Cablegate: Cuts to Latvian Health System Lowers H1n1 Readiness

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RUEAUSA/DEPT OF HHS WASHINGTON DC

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E.O. 12958: N/A
TAGS: TBIO PGOV SOCI AMED CASC LG
SUBJECT: CUTS TO LATVIAN HEALTH SYSTEM LOWERS H1N1 READINESS

SENSITIVE BUT UNCLASSIFIED

1. (SBU) Summary: Cuts to the Health Ministry's budget have
weakened Latvia's ability to respond to an unlikely but possible
H1N1 outbreak. Latvia cannot afford H1N1 vaccines and has fewer
resources to combat an outbreak. So far the virus does not appear
to be widespread in Latvia. End Summary.

Weakened Health System

2. (U) As a result of the economic crisis, the GOL has cut the
Health Ministry's budget by 21% in 2009. Under current plans, the
budget will be further reduced by another 11% in 2010. This returns
the budget to roughly the nominal level of 2006. The Health
Ministry provides the vast majority of health care in Latvia.
Sources roughly estimate that only about 5% to 6% of official health
care expenditures are from private sources.

Low H1N1 Readiness

3. (SBU) The economic crisis and the accompanying budget cuts are
having a direct and negative effect on Latvia's preparations for a
possible H1N1 outbreak. Health Ministry officials say that Latvia
cannot afford H1N1 vaccines this winter. According to the WHO,
vaccines cost $2.50 to $20 per dose, depending on a country's
ability to pay. Latvia has a pandemic flu preparedness plan drawn
up in 2006, but has not updated the plan to reflect the current
budgetary situation.

4. (SBU) Latvia and other EU countries are currently negotiating a
joint H1N1 vaccine purchase contract with drug manufacturers. The
contract will grant Latvia an option to purchase vaccines in the
future at the negotiated price. Latvia does not plan to exercise
this option unless the situation deteriorates. Latvian officials
are unsure about what level of pandemic would trigger a purchase and
would need to ask the parliament for more money to do so, but said
they would be ready to act when needed. Latvia has no current plans
to stockpile anti-viral drugs.

5. (U) It is unlikely that H1N1 vaccines will be made available to
private purchasers in Latvia through official sources. The Health
Ministry said that drug manufacturers in Europe are filling
government orders first and do not expect to have enough vaccines to
sell to private individuals. Fortunately, the H1N1 virus does not
appear to be widespread in Latvia. The Latvian Infectious Disease
Center has identified only 30 H1N1 cases since the virus began, and
most cases have been mild. The Center acknowledges that the actual
number of cases may be somewhat higher due to underreporting.

6. (U) The Center estimates that in a worst case scenario up to 35%
of Latvia's population could contract influenza, both seasonal and
H1N1 flu, this winter. In that scenario, an outbreak could kill
2,000 to 4,000 people and hospitalize up to 16,000 people, in excess
of bed capacity.

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