VZCZCXRO2117
PP RUEHDBU RUEHIK RUEHPW RUEHYG
DE RUEHBUL #3983/01 3371402
ZNR UUUUU ZZH
P 031402Z DEC 07
FM AMEMBASSY KABUL
TO RUEHC/SECSTATE WASHDC PRIORITY 1624
RUEHIL/AMEMBASSY ISLAMABAD PRIORITY 5948
RUCNAFG/AFGHANISTAN COLLECTIVE
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC 0088
RUEHPH/CDC ATLANTA GA

UNCLAS SECTION 01 OF 02 KABUL 003983 
 
SIPDIS 
 
 
DEPT FOR SCA/A AND THE AVIAN INFLUENZA ACTION GROUP (G-AIAG), 
ISLAMABAD FOR USDA 
 
SIPDIS 
 
E.O. 12958 N/A 
TAGS: ESTH AIAG PGOV PREL EAGR SENV AF
 
SUBJECT: AFGHAN SUPPORT FOR NEW DEHLI AVIAN FLU CONFERENCE AND 
PREPARATIONS IN COMBATING POSSIBLE AVIAN FLU OUTBREAK 
 
REF:  STATE 159330 
 
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Summary 
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¶1.  (U) Embassy confirmed Afghan attendance at the New Delhi Avian 
and Pandemic Influenza Conference (reftel).  Afghan Ministry of 
Agriculture Ubaidulla Ramin and Minister of Public Health Dr. Sayed 
Mohammad Amin Fatimi are scheduled to attend the conference, along 
with four others including their respective avian flu coordinators, 
Dr. Azizullah Osmani (Agriculture) and Dr. Jawad Mofleh (Public 
Health).  However, the applicants do not yet have Indian visas and 
hope to receive them shortly. 
 
¶2.  (U) The Embassy continues to work closely with Afghanistan 
authorities and locally-based international health organizations to 
monitor events and offer assistance in combating avian flu; in the 
past three weeks, both the Embassy and Afghanistan-based US 
Department of Defense (DoD) elements, namely, Combined Security 
Transition Command - Afghanistan (CSTC-A) in Kabul and Combined 
Joint Task Force - 82 (CJTF-82) at Bagram Air Field, have held 
civil-military coordination workshops.  Avian flu monitoring is 
currently through the Disease Early Warning System (DEWS), funded by 
USAID and implemented through the Afghanistan Ministry of Public 
Health (MoPH).  The system is designed to detect any suspected 
outbreak of influenza like illness (ILI case definition - fever of 
38 degrees Celsius, cough, sore throat and dyspnea) in the country. 
MoPH and the Ministry of Agriculture, Irrigation and Livestock 
(MAIL) respond to reports of avian flu with Rapid Response Teams 
that are currently located in 12 of 34 provinces (Bamyan, Helmand, 
Kabul, Kandahar, Kapisa, Khost, Kunar, Laghman, Nangarhar, Paktia, 
Paktika and Zabul).  These nine member teams consist of Public 
Health and Agricultural officials and are charged with surveillance 
of zoonotic diseases, fever monitoring, and with raising awareness 
in the affected communities.  Per diem and transportation costs are 
covered by the U.S. Center for Disease Control (CDC).  USAID is 
funding the World Health Organization, which supports the training 
of these teams.  Training is conducted by the Afghanistan Public 
Health Institute and WHO technical staff. 
 
¶3.  (U) Afghanistan continues to make significant progress in the 
development of avian flu strategies and plans, primarily through the 
efforts of the Ministry of Public Health and the Ministry of 
Agriculture and Livestock, with the assistance of the Food and 
Agriculture Organization (FAO), UNICEF, the World Bank, the World 
Health Organization and USAID/USDA.  A NAMRU-3 (U.S. Naval Medical 
Research Unit-3) sponsored laboratory in Kabul has significantly 
improved Afghan ability to test for HPAI (H5N1) in animals and 
humans.  USAID Kabul resources continue to strengthen Afghan 
surveillance systems, particularly timely sample collection and 
reporting. 
¶4.  (U) Last year H5N1 was confirmed in Afghanistan in March, 2006 
and also earlier this year in February, 2007.  Following the 
confirmation of these cases, the Afghan Ministries of Agriculture 
and Public Health took appropriate measures, including the culling 
of infected domestic poultry.  The major pattern of bird 
deaths/infections in Afghanistan appears to be primarily centered on 
live bird markets, as "backyard farming" is the country's primary 
method of poultry production.  A large portion of the Afghan 
population raises chickens in their backyards to supplement diet and 
to provide a small source of income.  To date, no human cases have 
been reported but there remains a high probability of eventual 
animal to human transmission because of poor living conditions and 
sanitation, high rates of morbidity and mortality, and close human 
contact with animals/birds.  A lack of infection control procedures 
in limited provincial health facilities would complicate the 
appropriate treatment and control for any human case of H5N1. 
 
¶5.  (U) Further testing did not/not confirm October 2007 initial 
reports of the H5N1 strain of avian flu in Kandahar province. 
However, given the security situation in the provinces with the 
suspected cases, future monitoring and preventive efforts will be 
difficult.  MOPH Avian Influenza Coordinator Dr. Mofleh has noted 
severe challenges with limited access for governmental Rapid 
Response Teams as local leaders could not guarantee security.  In 
place of the teams, the IRoA trained locals to conduct sampling and 
fever monitoring, but did not expect much efficacy from such 
efforts.  The Ministry is concerned that using Afghan, U.S. or 
International Security Assistance Forces (ISAF) military force 
protection and military public health resources in 
security-challenged areas would further hinder its future public 
health efforts among the local population, but realizes that such 
resources may have to be used to prevent a wider public health 
 
KABUL 00003983  002 OF 002 
 
 
threat in the safe areas.  November 24 discussions with the Afghan 
Military, as well as ISAF and U.S. resources are a step towards 
devolvement of an appropriate security assistance plan if needed. 
 
DELL