US embassy cable - 05HANOI2822

UNCLAS SECTION 01 OF 05 HANOI 002822 
 
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SENSITIVE BUT UNCLASSIFIED - DO NOT POST ON THE INTERNET 
 
STATE FOR G; CA/OCS/ACS/EAP; EAP/EX; EAP/MLS; 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) 
HOMELAND SECURITY COUNCIL FOR RVENKAYYA 
NSC FOR FSHIRZAD AND JMELINE 
USAID FOR ANE AND GH (DCAROLL, SCLEMENTS AND PCHAPLIN) 
STATE PASS USTR (ELENA BRYAN) 
STATE ALSO PASS HHS/OGHA (WSTEIGER AND EELVANDER) 
ROME FOR FAO 
USMISSION GENEVA FOR HEALTH ATTACHE 
 
E.O. 12958: N/A 
TAGS: PREL, CASC, EAGR, PINR, SOCI, PGOV, VM, AFLU 
SUBJECT: HHS SECRETARY LEAVITT'S MEETING WITH THE VIETNAMESE 
MINISTER OF AGRICULTURE AND RURAL DEVELOPMENT 
 
 
1. (SBU) Summary:  U.S. Secretary of Health and Human 
Services (HHS) Michael Leavitt met with Vietnamese Minister 
of Agriculture and Rural Development (MARD) Cao Duc Phat on 
October 14 to discuss avian influenza (AI) issues and ways 
to improve U.S.-Vietnam cooperation to combat AI more 
effectively.  Minister Phat described Vietnam's experience 
with AI and the efforts the GVN is undertaking to prevent 
its spread to humans, including advising farmers and local 
governments on better ways to raise and transport poultry. 
Both the Secretary and the Minister agreed on the importance 
of good and fast science in addressing AI, and the Minister 
requested the assistance of the United States and other 
international partners in helping to build up Vietnam's 
laboratory, research and animal medical capacities, and 
vaccine-production capabilities.  End Summary. 
 
2. (SBU) U.S. Secretary of Health and Human Services Michael 
Leavitt met October 14 with Minister of Agriculture and 
Rural Development Cao Duc Phat (full participants lists in 
paragraph 16).  Welcoming the Secretary, Minister Phat 
underscored his Government's hope that the United States 
will join Vietnam in its effort to combat avian influenza 
(AI), and added that the Secretary's presence is evidence of 
strong U.S. support.  Commenting on Vietnam's indelible ties 
to agriculture and agricultural life, the Secretary 
expressed his understanding of why and how Vietnam is going 
to great lengths to take on AI.  During this visit, the 
Secretary's delegation hoped to understand more completely 
 
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the connection between agriculture and human influenza, 
which will affect the USG's own preparations, the Secretary 
said.  The United States is very concerned about AI and 
wants to cooperate with the global community to ensure that, 
as we deal with this problem, the interests of those who 
raise livestock are looked after as much as possible, he 
continued. 
 
3. (SBU) At the invitation of the Secretary, U.S. Department 
of Agriculture (USDA) Deputy Under Secretary for Farm and 
Foreign Agricultural Services James Butler noted he had 
modified his schedule in Vietnam to allow him to spend more 
time with MARD counterparts to learn more about what the GVN 
is doing in response to AI.  Vietnam is undertaking a unique 
program to vaccinate its poultry, and through further 
discussions and visits we hope to understand better the 
GVN's unmet needs.  The United States and other 
international partners could be in a position to provide 
human and financial resources to allow Vietnam to succeed in 
this program, Deputy U/S Butler said. 
 
4. (SBU) Turning to an overview of AI in Vietnam and the 
GVN's efforts to respond, Minister Phat said that AI first 
occurred in Vietnam in late 2003 and was detected in 57 of 
64 provinces by spring 2004.  The disease both threatened 
people's health and adversely impacted Vietnam's economic 
development.  From early on, the GVN recognized the 
seriousness of AI and resolved to do everything in its power 
to protect the health of Vietnam's citizens.  Today, the GVN 
continues to mobilize every means at its disposal to stop an 
AI epidemic from occurring, with the paramount goal of 
protecting human health. The GVN's understanding is that 
only by controlling a poultry epidemic will human health be 
protected. 
 
5. (SBU) Since 2004, the GVN has implemented many programs, 
such as isolating outbreak areas and culling 45 million out 
of Vietnam's 250 million poultry, the Minister continued. 
The GVN also halted the movement of poultry between areas 
and instructed people to disinfect affected areas and farm 
units.  The GVN has also undertaken awareness campaigns to 
ensure people know AI's dangers and the importance of 
protecting their poultry flocks and their own health.  In 
2004, AI seriously damaged Vietnam's economic development, 
costing 0.5 percent in GDP growth and killed 24 people. 
 
6. (SBU) By the end of March 2004, AI's spread had stopped, 
but there were subsequent waves in July, August, October and 
November, Minister Phat said.  The peak of the epidemic was 
in December 2004 and January 2005.  At that time, the GVN 
spared nothing to control the epidemic and, thanks to prior 
experience and stronger efforts, the epidemic was better 
controlled than before.  Therefore, only 1.5 million (versus 
45 million) poultry had to be culled.  From spring 2005, the 
number of outbreaks has declined by about 60 percent, and, 
since August 24, there have been no AI-related deaths in 
Vietnam.  But the problem remains complicated:  a large 
number of waterfowl, ducks and chickens carry the virus, but 
have no clinical symptoms.  In fact, the GVN found that 70 
percent of the waterfowl in the Mekong Delta region had AI 
positive serotests.  Similarly, 1.5 percent of all chickens 
had positive serotests.  Further complicating things is the 
fact that many ducks and chicken that carry the virus no 
longer die. 
 
7. (SBU) As a result of these new difficulties, the GVN 
further strengthened its resolve to fight AI on every front 
simultaneously, Minister Phat stressed.  One major effort is 
the GVN's information program.  A lesson learned over the 
past two years is that the most effective way to tackle AI 
is to increase awareness among members of the public about 
how to protect themselves while raising poultry.  A second 
effort is to instruct farmers to regularly disinfect farming 
areas.  A third is to undertake a vaccination program for 
all bird flocks by using Chinese-made H5N1 and H5N2 
vaccines, and the GVN has budgeted USD 40 million for this 
effort over two years.  To date, 50 million poultry have 
been vaccinated, but 100 million remain, and the second 
round of vaccinations is to take place in November.  (Note: 
Not all poultry will be vaccinated.  End Note.)  (COMMENT: 
While Minister Phat projects confidence and competence, and 
appears to be by far the Vietnamese Government official most 
well-versed in the avian influenza situation, the experts 
from the agricultural sector on the delegation still 
harbored doubts about the Vietnamese vaccination campaign. 
USDA would like to have samples of the Chinese-made vaccine 
to test it for efficacy.  END COMMENT.) 
 
8. (SBU) But, as the GVN explains to farmers, vaccinations 
are merely part of the equation, and other measures are 
necessary, such as refraining from expanding waterfowl 
cultivation and avoiding raising poultry in open areas, the 
Minister continued.  The GVN is also advising farmers to 
change the way they raise poultry, turning from raising them 
in their backyards to commercial farm production.  The 
Government also advised localities to reorganize their 
system of transporting, slaughtering and processing poultry. 
In Vietnamese urban areas, particularly in the north, people 
prefer to buy and slaughter chickens themselves.  Now, the 
GVN says that that should not be done.  In response to the 
Secretary's question about enforcement mechanisms, the 
 
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Minister said that, at this point, the GVN can only advise 
what and what not to practice.  But it is difficult, because 
65 percent of all households in Vietnam have poultry in 
their backyards, the Minister acknowledged. 
 
9. (SBU) Another problem Vietnam faces is the weakness of 
its animal health system, he continued.  There are a 
shortage of veterinary staff at the local level and a lack 
of laboratories to monitor AI and test samples.  Labs in 
Hanoi and Ho Chi Minh City are thus forced to work day and 
night.  Vietnam also lacks experts to monitor changes in the 
AI virus, particularly at the genetic level.  While Vietnam 
very much appreciates the assistance of the labs at the HHS 
Centers for Disease Control and Prevention (CDC), the time 
it takes to exchange samples and information is too long. 
If possible, it would be useful for the United States to 
send its experts to Vietnam to help to monitor the disease, 
the Minister suggested.  The Secretary noted that this 
subject, and the broader issue of how we can help Vietnam to 
increase its animal health lab capacity, would be worth 
further discussions between MARD and USDA during this visit. 
 
10. (SBU) It is extremely important for Vietnam to identify 
AI and how it is mutating as soon as possible and deal with 
it as promptly as possible, the Minister stressed.  The 
Secretary agreed, noting that it appears that the United 
 
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States and Vietnam are in unison on the need for good, fast 
and well-planned science.  The GVN has approved an action 
plan, which will be transmitted to local governments next 
week, the Minister said. 
 
11. (SBU) At the Secretary's invitation, the HHS/CDC 
Director Dr. Julie Gerberding asked what Vietnam's advice 
would be for the United States for preventing infection of 
domestic birds by migratory birds, particularly as there are 
many people who hunt and could be thus exposed.  The 
Minister said that Vietnam is also a victim of migratory 
birds, but Vietnam's lesson is about the importance of close 
monitoring and supervision and identifying an outbreak as 
swiftly as possible. 
 
12. (SBU) HHS/National Institutes of Health National 
Institute for Allergy and Infectious Disease Director Dr. 
Anthony Fauci noted that one problem with preemptive 
vaccinations is that some AI strains continue to evolve and 
there are multiple bird flu strains still circulating.  In 
response to his question about how the GVN is addressing 
this, the Minister said that the GVN is aware of this issue, 
"but we have to make a choice."  One part of Vietnam's 
action plan is post-vaccination monitoring of poultry, but 
this is a great challenge, he admitted. 
 
13. (SBU) Dr. Alex Thiermann of the World Organization for 
Animal Health (OIE) thanked the GVN and MARD for their 
transparency and efforts, but noted that, while the 
vaccination efforts seem to have been the right choice and 
are a model for the region, they are only a temporary tool 
that cannot be used permanently.  The OIE will continue to 
support Vietnam in its efforts, he said.  The Minister 
responded by asking for continued international support for 
increasing Vietnam's research capacity and vaccine 
production capacity.  This is not a question of economics, 
but a necessity because, as the virus changes, Vietnam will 
need to respond quickly. 
 
14. (SBU) Dr. Changchui He of the Food and Agriculture 
Organization noted that, in pre-pandemic times, the 
agricultural sector can play a role in reducing the risk to 
the human population.  In this regard, it is critical for 
Vietnam to adopt with its partners a comprehensive strategy, 
including surveillance and vaccinations.  Furthermore, 
Vietnam's own interagency coordination will remain vitally 
important, he said. 
 
15. (SBU) Concluding, Ambassador Marine raised the question 
of Vietnam's national preparation plan and asked whether the 
GVN intends to exercise or test it.  The Minister responded 
that there are different scenarios under the plan, which are 
based on the World Health Organization's phases three, four, 
five and six of an AI outbreak.  For example, the scenarios 
for phases five and six deal with either AI's entering 
Vietnam from abroad or being homegrown.  Based these varying 
scenarios, Vietnam has three response models, and the GVN 
will try to work out what it will do to both protect human 
health and deal with poultry, and how various Government 
elements should coordinate. 
 
16. (U) Participants lists: 
 
United States 
------------- 
 
Secretary Leavitt 
 
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Ambassador Marine 
Under Secretary Paula Dobriansky 
James Butler, Deputy Under Secretary, USDA 
Kent Hill, Acting Assistant Administrator, USAID 
Julie Gerberding, HHS/CDC Director 
Anthony Fauci, HHS/NIH/NIAID Director 
Margaret Chan, WHO 
Changchui He, FAO 
Alexander Thierman, OIE 
William Steiger, HHS Special Assistant for International 
Affairs 
Suzy DeFrancis, HHS Assistant Secretary for Public Affairs 
 
Vietnam 
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Minister Phat 
Le Van Minh, DG, International Cooperation Department 
Tran Trong Hai, Deputy Director, International Cooperation, 
Ministry of Health 
Nguyen Quang Minh, DG, Ministerial Administration Office 
Nguyen Thi Tuyet Hoa, DDG, International Cooperation 
Department 
La Van Bam, DDG, Department of Science and Technology 
Hoang Van Nam, DDG, Department of Animal Health 
To Long Thanh, Deputy Director, National Center of 
Veterinary Diagnostics 
Tran Ngoc Thang, Head of International Cooperation, 
Department of Animal Health 
Nguyen Thi Thu Thuy, Expert, Department of Animal Health 
Nguyen Dang Vang, Director, Institute of Animal Husbandry 
Truong Van Dzung, Director, Institute of Veterinary Research 
Institute 
Nguyen Ngoc Nhien, Deputy Director, Institute of Veterinary 
Research Institute 
Nguyen Tien Dzung, Head of Virology Department, Institute of 
Veterinary Research Institute 
Nguyen Thanh Son, Division Head, Agricultural Department 
Le Minh Linh, Expert, National Center of Agricultural 
Extension 
Hoang Ngoc Bao, Senior Expert, International Cooperation 
Department 
 
17. (U) Secretary Leavitt's party cleared this message. 
 
MARINEBOARDMAN