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Cablegate: Nigeria Avian Flu U.S. Response

VZCZCXRO3333
PP RUEHMA RUEHPA
DE RUEHUJA #0404/01 0611250
ZNR UUUUU ZZH
P 021250Z MAR 07
FM AMEMBASSY ABUJA
TO RUEHC/SECSTATE WASHDC PRIORITY 8750
INFO RUEHZK/ECOWAS COLLECTIVE
RUEHNJ/AMEMBASSY NDJAMENA 0215
RUEHYD/AMEMBASSY YAOUNDE 0183
RUEHNR/AMEMBASSY NAIROBI 0219
RUEHSA/AMEMBASSY PRETORIA 1270
RUEHDK/AMEMBASSY DAKAR 0338
RUEHOS/AMCONSUL LAGOS 6243
RUEAUSA/DEPT OF HHS WASHDC
RHMFISS/CDR USEUCOM VAIHINGEN GE
RUEHRN/USMISSION UN ROME 0041
RUFOADA/JAC MOLESWORTH RAF MOLESWORTH UK
RUEAIIA/CIA WASHDC
RUEKDIA/DIA WASHDC
RUEKJCS/SECDEF WASHDC//USDP/ASD-HD//
RUEHPH/CDC ATLANTA GA
RUEHRC/DEPT OF AGRICULTURE WASHDC

UNCLAS SECTION 01 OF 02 ABUJA 000404

SIPDIS

SENSITIVE
SIPDIS

USDA FOR FAS/OSTA
USDA ALSO FOR APHIS/JOSPEH ANNELLI

E.O. 12958: N/A
TAGS: TBIO KFLU EAID EAGR NI
SUBJECT: NIGERIA AVIAN FLU U.S. RESPONSE

ABUJA 00000404 001.2 OF 002


1. (SBU) Summary: Although Nigeria is now better able to take
samples and test reported outbreaks, most of the problems that have
dogged the country in responding to AI persist. Surveillance remains
very weak and urgently needs attention. Inter-ministerial
cooperation is still a problem. The public is unconcerned about the
threat, with business remaining brisk in markets hosting infected
fowl. Both the GON and the UN institutions leading the response to
AI lack the capacity on the ground to affect the situation. The
Country teams believes the seriousness of the issues in Nigeria
merit a sustained medium-term focus on improving surveillance
through programs adequately and stably funded and directly managed
by the USG. End Summary.

U.S. Message
------------

2. (SBU) The U.S. Government has provided a consistent message to
the Government of Nigeria since Avian Flu was first confirmed in
February 2006. First, surveillance is crucial to an effective
response and strengthening both animal and human surveillance need
to be top priorities. Secondly, they need to strengthen interagency
coordination between the Ministries of Health, Agriculture and
Information, and with state and local governments. Thirdly they need
an adequate compensation policy that encourages farmers to report
cases.

Still Relevant Despite Some Progress
-------------------------------------

3. (SBU) This message continues to be relevant today. The Ministry
of Agriculture has improved its capacity to collect samples, test
them and announce results, and can often accomplish this chain in
about three days. Surveillance remains passive, however, and depends
on farmers voluntarily reporting cases, which many are reluctant to
do. An EU-funded effort to jumpstart active surveillance is only now
beginning to move into the field, several months behind schedule. On
the human side, lab technicians can competently test samples if
collected, but surveillance remains practically non-existent. In
both cases, the ability to amount a sustainable response to
outbreaks is lacking. Communication and cooperation between the
relevant ministries, remains hit or miss. The Ministries of Health
and Agriculture have been unable to cooperate in establishing a
unified AI crisis center. This refusal of the Ministries to
cooperate has impeded work of the USAID/FAO $1 million grant. The
grant was awarded to FAO in November of 2006 but has not moved
forward due to the Agriculture Ministry's refusal to share field
information with FAO or other ministries. On the positive side, the
Government this week announced a new compensation policy, which
doubles the payment per bird, but problems such as slow payment, and
payment only for birds culled could remain an issue. In addition,
the public information campaign leaves much to be desired.

Situation Today
---------------

4. (SBU) AI continues to be widespread in Nigeria and has now been
confirmed in 21 states and the FCT. The Ministry of Agriculture
reports that outbreaks have been reported on 600 farms over the year
and have been confirmed on about 300. As noted, testing of reported
outbreaks is improved. Active surveillance of farms was due to
launch, at long last, this week and USAID staff this week are
visiting some state offices, which we support directly, to see how
things are going in the field. FAO had recommended 10 actions to be
taken in response to the August outbreaks in Ogun and Lagos states.
A review in January, showed that only one of the actions had been
acted upon. On February 12, more than six weeks after the event, FAO
checked the Lagos market where the human victim's family bought
poultry. The market was operating normally, and a sickly chicken
picked out by the team tested positive for H5N1. Unlike last year,
the public report of a human case had little impact on the public's
willingness to buy chicken, and GON authorities had not closed or
cleaned the market as of February 19.

ABUJA 00000404 002.2 OF 002

5. (SBU) One issue is that the AI response is mainly in the hands of
a small group of people. When international visiting teams arrive
any activity to respond to AI stops as the GON team meets the
visiting team. Team members also have traveled a great deal in the
last year to various AI events or meetings, again halting decisions,
and intra-government communication on AI. The working style of the
UN agencies and some other visiting teams has contributed to this.

UN Agencies Lack Capacity
-------------------------

6. (SBU) The UN Agencies designated to take the lead in coordinating
the international response to AI, the WHO and the FAO, lack the
capacity on the ground to carry out this task in Nigeria. Though the
teams on the ground recognize this to some extent, and welcome USG
support, their desire to be instep with the GON sometimes results in
a tendency to gloss over key technical response issues. The UN
agencies tend to put maintaining a good relationship with the GON
above maintaining standards. As such, they have at times accepted
and circulated inaccurate information about the situation in Nigeria
and about the GON response. For example, an FAO team that visited
Nigeria in late November then circulated a report supporting the GON
contention that the AI problem was basically solved in Nigeria,
although by then it was clear the problem was re-emerging. Likewise,
there were press reports that WHO in Geneva announced that tests on
the suspected human case in Lagos in January were negative, before
the final tests were complete. This apparently was done on the basis
of preliminary tests done without the proper reagents. Subsequent
tests confirmed H5N1. The WHO initially touted the report of the
human case as a success of their surveillance system, when in fact,
it was an oil company contacted for Tamiflu that prompted the
reporting of the case to the authorities.

More Resources, More Control
----------------------------

7. (SBU) Nigeria has been identified, correctly in our view, as one
of the countries for greatest concern for the potential development
of a human pandemic. In the current situation, with AI becoming
endemic in poultry, and with very weak surveillance, we are poorly
equipped to identify and respond to any emerging problem. The issue
is serious enough that it warrants committing real resources to the
problem here. The Country Team believes that given these resources,
there is much we could do directly to improve surveillance in both
animals and humans, which is key to responding to any emerging
problem.

8. (SBU) Neither the GON nor the UN agencies have the capacity to
use significant amounts of USG resources effectively. Though we
would still recommend providing some support to FAO and WHO, we
would focus on directly managed USG programs that could strengthen
surveillance and a more coherent, routine response. On the animal
side, we would use contractors to provide expertise to the Ministry
of Agriculture, at the state level and to poultry farmers. On the
human side, WHO wants to depend on its IDSR system. IDSR is an
important component of active surveillance, but has not to date been
implemented effectively in Nigeria. Further, IDSR alone will not
provide surveillance coverage broad enough to identify H5N1 at the
community level in Nigeria. Using the platform already established
through PEPFAR, polio, immunization and our other health programs
we could improve human surveillance. To do so, however, we need
sufficient, stable multi-year funding. CAMPBELL

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