US embassy cable - 05MADRID3635

UNCLAS SECTION 01 OF 02 MADRID 003635 
 
SIPDIS 
 
DEPARTMENT FOR G, EUR/WE, AND OES/IHA; HHS FOR OGHA; GENEVA 
FOR WHO; ROME FOR FAO 
 
E.O. 12958: N/A 
TAGS: TBIO, EAGR, ECON, PREL, SOCI, KSCA, SP, WHO, FAO, OIE 
SUBJECT: SPAIN PLAYS DOWN AVIAN INFLUENZA THREAT 
 
REF: MADRID 3489 AND PREVIOUS 
 
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SUMMARY 
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1.  The reported arrival of the H5N1 virus in Greece and a 
flurry of EU and national meetings on Avian Influenza have 
kept "Bird Flu" in the Spanish headlines over the past week. 
Spanish Health and Agriculture Ministry spokespersons having 
been urging calm, alleging that Avian Influenza is not likely 
to arrive on Spanish shores anytime soon and that when it 
does arrive, the public health authorities will be prepared 
to respond.  END SUMMARY. 
 
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PRIME MINISTER URGES PREVENTION AND PRUDENCE 
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2.  After meeting with French Prime Minister de Villepin in 
Barcelona October 17, Spanish Prime Minister Zapatero urged 
"prevention and prudence" in meeting the challenge posed by 
Avian Influenza.  He indicated that the measures already 
adopted by his government were adequate in the event that a 
human Avian Influenza pandemic emerged and called for stepped 
up international cooperation to meet the threat. 
 
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AGRICULTURE BELIEVES OUTBREAK UNLIKELY BEFORE SPRING 
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3.  The Spanish Agriculture Ministry announced October 17 
that it was "very unlikely" that Avian Influenza would arrive 
in Spain this winter, but could possibly reach Spain in the 
spring of 2006.  The Ministry based its argument on an 
analysis of bird migratory routes, noting that birds 
migrating south through Spain this winter would not likely 
carry the virus, but might carry the disease to Spain when 
they return north from Africa next spring.  Notwithstanding 
the current threat, the Ministry announced that it had 
stepped up the monitoring of open air poultry farms located 
near the major bird migratory routes. 
 
4.  The policy line of the Agriculture Ministry is neatly 
captured in the following October 17 quote from Livestock 
Director General Beatriz Garces de Marcilla:  "The appearance 
of a suspect bird in Greece has not altered our perception of 
the threat, even if it is confirmed that this bird is 
infected with the H5N1 virus.  We are almost totally 
convinced that the cases registered in Romania and Turkey, 
like those in Russia, Kazakstan and Bulgaria, were caused by 
the dissemination of the virus by migrating birds.  They (the 
infections) coincide very well with the habitual bird 
migration routes toward the south during this season.  It is 
very unlikely that the current migration will introduce the 
virus into Spain.  The probability (of this occurring) is 
higher in the spring, when the birds migrate north.  But we 
should remain calm.  First, because we do not expect anything 
like a massive infection of poultry stocks.  The sickest 
birds cannot migrate and they can only provoke isolated 
infections.  These outbreaks can be rapidly controlled via 
preventative killings (of poultry) within a radius of three 
kilometers.  Furthermore, the great majority of farm poultry 
in Spain is raised indoors.  Only 10 percent are kept 
outdoors and we are going to reinforce our monitoring of 
those (open air facilities) that coincide with the principal 
bird migration routes." 
 
5.  Furthermore, Agriculture Minister Elena Espinosa 
delivered what she herself labeled a message of 
"tranquillity" on October 16, stressing that Spanish poultry 
consumption practices (e.g., avoiding consuming raw poultry) 
made it unlikely that a human outbreak of Avian Influenza 
could be spread via poultry consumption.  She admitted that a 
human outbreak could be spread via inhalation, but again 
noted that Spanish poultry raising practices (e.g., farmers 
do not generally live near their birds), would help limit the 
spread of any potential human outbreak.  The Minister 
nonetheless stressed that she had ordered stepped up 
monitoring of Spanish poultry farms and that Spain would 
continue to prohibit the import of poultry or poultry 
products from countries which have reported Avian Influenza 
infections among their poultry stocks.  Her Ministry also 
announced last week that it would order five million more 
animal H5N1 vaccines, giving Spain a total stockpile of 15 
million animal vaccines. 
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HEALTH MINISTRY CLAIMS IT IS READY FOR ALL EVENTUALITIES 
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6.  The Health Ministry has also urged calm and continues to 
resist growing calls for Spain to purchase more anti-virals 
(e.g., "Tamiflu") to combat any possible human Avian 
Influenza epidemic.  Spain has ordered two million "Tamiflu" 
treatments (costing a reported 14 million euros).  Spain has 
only received 10,000 treatments to date and is not expected 
to receive the full two million before June 2006.  The two 
million, once delivered, would serve to treat four percent of 
the Spanish population. 
 
7.  In October 14 testimony before the Spanish Congress, 
Health Minister Elena Salgado said her Ministry was 
"reasonably comfortable" with the April 2005 decision to 
order two million "Tamiflu" treatments but would revisit that 
decision should the majority of Spain's 17 regions wish to 
have more stocks on hand.  She said that the anti-virals, 
though paid for out of regional health budgets, would be held 
in a central store and would be diverted to wherever in Spain 
human outbreaks were first reported.  Special preference (in 
receiving anti-viral treatment) would be given to "high risk" 
populations (e.g., the elderly, chronically ill, health and 
poultry workers, and those with depressed immune systems). 
An unidentified percentage of the anti-virals would be 
reserved for the Spanish Armed Forces. 
 
8.  Salgado said she would push her EU colleagues to adopt on 
an EU-wide basis the Spanish model of maintaining a central 
anti-viral stockpile that could be diverted to initial 
infection outbreaks.  Summing up Spanish preparations to 
date, Salgado argued that Madrid has "taken all the necessary 
measures" to meet a possible human pandemic, that "our health 
system is prepared to act with efficiency," and that "we are 
prepared to detect any case (of human Avian Influenza) that 
arrives and can meet all eventualities."  She asked the 
Spanish people to "stay calm" and criticized some regional 
health authorities for creating "unnecessary and unjust 
alarm" among the public. 
 
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EU CALL TO STOCKPILE TAMIFLU MOST UNWELCOME 
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9.  The October 17 EU call for member states to stockpile a 
sufficient quantity of anti-virals to treat 25 percent of 
national populations will probably force the Health Ministry 
to order more anti-virals, despite Spanish doubts about 
"Tamiflu's" ability to treat the as of yet unknown viral 
strain that would emerge to threaten human populations, the 
Roche Company's reported inability to meet further orders 
until well into 2006, and the stated Spanish preference for 
assembling a shared EU "Tamiflu" stock (that could be 
directed toward outbreaks), rather than having each country 
chasing ever more elusive anti-viral stocks.  The Health 
Ministry revealed its ire at the EU decision October 17, with 
an unnamed Ministry source telling the Spanish press that 
Spain has "no idea" where the EU got the idea that the WHO 
had recommended stocking anti-virals to treat 25 percent of 
national populations.  The same source noted that "no OMS 
document mentions any recommended percentage for anti-viral 
coverage." 
 
10.  Senior Spanish Health Ministry officials will meet 
October 18 with health officials from the country's 17 
autonomous regions (which have line authority over public 
health issues) to discuss Avian Inluenza preparations.  One 
result may be the decision, against national level 
recommendations, to purchase more anti-virals.  Ordering 
enough "Tamiflu" to cover the 25 percent of the Spanish 
population recommended by the EU would cost Spain's regions 
over 80 million euros (and certainly would not be delivered 
until late 2006 at the earliest).  Nonetheless, given the 
fact that many EU nations have already decided to cover 
larger percentages of their populations and that Spain's 
largest opposition party has publicly called for purchasing 
more anti-virals, Spain will likely soon add yet another 
"Tamiflu" order to Roche's growing backlog. 
AGUIRRE