VZCZCXRO9138
OO RUEHAST RUEHCHI RUEHDH RUEHDT RUEHHM RUEHLN RUEHMA RUEHNH RUEHPB
RUEHPOD RUEHSL RUEHTM RUEHTRO
DE RUEHBK #1966/01 2230107
ZNR UUUUU ZZH
O 110107Z AUG 09
FM AMEMBASSY BANGKOK
TO RUEHC/SECSTATE WASHDC IMMEDIATE 7841
INFO RUEHCHI/AMCONSUL CHIANG MAI 6847
RUEHBJ/AMEMBASSY BEIJING 7307
RUEHUL/AMEMBASSY SEOUL 5659
RUEHKO/AMEMBASSY TOKYO 1789
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUCNASE/ASEAN MEMBER COLLECTIVE
RUEHKT/AMEMBASSY KATHMANDU 7513
RUEHSV/AMEMBASSY SUVA 0474
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHPH/CDC ATLANTA GA
RUEHRC/USDA FAS WASHDC

UNCLAS SECTION 01 OF 02 BANGKOK 001966 
 
SIPDIS 
SENSITIVE 
 
DEPARTMENT FOR OES/IHB:JJONES,CPATTERSON; EAP FOR DHANNEMAN 
DEPT FOR USAID/GBH 
USDA FOR FAS AND APHIS 
HHS FOR CDC 
USCINCPACLO FOR AFRIMS 
 
E.O. 12958: N/A 
TAGS: KFLU AEMR ASEC CASC TBIO KSAF KPAO PREL PINR AMGT
MG, ECON, EAID, WHO, EAGR, ETRD, TH 
SUBJECT:  H1N1 Vaccine development in Thailand 
 
REF: BANGKOK 01359 
 
BANGKOK 00001966  001.2 OF 002 
 
 
SENSITIVE BUT UNCLASSIFIED 
 
¶1. (SBU) SUMMARY:  Thailand's Government Pharmaceutical Organization 
(GPO) is moving ahead with its program to produce H1N1 vaccines 
later this year.  H1N1 continues to make headline news with the 
country's first prenatal infection, 81 deaths, over 10,000 cases and 
as many as 500,000 suspected cases.  The Ministry of Public Health 
(MoPH) has stopped updating H1N1 case data on a daily basis.  The 
MoPH is distributing Tamiflu without charge to reach more of those 
in need, but many private clinics are not joining in the effort. 
The U.S. agencies CDC and AFRIMS co-hosted with the MoPH a 
conference on Zoonotic and Vector-Borne Diseases.  END SUMMARY. 
 
THAILAND VACCINE PRODUCTION 
--------------------------- 
¶2. (SBU) Thailand is moving ahead with H1N1 nasal vaccine production 
plans, which could place it as one of the first nations to produce 
an H1N1 vaccine.  The World Health Organization (WHO) granted a 
sublicense agreement to Thailand's GPO to access Russian technology 
and use seed virus to produce live attenuated influenza vaccine. 
Thailand plans to start a phase I-II vaccine trial in early 
September.  The two-part trial will take an estimated 90 days to 
complete.  The first part will assess the safety-tolerability and 
optimal immune response of the newly manufactured PLAIV candidate 
strain.  The second part will use the suitable dose obtained from 
part A and study the safety and efficacy of the vaccine.  In 
December GPO plans to submit the vaccine to FDA for final approval 
after which vaccinations will begin. (Reftel) 
 
¶3. (SBU) There is also a separate initiative from the WHO/GPO live 
attenuated influenza virus (LAIV) project in which Thailand's 
biotechnology agency BIOTEC is supporting Dr. Prasert Urworakul of 
Siriraj Hospital to prepare pandemic influenza vaccine seeds as part 
of Thailand's self reliance objective.  They have succeeded in 
producing seed viruses but have not yet tested for safety or 
efficacy.  (Note: the WHO/GPO LAIV project uses seed strains from 
Russia that have already been well tested. End Note.) 
 
H1N1 MAKES HEADLINE NEWS 
------------------------ 
¶4. (U) H1N1 news continues to make headlines.  Press news about the 
decline in tourism has been widely reported and one of the concerns 
sited is the outbreak of H1N1.  The increased risk to pregnant women 
made front page news in Thailand recently when the country's first 
confirmed case of pre-natal H1N1 infection was announced.  The baby 
fully recovered but the mother died.  Details about the case were 
sent to the WHO for further examination.  In an effort to avoid 
public frenzy the MoPH, which publicizes the number of confirmed 
cases, has announced it will only release information on confirmed 
cases once a week instead of daily.  To date there have been 10,045 
confirmed infections and 81 deaths, although MoPH estimates that 
over 500,000 may have contracted H1N1 in Thailand.  (Note: 
Thailand's reported data indicate a disease spread greater than in 
neighboring countries, but it is not clear whether that results from 
a larger epidemic, or from a more well-developed reporting system.) 
 
 
¶5. (U) MoPH officials have announced that the rate of transmission 
is declining though they note that the data is showing more cases in 
rural areas and fewer in Bangkok.  Over 60 percent of deaths have 
been from patients that suffered from underlying issues such as 
heart, liver and lung diseases; many of the people who have died 
were also late in seeking medical treatment.  Health volunteers are 
visiting households across the country to educate families about the 
disease and ways to protect themselves from being infected. 
 
¶6. (U) The MoPH is providing state and private clinics with free 
anti-viral Oseltamivir phosphate (the generic form of Tamiflu) to 
give to flu patients.  The Government Pharmaceutical Organization 
(GPO), which manufactures Tamiflu, has enough to treat 10 percent of 
the population.  GPO is currently producing 20 million tablets and 
will import raw materials to produce 40 million more.  The GPO 
 
BANGKOK 00001966  002.2 OF 002 
 
 
produces Tamiflu at a cost of approximately $0.75 per tablet.  The 
MoPH hopes that the free distribution of antiviral drug will prevent 
delayed treatment of patients with severe flu cases.  Clinics will 
receive 50 tablets of Tamiflu, enough to treat five people.  Only 
doctors at clinics will be allowed to prescribe the antiviral drug 
and all patients treated with Tamiflu must be closely monitored. 
The Ministry of Public Health has so far found that few clinics 
nationwide have agreed to participate in this free distribution 
because they do not want to shoulder the burden of monitoring.  In 
particular, specialized clinics providing medical care for pregnancy 
and chronic diseases are not participating in this project for fear 
that their patients, who are in high-risk categories, may contract 
the virus from flu patients who would come to the clinic for the 
free antiviral drugs. 
 
U.S. AND THAI ZOONOTIC AND VECTOR-BORNE DISEASES 
--------------------------------------------- --- 
¶7. (SBU) The Armed Forces Research Institute of Medical Sciences 
(AFRIMS) and U.S. Centers for Disease Control and Prevention (CDC) 
held the first scientific conference on "Zoonotic and Vector-Borne 
Diseases" on June 25-56, 2009 in Bangkok, Thailand.  Ambassador John 
presided over the opening ceremony.  Partnering for this seminal 
event on Zoonotic and Vector-Borne Diseases were Major General 
Krisada, Director General, AFRIMS; COL James W. Boles, Commander 
US-AFRIMS; Dr. Michael Malison, Director, Thailand MOPH - U.S. CDC 
Collaboration (TUC) and US CDC Regional Office in Thailand; and Dr. 
Susan Maloney, Director International Emerging Infections Program 
(IEIP) and Global Disease Detection (GDD) Center, TUC, US CDC 
Regional Office. 
 
¶8. (SBU) Initial reviews of the conference were positive. 
Approximately 170 public health scientists from Thailand and the 
Asia-Pacific region joined this inaugural scientific conference to 
share scientific information on emerging and reemerging infectious 
diseases which currently pose public health threats to the region. 
In addition to updating their knowledge on regionally important 
diseases such as dengue, influenza, malaria, and chikungunya, 
participants also learned about national and regional partners and 
activities, and discussed ways to foster research collaborations and 
programmatic networking. 
 
¶9.  (U) AFRIMS in Bangkok is producing a bimonthly report on 
influenza surveillance.  It contains summarized influenza testing 
results from samples collected in the region.  The information is 
sent to stakeholders within South and Southeast Asia region that 
work on influenza in order to highlight global influenza activity. 
 
PRESS BRIEFING ON H1N1 
---------------------- 
¶10. (SBU) On July 22 the Ministry of Public Health held a Press 
Briefing on H1N1 status update. Dr. Michael Malison, the Director of 
TUC and the CDC Regional Office in Thailand, updated the media on 
current H1N1 status in the United States.  Dr. Malison also took the 
opportunity to commend the Ministry of Public Health on their 
efforts to contain the outbreak, reduce transmission and minimize 
mortality in high risk groups.  Thailand has proven itself as a 
leader on H1N1 vaccine development.  Experts agreed that Thailand 
will become a regional vaccine production center in the near future. 
 
 
¶11. (U) POC is regional/bilateral ESTH officer Hal Howard, 
howardhh@state.gov. 
 
COMMENT: 
-------- 
¶12. (SBU) While Thailand is expected to become an important regional 
vaccine production center in the future, Post believes that the 
timeline Thailand's health officials are asserting is overly 
ambitious. 
 
JOHN