US embassy cable - 05MADRID4022

UNCLAS SECTION 01 OF 04 MADRID 004022 
 
SIPDIS 
 
SENSITIVE 
 
STATE FOR OES/IHA (SINGER/DALEY), INR (LESTER), AND EUR/WE; 
HHS FOR STEIGER/BUDASHEWITZ/GAY) 
 
E.O. 12958: N/A 
TAGS: TBIO, SENV, ECON, EAGR, EAID, PREL, SP 
SUBJECT: SPAIN:  RESPONSE TO REQUEST FOR INFORMATION ON 
AVIAN AND PANDEMIC INFLUENZA 
 
REF: A. SECSTATE 206992 
 
     B. MADRID 3635 AND PREVIOUS 
 
Below are Post's responses to Ref A queries on Spain's 
response to the Avian Influenza threat. 
 
A) PREPAREDNESS/COMMUNICATION 
 
-- DOES THE GOVERNMENT HAVE A PREPAREDNESS PLAN/STRATEGY 
FOR PREVENTING AVIAN FLU FROM BECOMING A PANDEMIC AND 
CONTAINING A PANDEMIC ONCE IT OCCURS? 
 
Yes. 
 
IF THE COUNTRY HAS A STRATEGY, HOW CAPABLE IS IT OF 
IMPLEMENTING IT? 
 
Spain has a capable national health care system that should 
be able to implement this plan.  Of course the plan's 
effectiveness depends on the nature of any possible 
pandemic. 
 
PLEASE PROVIDE A COPY OF THE PLAN OR THE INTERNET ADDRESS 
FOR THE PLAN. 
 
The human plan is entitled National Influenza Preparedness 
and Response Plan and is available in English at: 
http://www.msc.es/enfermedadesLesiones/enfTra smisi/PlanPande 
miaGripre/pdf/PlanGripeIngles.pdf. 
 
The animal plan can be found at 
http://www.mapya.es/ganaderia/pags/influenza_ aviar/plan_esta 
tal.pdf. 
 
-- HOW TRUTHFUL WILL THE GOVERNMENT BE IN REPORTING THE 
SCOPE OF ANY DISEASE OUTBREAK AMONG PEOPLE? 
 
As an EU Member state and OECD economy, we are confidant 
that Spain will fully comply with national, EU and WHO 
guidelines regarding the reporting of any disease outbreak 
among people. 
 
AMONG ANIMALS? 
 
Ditto. 
 
WHAT INCENTIVES COULD BE OFFERED THAT WOULD LIKELY RESULT 
IN MORE TRANSPARENCY? 
 
Transparency is not a likely concern vis-a-vis Spain. 
 
-- WHERE DOES PREPARING FOR AN AVIAN FLU HUMAN PANDEMIC 
RANK AMONG GOVERNMENT PRIORITIES? 
 
This issue has been addressed by Prime Minister Zapatero 
and the Spanish Council of Ministers and is a clear 
government priority that has received continuous and 
constant attention from both the Health and Agriculture 
Ministries. 
 
WHO AND WHAT WOULD MOST INFLUENCE THE COUNTRY TO GIVE THE 
ISSUE A HIGHER PRIORITY? 
 
The Health and Agriculture Ministers are on public record 
saying that the immediate threat of a human Avian Influenza 
pandemic has been exaggerated and that Spain has adequate 
plans in place to deal with all eventualities.  Absent a 
sea change in the views of the Spanish scientific 
community, which also believes the threat has been 
exaggerated, influencing this policy line would likely 
require an approach to Prime Minister Zapatero.  However, 
should Spanish expert analysis change (e.g., in the event 
of a human pandemic gradually emerging), we would expect 
the two Ministries to alter their policy lines in keeping 
with widely held expert views.  The bottom line is that 
Spain has resisted what it believes to be the 
"politicization" of the issue and wants policy based on 
what it perceives to be a cold, hard assessment of the 
scientific facts. 
 
WHO IS THE KEY "GO-TO" PERSON, OFFICE OR DEPARTMENT (I.E. 
MINISTER FOR HEALTH, PRIME MINISTER, ETC.) FOR USG 
OFFICIALS TO ENGAGE ON THIS ISSUE? 
 
The key GOS official on human Avian Influenza is Health 
Ministry Director General for Public Health Manuel Onorbe. 
Be aware that Onorbe firmly believes that the threat of a 
human pandemic has been exaggerated. 
-- HAVE NATIONAL LAWS BEEN REVIEWED TO ENSURE THAT THEY ARE 
CONSISTENT WITH THE INTERNATIONAL HEALTH REGULATIONS AND DO 
NOT POSE BARRIERS TO AVIAN INFLUENZA DETECTION, REPORTING, 
CONTAINMENT, OR RESPONSE? 
Embassy is not aware of any national laws that had to be 
revised in connection with Spain meeting its detection, 
reporting, containment, or response commitments under 
either the national plans or international commitments. 
 
-- IS THE HOST COUNTRY ALREADY WORKING WITH INTERNATIONAL 
ORGANIZATIONS OR OTHER COUNTRIES ON THE AVIAN FLU ISSUE? 
 
Spain addresses this issue as an active member of relevant 
EU, WHO, and FAO bodies. 
 
ARE GOVERNMENT LEADERS LIKELY TO ASK FOR ASSISTANCE FROM 
THE US OR OTHER COUNTRIES? 
 
Spain is a strong supporter of greater EU cooperation on 
Avian Influenza, in particular urging the creation of an 
EU-wide anti-viral/vaccine repository which could be 
utilized for any potential outbreak inside EU borders. 
Spain would likely seek EU, WHO, or FAO assistance before 
requesting bilateral help from the U.S. 
 
WOULD GOVERNMENT LEADERS BE RECEPTIVE TO MESSAGES FROM US 
LEADERS THROUGH A BILATERAL APPROACH, AT A MULTILATERAL 
FORUM SUCH AS THE UN (WHO,FAO,ETC.) OR APEC, OR THROUGH 
BILATERAL CONTACTS BY A THIRD COUNTRY? 
 
Spanish authorities would be receptive to bilateral 
approaches from U.S. leaders.  There would be no need to 
deliver such messages via third countries. 
 
WHAT WOULD THE COUNTRY WANT FROM THE US IN RETURN FOR ITS 
EFFORTS? 
 
Spain would not likely link greater Avian Influenza 
cooperation to other issues. 
 
-- DOES THE COUNTRY CURRENTLY ADMINISTER ANNUAL FLU SHOTS? 
 
Yes 
 
IF NOT, MIGHT IT CONSIDER DOING SO? 
 
Not applicable. 
 
WHAT IS THE PRODUCTION CAPABILITY (I.E. HOW MANY DOSES OF 
THE ANNUAL TRIVALENT FLU VACCINE CAN THE COUNTRY MAKE) FOR 
HUMAN INFLUENZA VACCINES IN THE COUNTRY? 
 
To the best of our knowledge, Spain does not currently have 
a flu vaccine production capability.  It plans on opening 
such a facility in 2006. 
 
DOES THE COUNTRY PRODUCE INFLUENZA VACCINE FOR POULTRY AND 
IF SO HOW MUCH? 
 
Unknown. 
 
IF THE COUNTRY IS DEVELOPING AN H5N1 VACCINE, WHERE IS IT 
IN PRODUCTION AND TESTING? 
 
Spain does not yet have a domestic human vaccine production 
capability. 
 
ANY LICENSING ISSUES? 
 
Not applicable. 
 
IS THERE A LIABILITY SHIELD FOR FOREIGN MAKERS/DONORS OF 
VACCINES? 
 
No.  While this would not likely emerge as an issue, it 
would be prudent for any U.S. government agency donating 
vaccines to Spain to request such a liability shield. 
 
IF NOT, ANY PROSPECTS OF ONE BEING ENACTED? 
 
Not to our knowledge. 
 
--HOW WELL INFORMED IS THE POPULATION ABOUT THE AVIAN FLU 
THREAT AND ABOUT MEASURES THEY SHOULD TAKE TO MITIGATE THE 
THREAT? 
 
The population is well informed about the threat and of 
general measures they should take to mitigate the threat. 
 
WHAT MECHANISMS ARE AVAILABLE FOR PROVIDING ADDITIONAL 
INFORMATION TO THE POPULATION, PARTICULARLY IN 
RURAL AREAS AND HOW EFFECTIVE ARE THESE MEASURES? 
 
Mechanisms exist to disseminate such information.  The key 
challenge is convincing Spanish officials that the threat 
is currently serious enough to provide such information 
now. 
 
B) SURVEILLANCE/DETECTION 
 
-- HOW CAPABLE ARE THE MEDICAL AND AGRICULTURE SECTORS OF 
DETECTING A NEW STRAIN OF INFLUENZA AMONG PEOPLE OR ANIMALS 
RESPECTIVELY? 
 
Very capable.  Appropriate detection equipment has been 
widely deployed. 
 
HOW LONG MIGHT IT TAKE FOR CASES TO BE PROPERLY DIAGNOSED, 
GIVEN OTHER ENDEMIC DISEASES? 
 
Humans:  Same as in the U.S.  Spanish surveillance systems 
are similar to those in the U.S.  Spanish hospital and 
diagnostic skills and capabilities are comparable to those 
found in the U.S. 
 
Animals:  Madrid's Alegete Central Veterinary Lab has 
robotized diagnostic equipment than can analyze over 90 
samples per hour.  If a suspected case is reported, the 
entire diagnostic process from reporting through testing 
would likely take less than 24 hours. 
 
CAN INFLUENZA VIRUSES BE SUBTYPED IN THE COUNTRY, IF SO BY 
WHO, AND IF NOT WHERE ARE THEY SENT? 
 
Humans:  Yes.  At the National Virus Center in a Madrid 
suburb. 
 
Animals:  Yes.  By the Alegete Lab. 
 
DOES THE COUNTRY SEND SAMPLES TO A WHO/EU/US REFERENCE 
LABORATORY? 
 
Yes -- for confirmation of domestic results.  The samples 
are usually sent to the EU Lab in Weybridge, UK. 
 
-- WHAT ARE THE CRITICAL GAPS THAT NEED TO BE FILLED IN 
ORDER TO ENHANCE THE COUNTRY'S DISEASE DETECTION AND 
OUTBREAK RESPONSE CAPABILITIES? 
 
Detection:  None. 
 
Outbreak:   Develop a domestic vaccine production capacity 
and take delivery of anti-virals on back order (pending due 
to Roche's inability to meet current "Tamiflu" demand). 
 
WHAT IS THE COUNTRY'S GREATEST NEED IN THIS AREA FROM THE 
US OR INTERNATIONAL ORGANIZATIONS? 
 
More a question of time (build a vaccine production 
facility and take delivery of backordered anti-virals) than 
of assistance from the U.S. or an international 
organization. 
 
C) RESPONSE/CONTAINMENT 
 
-- DOES THE COUNTRY HAVE A STOCKPILE OF MEDICATIONS, 
PARTICULARLY OF ANTIVIRALS, AND IF SO HOW MUCH? 
 
Since the summer, Spain has begun efforts to stockpile 
anti-virals, in particular Roche's "Tamiflu." 
 
IF SOME HAS BEEN ORDERED, HOW MUCH AND WHEN IS IT EXPECTED? 
 
Spain has ordered anti-virals to cover approximately 25 
percent of its population but has only received  limited 
deliveries from Roche.  Delivery of the entire order is not 
expected until late 2006. 
 
--DOES THE COUNTRY HAVE A STOCKPILE OF PRE-POSITIONED 
PERSONAL PROTECTIVE GEAR? 
Yes.  There are 48 centers located around the country (at 
least one in each of Spain's 17 regions) that contain all 
necessary quick response equipment, including personal 
protective gear.  In addition, some special police, health, 
fire, and armed forces units control limited stockpiles of 
such gear. 
 
--WHAT IS THE RAPID RESPONSE CAPACITY FOR ANIMAL AND HUMAN 
OUTBREAKS? 
 
The rapid response capacity is delineated in the 
afore-mentioned national human and animal plans. 
 
ARE GUIDELINES IN PLACE FOR THE CULLING AND VACCINATION OF 
BIRDS, DISINFECTION OF FACILITIES, AND LIMITATIONS ON 
ANIMAL MOVEMENT? 
 
Yes.  They are being administered by the Agricultural 
Ministry, which has already ordered 15 million animal H5N1 
vaccines.  The government has closed down all Spanish open 
air poultry facilities near bird migratory routes.  (Note: 
less than 10 percent of Spanish poultry is raised in open 
air facilities). 
 
-- HOW WILLING AND CAPABLE IS THE GOVERNMENT OF IMPOSING 
QUARANTINES AND SOCIAL DISTANCING MEASURES (CLOSING 
SCHOOLS, PUBLIC GATHERINGS, MASS TRANSIT)? 
 
Opposition political parties have said that such plans are 
being developed but this has not been addressed publicly by 
Spanish authorities, who have preferred to emphasize that 
"everything is under control" vice increasing the general 
alarm among the Spanish people. 
 
WOULD ITS MILITARY ENFORCE QUARANTINES? 
 
The military currently has no plans to enforce a possible 
quarantine and has no ongoing staff study on this subject. 
We believe any possible quarantine effort would be led by 
local government assets, supported as necessary by the 
National Police and Civil Guard. 
AGUIRRE