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Cablegate: Chile: Part Ii - Public Health Preparations For

VZCZCXYZ0005
RR RUEHWEB

DE RUEHSG #2431/01 3341022
ZNR UUUUU ZZH
R 301022Z NOV 05
FM AMEMBASSY SANTIAGO
TO RUEHC/SECSTATE WASHDC 7956
INFO RUEHAC/AMEMBASSY ASUNCION 2423
RUEHBR/AMEMBASSY BRASILIA 2976
RUEHBU/AMEMBASSY BUENOS AIRES 2793
RUEHLP/AMEMBASSY LA PAZ NOV LIMA 4355
RUEHMN/AMEMBASSY MONTEVIDEO 3117
RUEHQT/AMEMBASSY QUITO 1503

UNCLAS SANTIAGO 002431

SIPDIS

SIPDIS

E.O. 12958: N/A
TAGS: TBIO SENV ECON EAGR EAID PREL CI
SUBJECT: CHILE: PART II - PUBLIC HEALTH PREPARATIONS FOR
AVIAN INFLUENZA

REF: A. SECSTATE 209622

B. SANTIAGO 02393

1. Summary: This cable outlines preparations in Chile's
public health sector. An evaluation of the Chilean
agricultural sector preparations was reported in reftel B.

2. Chile has experience with avian influenza (AI) issues due
to a 2002 outbreak of the disease in poultry. The
agricultural sector met the challenge and the outbreak was
quickly contained. The GOC demonstrated transparency and
efficiency throughout that time. While it is clear that the
outbreak prompted the poultry industry and the agricultural
inspectors to upgrade their biosafety measures, the public
health sector did not benefit from the same level of
attention and allocation of resources in 2002. In 2005,
Chilean health officials have worked with international
partners to address the latest global AI threats. The
Ministry of Health (MOH) has prepared an extensive plan to
address this issue. However, the public health sector does
not enjoy the same levels of resources or manpower as the
agricultural export sector to fulfill completely its
emergency plans. End Summary.

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---------------------
Historical Statistics
---------------------

3. To raise awareness of the impact of an influenza outbreak
in humans, the Ministry of Health has cited two previous
outbreaks in Chile's recent history. Influenza first
appeared in Chile in 1918. In a population of 3.6 million, a
total of 37,500 people died from the disease between 1918 and
1920.

4. There was another influenza outbreak in 1957. Over 1.4
million people became ill, although the mortality rate was
only 0.13 percent among those infected. This outbreak
prompted the formation of a National Committee for Influenza
to coordinate tracking and treatment of the disease. It
became the public's authoritative source of information on
the topic.

---------------------------------
Organizing for the Current Threat
---------------------------------

5. The idea of a national committee was revived on November
30, 2004 when the Chilean Congress passed a resolution to
create the National Response Commission for Outbreaks and
Sanitary Emergencies. The Committee is under the
jurisdiction of the MOH's Office of Epidemiology. The
mandate of this committee is to:

- propose contingency plans to confront the outbreaks of
infectious diseases, with a particular emphasis on AI;

- monitor the implementation of these contingency plans;

- provide technical advice to the country's decision
makers.

Most members of this committee are MOH staff, but there are
also representatives from the Agricultural and Livestock
Service (SAG) and the Chilean Society for Infectology. Under
Secretary of Public Health, Dr. Patricio Bustos, has been

SIPDIS
identified as the key contact for international coordination
on this issue.

6. Other GOC agencies have been included to implement the
committee's urgent response plans. These agencies include:

- Ministry of Interior, Office of National Emergency
Response (ONEMI)
- Chile's Armed Forces and National Police (Carabineros)
- Ministry of Education
- Treasury Ministry
- Labor Ministry
- Association of Municipal Governments
- Association of Private Health Clinics
- Association of Scientists
- Executive Office of the President

------------------------------
Preparedness and Communication

------------------------------

7. The GOC does have a preparedness plan for preventing
avian flu from becoming pandemic. A Spanish-language version
of this document can be found at:

http://www.minsal.gov.cl/ici/pandemiainfluenz a

This plan is extensive. The GOC has identified key public
health alert phases: preparatory, pandemic alert, pandemic,
and post-pandemic. There are a series of actions outlined to
be taken at each phase. The plan emphasizes open
communication both domestically and internationally.

8. The GOC has been working with international partners on
this issue. The Ministers of Health from the Andean region
met in Lima, Peru on October 21, 2005. A declaration was
signed and regional governments promised to coordinate
closely with each other on this global health concern. In
addition, the GOC's plan repeatedly cites coordination with
the World Health Organization (WHO).

9. The MOH has announced it will continue its annual flu
vaccine program in 2005. The MOH plans to purchase the H5N1
vaccine when it becomes available. Currently, 1.75 million
Chileans receive a flu shot every year. The MOH hopes to
expand the number of recipients in 2005 by also inoculating
very old and very young citizens.

10. The GOC has prepared a list of vaccines and
pharmaceutical companies that currently distribute in Chile:

- Vaxigrip (Aventis Pasteur)
- Fluarix (Glaxo Smith Kline)
- Influvac (Solvay)
- Agrippal S1 (Chiron)
- Inflexal V (Berna)

The MOH estimates that these vaccines cost between USD $9 and
$16 per patient.

11. Recent press coverage has raised general awareness in
Chile of global AI concerns. Contacts report that most
Chileans trust their government to handle this issue in a
proper manner. The GOC has made communication with the
public a key part of their response plan in the event of an
outbreak of AI in humans.

----------------------
Surveillance/Detection
----------------------

12. The Institute for Public Health (ISP) will be the main
point of contact for AI detection in Chile. It works with a
network of 16 public hospitals throughout the country to
identify cases of AI and to isolate infected persons in
special wards. A hospital in Santiago (Hospital de Torax)
will serve as the hub in the case of a widespread outbreak
among humans. In order to implement their AI contingency
plans, the ISP has asked the GOC for an additional USD $3.2
million for lab personnel. This request is still pending.
The ISP states it will turn to the WHO if the crisis produces
a lack of manpower. This is an area in which the USG could
contribute to the GOC's preparations for AI.

-----------
Containment
-----------

13. The GOC plans to contain the spread of the disease by
restricting international points of entry should AI affect
humans on a large scale. Internal controls would include the
cancellation of classes, a restriction on large public
events, and a restriction on non-essential work functions.

14. The GOC's plan also refers to the widespread distribution
of protective gear in the event of an outbreak. Unlike SAG,
the MOH does not appear to have enough supplies or resources
on-hand to meet this need. This is another potential area in
which the USG could provide support.

YAMAUCHI

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