US embassy cable - 05ATHENS2985

C O N F I D E N T I A L SECTION 01 OF 02 ATHENS 002985 
 
SIPDIS 
 
E.O. 12958: DECL: 11/10/2015 
TAGS: TBIO, SENV, ECON, EAGR, EAID, PREL, AVIANFLU 
SUBJECT:  GREEK PREPAREDNESS: REQUEST FOR INFORMATION: 
AVIAN AND PANDEMIC INFLUENZA. 
 
REF: A. SECSTATE 206992 
 
     B. ATHENS 002748 
 
Classified By: AMBASSADOR CHARLES RIES FOR REASONS 1.4(B) AND (C) 
 
1. (C) Summary: The GoG is engaged in serious efforts to 
prepare for a potential outbreak of Avian Influenza. 
However, while the specific functional responsibilities of 
the Agriculture, Health, and Public Order Ministries appear 
to be in place, lack of confidence in senior leadership as 
well as ministerial territorialism could detract from the 
overall efficiency of the GoG in the event of an outbreak. 
The GoG possesses the expertise to diagnose and efficiently 
quarantine an outbreak in the rural areas, but faces 
logistical and social challenges if the outbreak occurs in or 
migrates to an urban setting.  The strong working 
relationship established during the 2004 Olympic Games 
provides a platform by which the USG can offer the 
appropriate advice to the GoG regarding preparations for and 
actions to take during a potential pandemic situation.  End 
Summary. 
 
Preparedness and Communication 
------------------------------ 
 
2. (C) On 18 November, Econoff met with Dr. Theodoros 
Papadimitriou, Director of the Hellenic Center for Infectious 
Disease Control (HCIDC) to discuss GoG preparedness with 
respect to Avian Influenza. Papademitriou was also the GoG 
representative at October's Avian summit in Washington.  He 
complimented the USG on its aggressive preparations for Avian 
Flu and presented a copy of the GoG strategy relating to a 
potential Avian outbreak, drafted after his return from 
Washington.  (Note: Copy of GoG strategy sent to EUR/PGI via 
pouch. End Note.) 
 
3. (C) Papadimitriou was critical of Rural Development 
(Agriculture) Minister Evangelos Basiakos and his Ministry's 
handling of the inaccurate announcement that H5N1 was 
detected on the island of Oiniousses. (Reftel B)  He remained 
concerned about Basiakos' ability to handle any outbreak and 
said that he would soon ask Minister of Health Nikitas 
Kaklamanis for greater control over preparations for Avian 
Influenza.  At the working level, Papadimitriou assured 
Econoff that his "door was always open" and that at the 
Ministerial level, Kaklamanis would welcome a call from the 
Ambassador as required. 
 
4. (C) While legal review of the GoG Avian strategy has not 
yet been completed, the process is underway.  It is also 
worth noting that the GoG has also worked closely with its 
fellow EU members and according to Papadimitriou, has 
repeatedly consulted with Brussels on testing and 
preparedness issues.  The public and private healthcare 
system currently has this year's flu shots available around 
the country, although the vaccines are not produced in 
Greece.  The GoG is not currently developing an H5N1 vaccine, 
nor do any private Greek pharmaceutical companies possess the 
production capacity for such a vaccine if it did exist. 
 
Request for Assistance 
---------------------- 
 
5. (C) Papadimitriou made two requests of the USG at the 
meeting.  The first, was assistance in the acquisition of 
Tamiflu.  Papadimitriou was noticeably frustrated by the lack 
of support and financial assistance provided by the EU in the 
acquisition of Tamiflu.  The GoG did not expect to receive 
its order for 100,000 doses of Tamiflu until April at the 
earliest.  Referring to the maker of Tamiflu, Papadimitriou 
stated "..and Roche is French!" implying disbelief that they 
had not received more doses of Tamiflu from an EU member 
state and diplomatic ally.  The GoG currently has only 5,000 
doses of Tamiflu on hand.  The second was access to the 
information on the progress for an H5N1 variant vaccine and 
immediate access to such a vaccine when it is developed by 
the USG.  Econoff pledged to pass both requests to Washington. 
 
The Weakest Link 
---------------- 
 
6. (C) The hysteria surrounding the suspected case of Avian 
Influenza in October (Reftel B) led the GoG and the Greek 
media to provide an excess of information to the Greek 
public, some correct and some not.  Once it was confirmed 
that H5N1 was not in fact present in Greece, the GoG and the 
media made a limited attempt to bring some order to the chaos 
and present clear guidance.  The HCIDC has the main points of 
the GoG plan on their website (www.keel.gr) as well as some 
links and travel advice for Greeks going abroad.  For the 
rural areas in Greece without access to the internet or mass 
media, the Ministry of Agriculture has been keeping rural 
agricultural associations and veterinarians up to date. 
Overall the public appears to be well informed and has the 
perception that the GoG has been working on a plan to address 
Avian Influenza.  However, the overall GoG public diplomacy 
efforts and responsibility of the Greek media are certainly 
the weakest link in the entire Avian Influenza preparedness 
chain. It is also worth noting that public demand for Tamiflu 
has made the drug an un-obtainable commodity in Greece, where 
anti-virals and anti-biotics are otherwise available over the 
counter. 
 
Surveillance/Detection 
---------------------- 
 
7. (C) The working level personnel of the Greek Agricultural 
sector are competent and dealt with the foot and mouth 
disease outbreak of the late 1990's competently and 
efficiently.  The GoG possesses the latest diagnostic 
laboratory equipment at their Virological Laboratory in 
Thessaloniki but also has an arrangement with the EU lab in 
Weybridge U.K. to complete diagnostic testing.  Like the 
Ministry of Health, the working level personnel in the 
Ministry of Agriculture question their senior leadership and 
the effectiveness of the Ministries of Health and Public 
Order.  They remain confident in their expertise and 
communication channel with rural poultry producers to provide 
early warning, containment, and destruction of any infected 
birds.  Provided a timely diagnosis of H5N1 is made, Post 
believes that the Agricultural system in Greece posseses the 
internal expertise to effectively confront an outbreak of 
Avian Influenza should it arrive in the region in the 
rural/agricultural arena. 
 
Response/Containment 
-------------------- 
 
8. (C) The GoG preparations for a biological hazard attack at 
the 2004 Olympic Games provide an effective basis for their 
response to an outbreak of Avian influenza in a major urban 
center.  However, the current status of the individuals who 
worked on the bio-hazard task force remains undetermined and 
while Econoff was assured that there were stockpiles of 
personal protective equipment, this has not yet been 
verified. 
 
9. (C) It is also worth mentioning that with roughly 
two-thirds of the entire Greek population in the two major 
urban centers of Athens and Thessaloniki, the ability of the 
GoG to contain an outbreak of Avian Influenza to the rural, 
agricultural centers is key to preventing a pandemic within 
its borders.  The population density of Athens and to a 
lesser degree Thessaloniki, preclude almost any orderly 
social distancing or quarantine scenarios.  Added to this 
problem is the contentious role that the police and military 
play in the fabric of Greek culture. (Note: Greece was under 
military rule from 1967-74. End Note)  Any forced quarantine 
actions by either group would almost certainly ignite massive 
civil unrest that might transcend the public fears of Avian 
Influenza.  While the GoG has looked into this scenario in 
its Avain Influenza strategy, the actual implementation of 
such a contingency would be very difficult given the social 
reality of Greek society. 
 
Comment 
------- 
10. (C) It is worth noting that Minister of Health 
Kaklamanis, upon Papadimitriou's return from the October 
Avian Summit in Washington, called for a South Eastern 
European Avian Summit, which took place on 19 November in the 
Athens suburb of Glyfada.  Econoff was invited to attend the 
roundtable discussion but was not cleared to attend the 
ministerial level meetings because, according to 
Papadimitriou, "they wouldn't want you (the USG) to see how 
disorganized they really were."  Papdemitriou pledged to 
provide Econoff a summation of the meeting.  The planning and 
organization of the summit is a clear example of the GoG 
placing action behind their rhetoric of making Avian 
preparedness a priority.  While internal problems and details 
will surely need to be addressed with respect to the overall 
strategy, Post remains encouraged by the actions taken thus 
far by the GoG on Avian Influenza. 
RIES