and the potential for an outbreak in Burma.  The 
GOB, however, has failed to establish procedures for 
information sharing and has neglected to create any ad hoc 
testing mechanism.  JAPFA reps said that Burma is far behind 
other countries in the region in staying on top of the AI 
problem.  They confided that GOB shortcomings are partially a 
result of a lack of resources, but more importantly reflect 
the mindset of a military regime that withholds negative news 
in order to avoid instability or negative economic 
repercussions. 
 
8. (SBU) USAID/Bangkok's Matt Friedman also briefed the task 
force on the regional impact of AI and explained that the 
real threat of an outbreak in Burma does not exist at large 
production facilities--such as JAPFA's, where the company has 
the resources and incentive to protect its substantial 
investment and income--but rather among the countless "free 
range" backyard poultry operations run by small companies or 
individual farmers.  At these locations, which are numerous 
in Burma, the poultry populations are more exposed to 
infected wild birds.  Small poultry operators are unlikely to 
report suspicious infections for fear of provoking massive 
culling without compensation.  Friedman stated that the AI 
threat in Burma will remain extremely serious in the absence 
of public education programs, systematic testing, 
transparency, and adequate procedures for dealing with a 
potential outbreak. 
 
COMMENT: NO CAPACITY, NO WILL 
----------------------------- 
 
9. (C) Many local observers believe that the GOB would treat 
a serious AI outbreak in Burma as it handles other diseases 
and natural disasters, i.e. with silence.  Burma lacks the 
resources to handle adequately the public safety and 
assistance dimensions of a major health crisis and the regime 
generals would likely be unwilling to disseminate information 
widely, for fear that they would appear weak and vulnerable. 
It took years before the GOB acknowledged the country's 
severe HIV/AIDS crisis and the domestic repercussions of 
illicit drug production and trafficking.  It took even longer 
to respond with minimal countermeasures. 
 
10. (C) We do not see many encouraging signs that the senior 
leadership will act any more quickly in dealing with the 
threats posed by Avian Influenza.  We will nonetheless 
continue to work closely with the interested NGO and UN 
community to increase public awareness of the threat and 
suggest preventative measures.  In the meantime, Health and 
Livestock Ministry officials welcome increased information 
and assistance and are willing to join regional meetings.  We 
should encourage their participation.  End Comment. 
Villarosa