US embassy cable - 05ABUDHABI4902

UNCLAS SECTION 01 OF 03 ABU DHABI 004902 
 
SIPDIS 
 
USDA/FAS FOR CMP/DLP/WETZEL 
 
E.O. 129589:  N/A 
TAGS:  TBIO, SENV, ECON, EAGR, EAID, PREL, TC 
SUBJECT: UAEG'S PREPARATIONS FOR AVIAN INFLUENZA 
 
REF: A)STATE 209622, B)STATE 153483, C)STATE 151549, 
D) ABU DHABI 04225 
 
1. (U) In response to the questions posed Reftel A regarding the 
UAEG's efforts to protect against avian influenza (AI) and its 
capability to respond to a pandemic, the following information is 
provided. 
 
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Preparedness 
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2. (U) The UAEG has formed a National Avian Influenza Emergency 
Committee (NAIEC) composed of representatives from the 
Environment Agency, the General Authority for Health Services, 
the Ministry of Agriculture and Fisheries, the Health Authority, 
General Secretariat of Municipalities and the military to develop 
a comprehensive plan to prevent and/or manage an AI pandemic in 
the UAE.  Majid Al Mansouri, Secretary General of the Abu Dhabi 
Environment Agency, chairs the committee.  Weekly meetings are 
held with all members of the committee.  Sheikh Mohamed bin Zayed 
Al Nahyan, Crown Prince of Abu Dhabi and Deputy Supreme Commander 
of the UAE Armed Forces, also attends the meetings once a month. 
The UAEG's plan is based on the WHO Health and Medical Services 
Contingency Plan for an Influenza Pandemic.  The UAEG has a flow 
sheet in Arabic detailing what their response will be in various 
stages of pandemic preparation.  The flow sheet details 
procedures for preparation for both an avian epidemic and a human 
epidemic.  Emboffs along with USDA consultants reviewed the flow 
chart with Ministry of Agriculture & Fisheries (MAF) officials 
with regard to an avian outbreak, but were not given a copy of 
this internal UAEG document. 
 
-Prevention of an avian epidemic involves measures such as 
banning the importation of live birds from countries that have 
reported cases of High Pathogenic Avian Influenza (HPAI) H5N1. 
The MAF is quarantining and testing non-poultry birds, 
particularly falcons, which arrive at major ports of entry and is 
also coordinating inspections of live bird markets, pet stores 
and commercial poultry farms. The Abu Dhabi Environmental Agency 
has closed live bird markets both in Abu Dhabi and Al Ain and 
instructed owners to confine domestic birds indoors as an 
additional precaution against inadvertent infection by migratory 
birds.  The UAEG established and broadly publicized a consumer 
hotline.  Reportedly, response time on calls to the hotline is 
slow. 
 
-The UAEG is capable of implementing any AI plan developed.  This 
is a country rich in fiscal resources and appears to have the 
political will to address the AI issue in the event of an avian 
or human epidemic. 
 
-The UAEG will likely be forthcoming in reporting cases of AI in 
humans, but not in avian populations due to sensitivities 
concerning the falconry industry.  (Falcons are kept as pets and 
used in hunting by Gulf Arabs.  The most expensive falcons cost 
$30-40K.) The U.S. could offer more technical assistance to 
encourage transparency and prompt reporting of AI. 
 
-The UAEG appears to be taking the threat of AI seriously with 
preparation for a pandemic high on the UAEG's list of priorities. 
The key go-to person is Majid Al Mansouri, Secretary General of 
the Abu Dhabi Environmental Agency, who heads the AI committee. 
He reports directly to the Abu Dhabi Crown Prince.  However, if 
dealing with live avians, the go-to person is Asst. U/S Abdullah 
Abdul Azziz, Ministry of Agriculture and Fisheries.  The country 
has allocated 35 million dirhams (9.5 million USD) to combat AI 
via preventive programs and post-detection eradication measures. 
 
-UAE national laws restrict the Federal Ministry of Agriculture's 
ability to confiscate privately-held exotic birds.  However, 
municipalities are not constrained by this legal restriction and 
can, and have, confiscated pet birds and poultry as a risk 
reduction measure among domestic avian and poultry populations. 
 
-The UAEG is in regular contact with the WHO and the Food and 
Agricultural Organization (FAO) and has repeatedly stated that 
they are following WHO planning and response guidelines.  UAE 
officials have met with embassy staff on several occasions and 
have been helpful and responsive.  Teams of AI experts from the 
US, the FAO, Belgium and Australia evaluated the UAEG's AI action 
plan and its implementation thus far.  The UAEG remains very 
interested in more bilateral assistance from the USG and is also 
coordinating a multilateral approach with other GCC countries to 
promote prevention, detection and eradication of AI H5N1 within 
the region. 
 
-The UAE's annual Flu Vaccine Program is implemented through 
hospitals, clinics, and the preventive medicine clinic.  The Flu 
vaccine given is Aventis Pasteur Vaxigrip, which is produced in 
Lyon, France.  No flu vaccine is produced locally.  The UAE does 
not produce AI H5N1 vaccine for poultry, but likely would once 
such vaccine is developed. 
 
-The Abu Dhabi Environment Agency produced and distributed an 
informational brochure on AI to consumers throughout the UAE 
while the MAF issues a separate brochure to the poultry sector. 
AI has figured prominently in the newspapers, although 
comprehensive information on a)the potential avenues for AI to 
spread or b) basic preventive health measures consumers could 
adopt is not well disseminated.  Many sectors of the population 
are receiving some information about the disease, but there is a 
risk that many third-country nationals will remain ill-informed. 
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Surveillance/Detection 
---------------------- 
 
3. (SBU) Avian surveillance is ongoing in commercial poultry, 
imported avian and live bird markets. However, the Ministry of 
Agriculture does not have strong diagnostic capabilities and 
relies almost exclusively on a reference laboratory in England to 
analyze samples.  The USDA is addressing this dependency on 
outside resources by sponsoring local Ministry officials for 
training in the U.S.  The November visit of USDA officials 
revealed that MAF field officials were applying a rapid response 
ELIZA test, designed for detecting H5N1 in falcons, to all avian 
species.  Officials seemed unaware that such a test will always 
generate a false negative in an infected bird.  During an 
interview, MAF officials confirmed that technical advisors from 
the Food and Agricultural Organization, Belgium and Australia had 
also identified this field test as erroneous.  The MAF explained 
that this test was utilized on the order of the National Avian 
Influenza Emergency Committee as the official test to be given 
throughout the country. 
 
-Testing of humans can be done at Sheikh Khalifa Medical Center. 
The center already has the technical equipment needed to run the 
verification tests for H5N1 in samples. Reagents for the PCR of 
H5N1 have been ordered and are expected to arrive in 4 weeks. 
The GAHS has a contract with a laboratory in the UK for viral 
cultures needed for verification. 
 
-There are critical gaps in the UAE's detection capabilities. 
The most pressing gap in the UAE's outbreak response capability 
is the threat of hospitals being overwhelmed by patients in the 
event of an outbreak.  There are currently 55-72 beds designated 
for AI isolation.  In the event of an outbreak, it is expected 
that the military would be able to increase that capacity.  All 
AI cases would be treated at government hospitals.  It is not 
clear how many of those are negative flow rooms.  However, the 
ICU beds in the government hospitals here often have terminally 
ill VIP patients who remain in the ICU for months to years, 
taxing the potential response of the health care system.  While 
the UAE has good hospitals and equipment, an AI epidemic could 
quickly overwhelm the health system. 
 
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Response/Containment 
-------------------- 
 
4. (U) The UAE public health sector has 10,000 doses of Tamiflu 
stockpiled.  They have ordered 4 million more doses, expecting 
the first 1 million to arrive in March.  One source reported that 
the Health Authority has increased its order to 10 million doses. 
The country also has stockpiles of antibiotics to treat secondary 
infections. 
 
-The UAE has sufficient supplies of Personal Protective Equipment 
(PPE) in place for its medical staff, and have ordered more as a 
back-up.  The Ministry of Agriculture does not have any PPE for 
its employees.  Of the Municipalities, only Abu Dhabi is known to 
have a limited quantity of PPE for its Department of Agriculture 
veterinarians. 
 
-The rapid response capacity for an outbreak of AI is based on 
police and military support.  Existing Ministry of Agriculture 
guidelines would be the basis for any action taken related to 
culling, facility sanitizing and animal movement control in the 
event of an outbreak among avian populations, although no 
official plan has been developed.  The Ministry of Agriculture 
appears willing to quarantine poultry and falcons, which are the 
primary vector risk for the disease into the country's poultry 
sector--aside from migratory fowl. 
 
-The Health Authority and Military will likely work together in 
the event of a human outbreak.  Quarantine measures are 
recognized as the appropriate course of action, but details on 
how such measures would be implemented are still under 
development.  We expect that the UAE health system could be 
quickly overwhelmed in the event of a regional pandemic, simply 
because of the sheer numbers of desperately ill persons who would 
be present at hospitals.  The health care that hospitalized 
patients generally receive here is of good quality based on world 
standards. 
 
-The UAEG is willing to impose quarantines.  It is unclear how 
these quarantines will be implemented, but it is likely that the 
military would assist.  It is unclear if quarantine mandates 
could effectively control the movement of VIPs or other elite 
segments of local society.  However, it is likely that the UAEG 
would be highly proactive in closing schools and banning public 
gatherings.  UAE officials have indicated that air travel could 
also be halted. 
 
SISON