US embassy cable - 05MANILA5059

UNCLAS SECTION 01 OF 04 MANILA 005059 
 
SIPDIS 
 
SENSITIVE 
 
STATE FOR OES/IHA FOR JKAUFMANN 
STATE FOR INR/EAP FOR JSTROTZ 
STATE PASS USDA/FAS/DL&P FOR WETZEL & MAGINNIS 
STATE PASS USDA/FAS/ITP/AAD FOR GRUNENFELDER & ALEXANDER 
STATE PASS USDA/FAS/FAA FOR YOUNG 
STATE PASS USDA/APHIS/IS FOR SHEESLEY 
STATE PASS USAID FOR DCARROLL AND ACLEMENTS 
BANGKOK FOR REO JAMES WALLER 
CIA FOR NATIONAL INTELLIGENCE COUNCIL NIO/EA 
 
E.O. 12958: N/A 
TAGS: ECON, PINR, SOCI, EAGR, SENV, TBIO, TSPL, RP 
SUBJECT: AVIAN INFLUENZA - LIMITED SURVEILLANCE AND 
DIAGNOSTIC CAPABILITIES 
 
REF: A) STATE 151549 
 
     B) MANILA 2053 
     C) MANILA 3883 
     D) MANILA 4278 
     E) STATE 183776 
 
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SUMMARY 
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1.  (U) This is the third of a series of reports on the 
Philippines' preparedness to avert a highly pathogenic 
avian influenza (HPAI) outbreak (Refs C and D).  This 
report focuses on stages 1 and 2 of the Philippines' 
Avian Influenza Protection Program: HPAI prevention and 
the establishment of control measures for an outbreak in 
domestic poultry.  Future reporting will cover human 
health preparedness for HPAI outbreaks, including the 
mission's action plan. 
 
2.  (SBU) The implementation of the Department of 
Agriculture's (DA) HPAI surveillance and response plan 
continues to be constrained by inadequate resources. 
Although the GRP has yet to detect evidence of the HPAI 
H5N1 virus, its surveillance system is limited.  The 
country remains vulnerable, especially through smuggling 
of poultry and visits of migratory birds from HPAI- 
affected countries.  Clinical testing for HPAI suffers 
from inadequate laboratory facilities.  In addition to 
random surveillance of priority areas, DA relies on 
poultry farmers to report suspected cases of HPAI. 
Grassroots education and more aggressive public 
information campaigns are needed.  The lack of an 
indemnity fund discourages the prompt reporting of 
potential cases and would impede efforts to contain an 
outbreak. 
 
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LIMITED SURVEILLANCE SYSTEM 
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3.  (U) The GRP has designated 20 areas as priorities for 
surveillance.  DA conducts semi-annual collection and 
testing of 180 random samples from poultry flocks in each 
area (3600 samples every six months).  These sites were 
chosen because of their significant poultry populations 
and their proximity to migratory bird sanctuaries.  The 
DA has formed 10-person interagency teams consisting of 
regional office staff, Department of Environment and 
Natural Resources and local government unit 
representatives, and local police in 11 of the 15 regions 
around the country.   The GRP is procuring a limited 
quantity of personal protective equipment (PPE) and 
Tamiflu vaccines for the teams. 
 
4.  (SBU) The DA estimates that the surveillance program, 
based on random sampling methods, provides 95% confidence 
of detecting exposure to AI assuming an infection rate of 
20% (the level of surveillance recommended by the World 
Organization for Animal Health for countries where HPAI 
has not been detected).  However, Bureau of Animal 
Industry (BAI) officials said that the actual sample 
sizes were smaller than planned because of budget 
constraints and the lack of cooperation among poultry 
raisers. 
 
5.  (U) Since random surveillance has a limited 
probability of detecting smaller and isolated outbreaks, 
the DA relies on poultry farmers and provincial 
veterinarians to identify suspected cases from clinical 
signs and high mortality rates.  The DA is conducting 
public information campaigns to increase awareness and 
encourage early detection of potential cases.  BAI plans 
two training sessions in November on diagnosis of HPAI. 
 
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INADEQUATE DIAGNOSTIC CAPABILITIES 
----------------------------------- 
 
6.  (U) APHIS Area Director, Ag Attache and Econoffs met 
with Philippine Animal Health Center (PAHC) Director 
Magdalena Cruz, D.V.M. to review their testing 
capabilities.  PAHC, the national reference laboratory 
for AI surveillance in poultry, able to conduct several 
screening tests (ELISA, Agar Gel Immunodiffusion and HA 
tests) and isolate the virus, but it lacks the equipment 
needed to specifically identify the H5N1 virus.  When 
PAHC detects evidence of antigens for H5 or H7 viruses, 
it can isolate the virus and forward samples to the 
Australian Animal Health Laboratory (AAHL) in Geelong, 
Australia, for more sensitive and confirmatory tests. 
 
7. (U) PAHC has built a new specialized AI laboratory 
within its facility that is expected to be operational in 
November.  PAHC also plans to procure a polymerase chain 
reaction (PCR) machine to enable it to quickly identify 
the H5N1 virus (and other virus types).  The DA has 15 
regional labs around the country, but only four labs are 
equipped to perform ELISA tests and none are currently 
testing for HPAI.  The USDA's Animal and Plant Health 
Inspection Service (APHIS) Area Director is working with 
PAHC to specify training requirements and identify 
potential sources of technical assistance.  APHIS 
underscored the immediate need to train PAHC staff to 
operate the new laboratory.  They also would require 
training in applied methods for PCR-related research. 
PAHC also prepared an $840,000 proposal for which it is 
seeking funding to further upgrade and acquire supplies 
for its facilities. 
 
8. (U) The GRP will implement quarantine and control 
measures for poultry under two scenarios: (1) if the PAHC 
or the Australian reference laboratory isolates an HPAI 
virus or (2) if at least 50% of samples test positive in 
rapid tests for Influenza A with increasing mortality and 
no evidence of other diseases.  The identification of a 
suspected case would trigger a 3-kilometer radius 
quarantine around the potential outbreak while a 
confirmed case would expand the quarantine area to a 7- 
kilometer radius and trigger the culling of all poultry 
within these areas.  Vaccination of poultry is planned 
only if DA detects related outbreaks in an expanding 
geographic area and vaccination is deemed to be more 
economical than culling.  In this scenario, all poultry 
would be vaccinated within a 50-kilometer radius of each 
outbreak. 
 
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INDEMNITY FUND NEEDED 
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9.  (U) As the GRP improves its response capacity, lack 
of an indemnity fund may limit the GRP's ability to 
detect, contain and eradicate any HPAI outbreaks.  The DA 
estimated that losses could exceed 312 million pesos 
(about $5.6 million) if an HPAI outbreak occurs in a 
major poultry-producing region such as Minalin, Pampanga 
(based on an estimated poultry population of 4 million 
within a 3 km radius and a price of 78 pesos per bird). 
Wider outbreaks could incur much higher costs - USDA/FAS 
estimated the Philippines' total chicken production 
reached 136 million in 2004.  In the absence of 
indemnity, there remains a significant risk that HPAI- 
infected birds could be killed and sold for human 
consumption by farmers seeking to recover their 
investments.  If an outbreak occurs in an intensive 
poultry-producing area, the GRP may need to quickly ramp 
up its capacity to quarantine and cull the affected 
poultry population.  At present, the GRP does not appear 
to have the capacity for a rapid, effective response. 
 
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BUDGET CONSTRAINTS 
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10.  (U) All aspects of AI preparedness are constrained 
by limited financial resources.  Since President Arroyo 
issued Executive Order 280 in February 2004 promising to 
use 250 million pesos in discretionary lottery funds for 
AI preparedness, only 40 million pesos have been 
allocated to the DA.  After initially allocating 20 
million pesos ($360,000) to the DA, the GRP recently 
added a supplementary allocation of 20 million from 
lottery funds.  DA has estimated budget requirements of 
175 million pesos ($3.2 million) for surveillance and 
preparedness for HPAI in poultry.  The bulk of this is 
for poultry vaccines (42 million pesos), an indemnity 
fund (50 million pesos), upgrading labs (32 million 
pesos) and culling operations (27 million pesos).  With 
the 2006 budget still under consideration by Congress, 
funding levels for 2006 have not been set. 
 
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Comments 
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11.  (SBU) Given the Philippines' close proximity to HPAI- 
affected countries, the GRP's most pressing priority is 
to strengthen its capacity to detect and contain 
potential HPAI outbreaks in poultry.  The GRP's 
preparedness plan looks good on paper and is consistent 
with international guidelines, but resource constraints 
have prevented the GRP from fully implementing the plan. 
With a limited surveillance program, grassroots education 
and a more aggressive public information campaign along 
with an adequate indemnity fund are important to ensure 
that potential HPAI cases are detected and investigated. 
Prompt reporting is possible in the principal poultry- 
producing provinces in central Luzon, but less certain in 
more remote rural areas, particularly in Mindanao.  In 
the absence of an indemnity fund, economic incentives and 
community pressures could deter self-reporting of 
possible cases.