This record is a partial extract of the original cable. The full text of the original cable is not available.

UNCLAS SECTION 01 OF 05 HANOI 003240 
 
SIPDIS 
 
FOR USAID/RDM-A/BANGKOK PRIORITY 
STATE FOR G; CA/OCS/ACS/EAP; EAP/EX; EAP/BCLTV; EAP/EP; INR; 
OES/STC (PBATES); OES/IHA (DSINGER AND NCOMELLA) 
BANGKOK FOR RMO, CDC, USAID/RDM/A (MFRIEDMAN AND JMACARTHUR) 
USDA FOR FAS/PASS TO APHIS 
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (LSTERN) 
USAID FOR ANE AND GH (DCARROLL, SCLEMENTS AND PCHAPLIN) 
STATE PASS USTR (ELENA BRYAN) 
STATE ALSO PASS HHS/OGHA (EELVANDER) 
 
E.O. 12958: N/A 
TAGS: AMED AMGT CASC EAGR PINR SOCI PGOV TBIO VM AFLU
SUBJECT: VIETNAM: AVIAN INFLUENZA WEEKLY REPORT FOR DECEMBER 
9, 2005 
 
REF: A) HANOI 3190, B) HCMC 1269 
 
¶1.  (SBU) Summary.  There have been no new human Avian 
Influenza (AI) deaths since the confirmed October 29 death 
of a Hanoi man.  The total number of active AI-affected 
provinces and cities decreased to 15 out of Vietnam's 64 
provinces and cities, but localized poultry outbreaks have 
spread.  The Government of Vietnam (GVN) has banned over-the- 
counter sales of Tamiflu to build up a national stockpile. 
The GVN has plans to produce Oseltamivir, a generic version 
of Tamiflu, beginning in June 2006, but under an agreement 
with Roche GVN will not be allowed to export the product. 
Deputy Prime Minister Pham Gia Khiem has agreed with a 
Ministry of Agriculture and Rural Development (MARD) 
proposal to kill all 62 million waterfowl across the 
country.  Local authorities in Ho Chi Minh City (HCMC), Hue 
and Danang adopted extreme measures such as poisoning and 
hunting wild birds in public areas, but have since been 
ordered to cease.  The World Health Organization (WHO) and 
Food and Agriculture Organization (FAO) provided guidance to 
GVN food safety authorities after growing concern among 
officials and public of contracting AI from consumption of 
poultry and eggs.  The Mission has received approval from 
GVN to begin its communication and awareness project for 
rural farmers and later this month will host an AI 
diagnostic training for 20 animal health technicians, 
thereby enhancing GVN's ability to track the spread of AI in 
poultry.  End Summary. 
 
No New Confirmed AI Human Fatalities 
------------------------------------ 
 
¶2.  (U) There have been no new confirmed AI human fatalities 
since the October 29 death of a Hanoi man reported 
previously.  The most recent confirmed bird flu victim 
remains to be the 15-year old boy from Haiphong who is in 
stable condition.  As reported previously (Ref A), a three- 
year-old boy from southern Tien Giang Province who has 
remained hospitalized is infected with bird flu according to 
initial tests.  Those results have yet to be confirmed by 
WHO. 
 
The Scoop on Tamiflu 
-------------------- 
 
¶3.  (SBU) Contrary to reports in the international and local 
press, Post has learned that Swiss manufacturer Roche has 
not licensed GVN to produce branded "Tamiflu", but if an AI 
pandemic occurs, GVN will be able to produce the generic 
medicine named Oseltamivir.  Under conditions of the 
agreement, Vietnam-produced Oseltamivir will be for use in 
Vietnam only and not for export.  The GVN has plans to 
produce Oseltamivir beginning in June 2006, but details of 
how local producers will extract shikimic acid on a 
commercial scale from domestically grown star anis remain 
unclear. 
 
¶4.  (U) Roche has also agreed to supply or sell the GVN 25 
million Tamiflu capsules before the end of 2006.  The 
company is reportedly in talks with eight companies to 
produce the drug locally.  In Hanoi, prices of the medicine 
have range from USD 35 to 70 for a box of 10 capsules. 
 
¶5.  (U) A circular issued on November 23 banned the over-the- 
counter sales of Tamiflu to build up a national stockpile in 
case of a mass AI outbreak.  According to press reports, 
Health Minister Tran Thi Trung Chien gave the order in early 
November in the face of intense demand for the drug. 
Provincial authorities have been ordered to ban local sales 
of Tamiflu doses and to stockpile them in national reserves. 
 
¶6.  (U) On December 8, the MOH announced that 420,000 
Tamiflu capsules had been allocated to hospitals in all 64 
cities and provinces.  It is unknown how many of these doses 
are from the 600,000 capsules donated by the Government of 
Taiwan, half of which have been allocated to eight "leader" 
hospitals in Hanoi and HCMC. 
 
Infections In Poultry Spreads, But In Fewer Provinces 
--------------------------------------------- -------- 
 
¶7.   (U) The number of current, active AI-affected provinces 
decreased  to  15 this week, down from the 17 provinces  and 
cities  reported  previously.   Quang  Ninh  and  Ha   Giang 
provinces  in northern Vietnam are the latest to  report  AI 
outbreaks  in  poultry.   AI poultry outbreaks  continue  to 
spread  within affected localities of Hai Phong,  Vinh  Phuc 
and  Cao  Bang Provinces in northern Vietnam.  AI  currently 
exists  in  63  districts of 15 provinces, specifically  Bac 
Giang,  Bac Ninh, Cao Bang, Hai Duong, Hoa Binh, Ninh  Binh, 
Phu  Tho,  Son  La, Thai Nguyen, Thanh Hoa,  Haiphong,  Vinh 
Phuc, Long An, Quang Ninh and Nghe An. 
 
¶8.  (U) Specimens from suspected poultry in the northern 
province of Yen Bai are being tested for the viruses.  Tests 
showed that poultry in the two central provinces of Quang 
Nam and Quang Ngai and the southern province of Dong Thap 
were not infected with bird flu viruses.  Hanoi, three 
northern provinces of Thai Binh, Hoa Binh and Hung Yen, and 
two southern provinces of Bac Lieu and Long An have met 
criteria for announcing an end to bird flu outbreaks - that 
is, detecting no new poultry outbreaks for at least three 
weeks. 
 
Authorities Adopt Drastic Measures to Protect Public Health 
--------------------------------------------- -------------- 
 
¶9.  (U) On December 8, Deputy Prime Minister Pham Gia Khiem 
signed off on a proposal to kill all 62 million waterfowl 
across the country, according to Minister of Agriculture and 
Rural Development and head of the National Steering Board on 
Bird Flu Prevention and Control Cao Duc Phat.  Minister Phat 
said to local press that 90 percent of waterfowl blood 
samples tested positive to the virus, and that if waterfowl 
continue to be raised, Vietnam will not be able to stamp out 
the bird flu epidemic. 
 
¶10.  (U) On November 30, the MARD had announced that it 
would not order the culling of the entire poultry stock in 
the country, which numbers roughly 220 million fowl.  Since 
AI began ravaging poultry farms across Vietnam in late 
November 2003, authorities have reportedly culled about 66 
million fowl.  Since the latest wave of AI outbreaks began 
in early October 2005, 2.88 million fowl have been culled. 
 
¶11.  (U) During this latest round, Hai Duong Province in 
northern Vietnam has culled 714,000 fowl, of which 142,000 
fowl (primarily ducks, geese and quail) were culled within a 
three-day period earlier this week.  Most of the poultry 
found to be infected were ducks, leading the Hai Duong 
People's Committee to order all ducks and geese destroyed. 
 
¶12.  (U) In efforts to stem a potential pandemic and 
minimize human infection, authorities in HCMC have adopted 
strict measures including the banning of poultry and pet 
birds, keeping open only three official slaughterhouses, and 
monitoring the transport of poultry into the city. 
Officials from neighboring provinces, however, have openly 
criticized such measures, stating in the press that HCMC 
authorities should allow more of the existing poultry from 
the countryside be sold in Vietnam's largest city of over 
six million people.  One official from Tien Giang Province's 
Animal Health Department was quoted in local press saying 
"Poultry consumption has ground to a halt, really hurting 
our farmers," for which the head of HCMC's Animal Health 
Department replied "Though the market is now frozen, the 
city's tight control is vital in protecting human health." 
With the regulations in effect, transport of live birds from 
neighboring provinces has fallen by 75-80 percent.  Only 
8,000 to 9,000 birds are slaughtered daily compared to 
39,000-40,000 previously. 
 
¶13.  (SBU) While Deputy Prime Minister Nguyen Tan Dzung has 
asked localities to continue taking regular preventive 
measures and add more drastic ones to cope with AI 
outbreaks, officials in HCMC, Danang and Hue are apparently 
willing to take extreme, unilateral measures.  Despite 
previous denial by HCMC Animal Health officials (ref A), 
sources from an international non-governmental organization 
have corroborated international press reports that HCMC 
authorities have used Dipterex, a deadly poison agent, to 
cull wild pigeons in public areas.  Authorities pulled back 
from a full feral pigeon culling campaign after they 
realized that the pigeons fly off after consuming the deadly 
poison and, hence, could cause a public health concern if 
subsequently eaten by humans. 
 
¶14.  (SBU) In Danang and Hue, officials within the 
Departments of Animal Health have confirmed similar reports 
in the local press that authorities have contracted bands of 
hunters to shoot feral pigeons and wild birds within the 
city bounds.  Hue Department of Animal Health Director 
Nguyen Van Hung declared, "All birds that fly in the sky of 
Hue City will be killed."  During an eight-day period, only 
300 pigeons and a few cattle egrets were extirpated.  The 
hunters receive VND 10,000 (USD 0.63) per bird.  During the 
first two days of the campaign, 211 feral doves were shot, 
some of which were eaten by locals to celebrate Vietnam's 
success at the Southeast Asian Games held in the Philippines 
last week. 
 
¶15.  (SBU) In response to such drastic measures, the WHO and 
FAO submitted a letter to Deputy Prime Minister Dzung and 
MARD Minister Phat imploring the GVN not to cull wild bird 
populations.  In response, the GVN issued a letter on 
December 6 to the three Provincial People's Committees 
ordering them to halt the killing of pigeons and wild birds. 
The letter stated that the killing of pigeons and wild birds 
is not a national policy and that this practice is not only 
an inappropriate measure, but is also likely to cause bad 
effects to the ecosystem. 
 
Injecting Reason and Reassure 
----------------------------- 
 
¶16.  (U) On December 8, Deputy Prime Minister Pham Gia 
Khiem, quoting WHO and FAO sources, encouraged local people 
to consume safe poultry and poultry products.  The WHO and 
FAO provided guidance to GVN food safety authorities after 
growing concern among officials and public of contracting AI 
from consumption of poultry and eggs.  The three-page 
document states "In areas where there is no bird flu 
outbreak in poultry, there is no risk that consumers will be 
exposed to the virus via the handling of consumption of 
poultry and poultry products." 
 
¶17.  (U) On December 6, the Ministry of Natural Resources 
and Environment distributed guidelines to local authorities 
on how to correctly destroy and bury diseased poultry in 
order to protect the environment and prevent further spread 
of AI.  Before burial, staff wearing proper personal 
protective gear must chemically disinfect poultry. 
 
¶18.  (SBU) USAID Regional Infectious Diseases Advisor and 
EconOff from HCMC reported on how four provinces in the 
Mekong Delta have prepared for an AI outbreak (Ref B).  The 
report provides an in-depth look at surveillance and 
outbreak response, the nationwide poultry vaccination 
program, and the need to raise public awareness.  The 
principle finding is that strengthening surveillance and 
public awareness are essential for strengthening Vietnam's 
capacity to stem a possible AI epidemic. 
 
USG Assistance Underway 
----------------------- 
 
¶19.  (U) The U.S. Agency for International Development 
(USAID) has received approval from GVN to begin a rapid 
survey in two provinces on the most appropriate public 
education outreach materials for rural farmers.  The project 
will provide technical assistance and support to train 
information officers of the Ministry of Culture and 
Information in AI to ensure that correct and appropriate 
information is disseminated through the media.  The project 
also has an AI Behavior Change Communication activity under 
which a local firm, Ogilvy Public Relations, will train 600 
reporters in Hanoi, Hue and HCMC on AI reporting during 
December. 
 
¶20.  (U) The U.S. Department of Agriculture (USDA) will host 
an AI diagnostic training seminar in December for 20 
technicians in the Department of Animal Health in Hanoi. 
The USDA trainers will bring equipment and supplies 
including an additional real-time PCR machine, which can 
identify the genetic makeup of the virus in a specimen, to 
complement the more antiquated diagnostic equipment the 
Vietnamese currently use.  This training will prepare the 
Vietnamese participants for using six new real-time PCR's 
scheduled to arrive later this month.  Proper use of the 
machines will substantially enhance Vietnam's ability to 
track the spread of AI in poultry. 
 
"...And Treatment for All" 
-------------------------- 
 
¶21.  (U) The Ministry of Health (MOH) has proposed to the 
GVN to guarantee free treatment to expatriates, in addition 
to Vietnamese who have contracted AI.  Vice Minister Trinh 
Quang Huan told reporters on December 6 that the MOH has 
proposed a free treatment policy for foreigners who have 
been living and working in Vietnam. 
 
MARINE