US embassy cable - 05DJIBOUTI1156

UNCLAS SECTION 01 OF 02 DJIBOUTI 001156 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: TBIO, SENV, ECON, EAGR, EAID, PREL, DJ 
SUBJECT: REQUEST FOR INFORMATION: DJIBOUTI'S 
ABILITY TO HANDLE AVIAN AND PANDEMIC 
INFLUENZA 
 
REF: STATE 209622 
 
1. (U) Summary: Djibouti has very little 
capacity to handle avian and pandemic 
influenza. Responses below are keyed to 
questions in reftel. End Summary. 
 
2. (U) Preparedness/Communication: 
 
-- Djibouti does not have a plan/strategy 
for preventing avian flu from becoming a 
pandemic and containing a pandemic once it 
occurs. It does not have sufficient 
capability to implement such a plan. 
Djibouti has not yet produced a plan, but 
has been talking about writing one. 
 
-- Djibouti will report a case, if they are 
aware of it, however, since they have no 
surveillance system for even basic diseases 
among humans or animals, it is more likely 
than not that they will not know. We do not 
believe any incentives are needed for 
transparency should the Government of 
Djibouti discover a case. 
 
-- Preparing for an avian flu pandemic does 
not rank very high among government 
priorities. We are not certain there is a 
certain person or action that could 
influence Djibouti to give the issue higher 
priority. The Minister of Health is the 
primary point of contact to engage on this 
issue. 
 
-- Post has no knowledge that Djibouti has 
or has not reviewed its national laws to 
ensure they are consistent with 
international health regulations and do not 
pose barriers to avian flu detection, 
reporting, containment, or response. 
 
-- Djibouti is currently working with 
international organizations to a small 
degree on the avian flu issue. Post is 
certain Djibouti will seek assistance from 
the US or other countries should the need 
arise. Post believes government leaders 
would be receptive to messages through all 
channels. Djibouti would want money and 
technical assistance in return for its 
efforts on the avian flu. It is important to 
note that Djibouti has asked chicken 
importers to stop importing from Asia due to 
the recent developments on Avian Flu. 
 
-- Djibouti does not currently administer 
annual flu shots, but may consider doing so 
if it were funded by outside sources. The 
Government does not have a budget to cover 
such an expense. Djibouti has no production 
capability for human influenza vaccines. 
Djibouti does not produce influenza vaccine 
for poultry , nor H5N1 vaccines, and does 
not have a poultry industry. Licensing and 
liability shields  issues are not applicable 
in this case. 
 
-- The population of Djibouti is not very 
well informed about the avian flu threat. 
However, since there is no poultry industry 
or lacustrine environment, the threat is 
relatively low compared to other African 
countries. Radio and community announcement 
systems are available for providing 
additional information to the population, 
particularly in rural areas. Radio is fairly 
effective for spreading messages throughout 
the country. 
 
3. (U) Surveillance/Detection 
 
-- Medical and agricultural sectors are not 
at all capable of detecting a new strain of 
influenza among people or animals. All 
diagnosis would have to be made outside the 
country as there is no capacity to do so in 
country. Samples would have to be shipped to 
another country. Influenza viruses cannot be 
subtyped in the country. In past polio 
cases, samples were sent to a WHO reference 
laboratory. 
 
-- Djibouti has no effective systems in 
place for any disease surveillance, not even 
the most basic and common, such as polio, 
diarrhea, malaria, etc. The greatest need in 
this area is assisting the government in 
building from the ground up an entire 
disease surveillance system for all 
diseases, not just Avian Flu. 
 
4. (U) Response/Containment 
-- Djibouti does not have a stockpile of 
medications, particularly of antivirals. To 
date, nothing has been ordered, but some 
discussion on whether to order some has 
occurred. 
 
-- Djibouti does not have a stockpile of 
pre-positioned personal protective gear for 
humans working with poultry, nor for health 
care personnel working with sick people. 
 
-- There is little to no rapid response 
capacity for animal and human outbreaks. 
There are guidelines in place for the 
culling and vaccination of birds, 
disinfection of facilities, and limitations 
of animal movement. 
 
-- Djibouti is willing, but not very 
capable, of imposing quarantines and social 
distancing measures. This is due to 
extremely porous borders and mass transit 
being the only means of earning a small 
daily income for a large portion of the 
population. Schools could be closed if 
necessary. Post believees Djibouti's 
military would enforce quarantines if called 
upon. However, Post does not know what the 
general policy is and there is no strategy 
currently in place for such an event. Post 
has been told a strategy is being formed.