US embassy cable - 05QUITO2673

UNCLAS SECTION 01 OF 02 QUITO 002673 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: TBIO, SENV, EAGR, EAID, ECON, PREL, EC 
SUBJECT:  ECUADOR - AVIAN AND PANDEMIC INFLUENZA 
PREPAREDNESS 
 
REF:  STATE 209622 
 
1.  Per reftel, post is providing the following information 
regarding the GOE's efforts to control Avian Influenza (AI) 
and its capability to respond to an influenza pandemic.  The 
answers are keyed to reftel questions. 
 
A)  PREPAREDNESS/COMMUNICATION 
 
-- The GOE began working on a preparedness plan to prevent 
and contain AI in September 2005.  National Director of 
Public Health Dr. Marcelo Aguilar will provide Econoff with 
a copy of the plan upon its completion on December 15.  The 
plan divides up preparedness and containment duties among 
the Ministry of Public Health (MPH), the Ministry of 
Agriculture (MAG), and the Ministry of Environment (MOE). 
The MAG, to include its Ecuadorian Sanitary Service (SESA), 
will be the main point of contact on AI.  The MPH will be 
the lead for human components of influenza viruses.  The MOE 
will focus on wild migratory bird issues. 
 
-- Individual interests are able to manipulate the national 
discourse through their influence over the press.  This 
influence could extend to AI discussions as well.  The lack 
of professionalism in the Ecuadorian press makes them 
susceptible to such pressure.  Meanwhile, delayed or 
inaccurate reporting on AI outbreaks in either humans or 
animals also could result from poor communication within the 
GOE rather than a lack of desire to be forthcoming.  For 
example, Dr. Aguilar notes that poor inter-Ministry 
communication is his biggest fear regarding the accurate and 
timely reporting of outbreaks. 
 
-- The GOE is preoccupied with a number of politically 
charged issues that detract from AI.  While within health 
circles AI is a top priority, concern with its political 
survival keeps the presidency from making AI issues more 
prominent.  Only an outbreak of AI in Ecuador would raise 
the issue to a higher priority. 
 
-- In the MAG, the main contact for AI is Dr. Abel Viteri, 
the Director of SESA.  The MPH contact is National Director 
of Public Health Dr. Marcelo Aguilar. 
 
-- The National Health System Law establishes an inter- 
institutional and regional network of detection, reporting, 
and containment that would guide the country's response to 
an AI outbreak.  Post has no indication that this Law would 
undermine GOE preparedness regarding AI.  MPH officials 
report that the Law is consistent with international health 
regulations. 
 
-- The GOE is engaged with the World Health Organization 
(WHO) and the Pan American Health Organization (PAHO) on AI 
and other health-related issues.  GOE leaders would be more 
receptive to messages from international organizations, 
rather than the USG.  In addition, the MPH has expressed 
concern that from an operational (though not scientific) 
perspective, language barriers would undermine any bilateral 
programs with the United States. 
 
-- The GOE currently does not administer annual flu shots. 
Ecuador does not have any production capability for flu 
shots and would purchase vaccines from Brazil if it 
initiates a flu shot campaign planned for 2006.  Ecuador is 
not technologically capable of developing an H5N1 vaccine. 
Ecuador's Sanitary Registry Law provides for liability 
protection. 
 
-- The MPH and the MAG maintain their own press offices 
through which they share information with the press and with 
a network of public officials.  Community-based radio is one 
of the more effective means of informing rural areas. 
Meanwhile, sensationalism by the press can misinform the 
public.  For example, following the October 2005 detection 
of a low pathogenicity strain of avian influenza in Colombia 
that was not/not identified as the H5N1 strain, Ecuadorian 
press provided extensive coverage about the hazards AI poses 
to human health.  Ecuadorian consumers, out of fear for AI 
and uninformed about the exact nature of the Colombian avian 
influenza strain, drastically reduced poultry consumption. 
This triggered a 30% drop in poultry sales that lowered 
poultry prices to unsustainable levels and caused financial 
problems within the feed industry.  Currently, the poultry 
industry, through the Poultry Producers Association 
(CONAVE), is investing large amounts of money in radio spots 
and other media to educate consumers regarding the real 
consequences of AI. 
 
B) SURVEILLANCE/DETECTION 
 
-- The GOE maintains 3 labs that could provide initial 
testing of samples.  The labs are geographically located in 
the north (Quito), the coastal region (Guayaquil), and the 
south (Cuenca).  The GOE also maintains a relationship with 
the CDC to which isolated samples can be sent for 
verification. 
 
-- The most critical gap in Ecuador's detection and response 
capabilities is a lack of anti-viral stockpiles.  Despite 
the countrywide network of health-care professionals, 
Ecuadorian health care services lack equipment and 
adequately trained personnel necessary to adequately respond 
to an AI outbreak.  Dr. Aguilar also noted the lack of field 
emergency hospitals that would assist in responding to 
outbreaks in rural areas. 
 
C) RESPONSE/CONTAINMENT 
 
-- The GOE maintains no stockpiles of Amantadine, 
Rimantadine, Oseltamivir, or Relenza.  The MPH reports that 
they have placed orders for Oseltamivir (Tamiflu).  The 
delivery date for this order is not known.  The MPH 
maintains a network of vaccine banks that provides 
refrigeration capabilities for the distribution of vaccines. 
Supplies of protective gear, while available in some areas, 
are very low. 
 
-- The GOE is in the process of finalizing guidelines for 
the culling and vaccination of birds, disinfection of 
facilities, and animal movement with respect to an outbreak 
of AI.  However, finalized guidelines will not guarantee a 
rapid response because GOE institutions can be highly 
ineffective and inter-institutional communication is 
wanting. 
 
-- The banning last month of poultry imports from Colombia 
shows the GOE's willingness and ability to take action 
swiftly.  At the same time, the action also shows erroneous 
application of World Organization for Animal Health (OIE) 
standards since the AI outbreak in Colombia was proven to be 
a low-pathogenic strain of the virus, making the import ban 
unjustified under OIE.  Such decisions, whether or not they 
are justified on public health grounds or used as an excuse 
to limit competition for local producers, require the 
necessary political will and interest.  The Ecuadorian 
military is capable of imposing quarantines and social 
distancing measures.  The Ecuadorian military currently 
participates in regional response exercises with local and 
international health agencies. 
 
JEWELL