US embassy cable - 05HANOI2762

UNCLAS SECTION 01 OF 04 HANOI 002762 
 
SIPDIS 
 
USAID WASHDC 
USAID/RDM-A/BANGKOK PRIORITY 
 
SENSITIVE 
 
STATE FOR G; CA/OCS/ACS/EAP; EAP/EX; EAP/BCLTV; EAP/EP; INR; 
OES/STC (PBATES); OES/IHA (DSINGER AND NCOMELLA) 
BANGKOK FOR RMO, CDC, USAID/RDM/A (MFRIEDMAN) 
USDA FOR FAS/PASS TO APHIS 
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (LSTERN) 
USAID FOR ANE AND GH (DCAROLL, SCLEMENTS AND PCHAPLIN) 
STATE PASS USTR (ELENA BRYAN) 
STATE ALSO PASS HHS/OGHA (EELVANDER) 
ROME FOR FAO 
 
E.O. 12958: N/A 
TAGS: AMED, AMGT, CASC, EAGR, PINR, SOCI, PGOV, TBIO, VM, AFLU 
SUBJECT: VIETNAM: AVIAN INFLUENZA WEEKLY REPORT FOR OCTOBER 
20, 2005 
 
REF: A) Hanoi 2655 and previous 
 
1. (U) Summary.  There have been no new cases of human Avian 
Influenza (AI) reported since Mission Vietnam's last weekly 
update on October 13 (reftel).  The Government of Vietnam 
(GVN) is showing increasing commitment to deal seriously 
with AI.  The level of direct involvement in dealing with a 
potential AI pandemic has risen to the Office of Prime 
Minister and the chain of command has been streamlined. 
Secretary of Health and Human Services Michael Leavitt and 
 
SIPDIS 
his delegation met with GVN officials to discuss the AI 
situation firsthand during their four day visit to Hanoi. 
Poultry vaccinations continue in Vietnam and the need for 
assistance to increase lab capacity and provide 20,000- 
30,000 injector guns was highlighted during U.S. Department 
of Agriculture (USDA) Undersecretary James Butler's visit. 
The Embassy and Consulate General held AI Town Hall Meetings 
for American citizens.  End Summary. 
 
No New Human Cases 
------------------ 
 
2. (U) There have been no new human AI cases since August 
29. 
 
The Level of Concern for AI is High 
----------------------------------- 
 
3. (SBU) Over the past week, it has become clear that the 
level of concern for an AI epidemic has risen to the Office 
of Prime Minister and the chain of command has been 
streamlined.  The GVN has named Deputy Prime Minister Nguyen 
Tan Dung as chair of a National Steering Committee for AI 
Control, which is currently finalizing a draft Emergency 
Action Plan for Vietnam.  Furthermore, Minister of 
Agriculture and Rural Development (MARD) Cao Duc Phat has 
been assigned an AI coordinating role that expands beyond 
MARD. (Note: Mission will provide comment on the draft AI 
Emergency Action Plan once it has been translated and 
received.  End note.) 
 
4. (U) Prime Minister Phan Van Khai issued a directive for 
all concerned ministries, agencies and sectors on October 15 
to urgently develop and implement their respective action 
plans.  The directive expands the GVN's contingency planning 
beyond the Ministries of Health (MOH) and MARD to include 
the Ministries of Culture and Information, Public Security, 
and Transportation. 
 
READY OR NOT... 
--------------- 
 
5. (SBU) Several GVN officials have directly indicated that 
Vietnam is ill-prepared for a widespread AI pandemic, such 
as a worst case scenario where ten percent of the population 
is infected with Avian Influenza.  During a side 
conversation at an AI Donor Meeting October 13, MARD 
Minister Phat specifically told the Deputy Chief of Mission 
(DCM) that Vietnam does not have sufficient stockpiles of 
Tamiflu and respirators to respond to more than a few AI 
cases at the same time.  For example, in high-risk areas 
such as Haiphong Province in northern Vietnam, there are 
approximately 20 respirators for a population of nearly 
700,000 people. 
 
PRESS REPORTS ON AI 
------------------- 
 
6. (U) The press has also reported on the potential effects 
to the healthcare system.  The Ministry of Health (MOH) has 
directed hospitals to set up steering boards against bird 
flu, build isolation rooms for bird flu patients, and 
prepare a sufficient supply of standard equipment amidst the 
threat of bird flu outbreaks.  MOH also urged hospitals at 
all levels to obtain adequate reserves of anti-bird flu 
drugs and supplies of medical equipment in order to provide 
immediate treatment to patients.  The Associated Press 
quoted Deputy Head of Haiphong Department of Preventative 
Medicine Dr. Le Thi Song Huong (translated), "We can cope 
with a small-scale epidemic, as it has already happened over 
the past two years, (but if a pandemic occurs), we don't 
know what to do." 
 
7. (U) Quoting Ho Chi Minh City Health Service Vice-Director 
Dr. Le Truong Giang, the Nguoi Lao Dong Daily said that an 
AI preparedness plan has been issued to all local related 
agencies in Ho Chi Minh City.  The plan is focused on the 
quarantine and monitoring systems at the district healthcare 
level.  Press reports indicate that Ho Chi Minh City is 
importing 14 kilograms of Tamiflu powder as part of its AI 
preparedness plan.  According to Giang, however, this amount 
of Tamiflu, in additional to 1,000 courses of Tamiflu that 
Ho Chi Minh City has already stockpiled, is only enough to 
cope with a pandemic of approximately 15,000 people. 
 
HHS Secretary Leavitt Visit to Vietnam 
-------------------------------------- 
 
8. (U) U.S. Health and Human Services (HHS) Secretary 
Michael Leavitt and his delegation of AI experts visited 
Vietnam October 15-18.  The Secretary met with MOH, MARD, 
Vietnam's National Institute of Hygiene and Epidemiology 
(NIHE), Haiphong People's Committee, Haiphong Health 
Department and Hospital, and toured an HHS/CDC funded 
HIV/AIDS Voluntary Counseling and Testing Center (septels). 
The Secretary also visited a Hanoi wet market and met with a 
family that had contracted and survived AI during his four 
day visit. 
 
9. (U) The Secretary's delegation included: Undersecretary 
of State for Global Affairs Paula Dobriansky, HHS Deputy 
Chief of Staff Kerry Weems, U.S. Agency for International 
Development Assistant Administrator Kent Hill, USDA 
Undersecretary James Butler, Center for Disease Control 
Director Julie Gerberding, National Institute of Allergy and 
Infectious Diseases Director Anthony Fauci, HHS National 
Vaccine Program Office Director Bruce Gellin, HHS Assistant 
Secretary Suzy De Francis, HHS Special Assistant (S/A) 
 
SIPDIS 
Steiger, Department of State S/A Turekian, and HHS S/A Bell. 
 
Poultry Vaccination Program Update 
---------------------------------- 
 
10. (U)  According to Vietnam News, the GVN has spent VND 
700 billion (USD 44.3 million) for the national vaccination 
program, and has vaccinated 50 million birds to date.  The 
program plans to vaccinate an additional 100 million in 
November.  According to the World Bank, the GVN is in the 
process of purchasing an additional 260 million doses. 
Since winter 2004, the GVN has implemented a three-prong 
strategy to prevent new outbreaks of AI in poultry and 
waterfowl, namely culling, bio-security and movement control 
and large-scale vaccination campaign for domestic poultry 
and ducks. 
 
11. (SBU) USDA Undersecretary James Butler observed poultry 
vaccinations in Bac Ninh province and had discussions with 
officials from MARD's Department of Animal Health (DAH) on 
October 12.  Butler's visit was useful in defining USDA's 
role in assisting Vietnam's AI control program.  USDA APHIS 
Epidemiologist Dr. Cheryl Hall, who has expertise in 
training in real time PCR (a diagnostic test), will be 
posted to Hanoi as an Embassy Science Fellow.  DAH currently 
has one laboratory capable of real time PCR, but needs to 
extend the capability to two more labs.  The additional 
equipment and supplies for this expansion would cost in 
total $100,000 to $150,000.  (Note: Embassy believes that 
USDA should consider providing equipment along with a 
laboratory expert.  USDA could also use its AI funding to 
replace some of the inadequate Chinese injection guns being 
used in the vaccination program with better American models. 
FAO has identified 2 suppliers in Europe to provide better 
guns but it will probably take additional suppliers to 
quickly procure 20,000-30,000 vaccination guns Vietnam 
needs.  End Note) 
 
U.S. and Other Donor Assistance and Coordination 
--------------------------------------------- --- 
 
12. (U) The United Nations Resident Representative hosted a 
meeting of resident ambassadors in Vietnam on October 17 to 
discuss AI issues with the new Global Coordinator for AI 
David Navarro.  Navarro spoke about the importance of donor 
coordination and of balancing short-term efforts with medium 
to long-term planning.  He encouraged support for the 
upcoming November 7-9 meeting of international donors which 
will determine the principles for AI funding distribution 
and establish a mechanism for donor communication. 
 
AI Town Hall Meetings 
--------------------- 
 
13. (SBU) The DCM hosted an AI preparedness "Town Hall 
Meeting" for private American citizens and representatives 
of U.S. companies on October 19 (septel).  Sponsored by 
AmCham, there were more than 100 and others present.  During 
a side conversation, SOS, a private clinic serving the 
expatriate community, said they were informed by Roche Drug 
Company on October 14 that they will not be able deliver 
their current Tamiflu order.  Roche told SOS that the GVN 
was "taking" the drugs for their use in the country.  (Note: 
This is unconfirmed but likely an indication of the GVN's 
efforts to stockpile Tamiflu under Central Government 
control.  End Note.) 
 
14. (U) In Ho Chi Minh City, the U.S. Consulate General also 
gave an AI presentation to approximately 110 AmCham members. 
The session touched on what is known about AI in Vietnam, 
fact vs. speculation, and the ConGen's own plans and 
responsibilities to the Amcit community in case of a broader 
AI outbreak.  ConGen's medical staff was on hand to give an 
overview of causes of, symptoms of, and preparedness for AI, 
including a summary of Tamiflu's potential role in treatment 
and prophylaxis.  The presentation was followed by a 
question and answer period, during which AmCham members 
raised a wide range of issues, including alternatives to 
Tamiflu, flu shots, and the Consulate's warden system. 
 
BOARDMAN