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

051518Z Dec 05

UNCLAS SECTION 01 OF 02 KINGSTON 002643 
 
SIPDIS 
 
DEPARTMENT FOR WHA/CAR (BENT) 
 
E.O. 12958: N/A 
TAGS: TBIO SENV ECON EAGR EAID PREL JM
SUBJECT: RESPONSE TO INFORMATION REQUEST: AVIAN AND PANDEMIC 
INFLUENZA 
 
REF:      A) STATE 209622 
 
     B) KINGSTON 2306 
 
¶1. (U) This cable responds to information requested by 
Department (Ref A).  It is a joint State-USAID message. 
Answers are updated from information provided by post (Ref 
B). 
 
¶2. (U) Responses are keyed to Ref A. 
 
A) PREPAREDNESS/COMMUNICATION 
 
-- The Government of Jamaica (GOJ) has a draft entitled: 
"Influenza Pandemic Preparedness Plan" that, to date, has 
not been finalized.  The primary areas that still need to be 
addressed involve budget assistance and persons/agencies of 
final responsibility.  The draft plan covers five topics: 
Planning and Coordination; Human and Animal Surveillance; 
Prevention and Containment; Health System Response; and, 
Communications.  Post will forward a hard copy of the draft 
plan at the Department's request.  Electronic copies are not 
currently available. 
 
-- GOJ is typically very open on many issues.  However, the 
GOJ's openness and transparency may depend on the 
circumstances of an initial outbreak.  If, as is likely, the 
first signs of an infection occur in a rural area, fears of 
an adverse effect on the tourism industry may prompt an 
effort by authorities to manage the problem quietly.  On a 
positive note, the GOJ has shown itself proactive in the 
airing of a public education campaign in the print media 
about the disease and its dangers. 
 
-- An Avian Influenza (AI) human pandemic is not currently 
high among government priorities.  Once the disease is more 
prevalent in the Western Hemisphere, or if the GOJ comes to 
understand that the tourism industry could be affected, it 
will gain traction.  The GOJ simply has greater priorities 
such as high levels of violent crime, upcoming general 
elections, and few resources to allocate.  Given these 
constraints, the GOJ would be obliged to spend funds now - 
funds they do not possess - to guard against an issue, the 
risk of which is still perceived as minimal.  The key 
figures for USG officials to engage are Dr. Headley Edwards, 
Director of Veterinary Services at the Ministry of 
Agriculture, and Dr. Elizabeth Ward at the Ministry of 
Health.  These officials in themselves indicate the priority 
that the GOJ places on AI.  While both are respected 
professionals, neither is at the level of decision-making 
that would enable swift and decisive action. 
 
-- While Post knows of no systematic review of national laws 
to ensure consistency with international health regulations, 
GOJ follows Pan American Health Organization (PAHO) 
guidelines, who in turn follow WHO guidelines.  Although 
there are no legal or regulatory barriers to Avian Influenza 
detection, reporting, containment and response, GOJ has 
indicated that the monitoring capacity of the Ministry of 
Agriculture laboratories would be insufficient to handle a 
pandemic-level outbreak. 
 
-- As reported in Ref B, GOJ has been somewhat proactive in 
reaching out to the international community.  The GOJ has 
been working with PAHO on the issue, and has good relations 
with CDC and with the Caribbean Regional Epidemiological 
Center (CAREC).  GOJ has asked what the USG can contribute 
on any level, be it materiel, vaccine or funding.  USAID 
communication with the rest of the international donor 
community has revealed little outreach.  While GOJ is likely 
to be receptive to any approach that involves financial aid, 
interlocutors reiterated their concern that Jamaica (and 
other small Caribbean nations) may become a low priority 
concern in the event of a pandemic.  Financial assistance 
would be welcomed by the GOJ in return for their efforts to 
combat the spread of the disease. 
 
-- Jamaica does not currently implement a national flu 
vaccine program, as it does with other diseases such as 
polio and MMR.  GOJ gave no indication as to whether they 
would be receptive to doing so, but the policy is under 
review.  Jamaica neither develops trivalent flu vaccine for 
human influenza, nor for poultry influenza, nor is Jamaica 
developing an H5N1 vaccine.  All vaccines are imported from 
abroad, although statistics on how much and from which 
countries have not been obtained. 
 
-- Although there has been a public campaign, it has been a 
muted one only seen in the print media.  Particularly in 
rural areas, radio is the main source of news and 
information for the populace, and Post is unaware of any 
outreach through this medium.  While there are public sector 
health clinics where citizens can obtain information about 
the disease, a greater public outreach campaign is required. 
The Rural Agriculture Development Agency (RADA) is making 
some effort, but often it is reactive.  In addition, RADA is 
sharply hindered by a lack of resources. 
 
B) SURVEILLANCE/DETECTION 
 
-- In general, the medical and agricultural sectors are 
capable of identifying a new strain of influenza among 
people or animals.  However, Jamaica has limited capacity 
for testing.  USAID's HIV/AIDS outreach has exposed critical 
gaps in this arena, most notably in rural areas.  All 
capable testing centers are in the capital, Kingston, at GOJ 
and academic laboratories.  Given that the rural areas are 
the most likely to see the first outbreak, there may be a 
significant delay in detection.  The GOJ can send samples to 
CAREC and/or to the United States for further testing and 
confirmation, but CAREC is already overstretched, and would 
lack the ability to perform effectively in the event of a 
Caribbean pandemic.  Embassy contacts expressed a desire to 
obtain more equipment for testing, more reagent, more test 
kits and more lab technicians. 
 
-- The most critical gaps that remain to be addressed are 
front-end: clinical surveillance and detection.  Jamaica 
must strengthen its public laboratory capacity.  To do this, 
equipment, supplies and personnel are all needed.  This 
capacity-building would allow for faster, more efficient 
testing with a view to containment once diagnosed. 
Following identification of an outbreak, GOJ lacks a 
coherent, written strategy for overall management of a 
pandemic.  Jamaica must also develop a national 
communication strategy, as well as guidance on intervention: 
practical assistance on school closures, isolation, internal 
travel, and port-of-entry monitoring. 
 
C) RESPONSE/CONTAINMENT 
 
-- GOJ has no stockpile of medications, and orders have not 
yet been placed.  GOJ sources told emboffs that since they 
lack treatment protocols, they are reluctant to order drugs. 
Before the GOJ has established what drugs it requires, in 
what quantities, and at what doses, it cannot spare the 
financial resources to order them.  Post will continue to 
engage the GOJ this issue, by encouraging interaction with 
PAHO and WHO to establish such protocols. 
 
-- The country has no stockpile of pre-positioned personal 
protective gear. 
 
-- As discussed above, GOJ currently lacks a specific 
strategy for rapid response.  No written guidelines are in 
place for culling and vaccination of birds, disinfection of 
facilities, and movement restrictions. 
 
-- GOJ certainly possesses the political will to impose 
quarantine and social distancing measures.  The question of 
capability is more hypothetical, but post believes that the 
use of the disciplined and well respected Jamaica Defense 
Force (JDF) would be likely to probable, as in the event of 
a pandemic outbreak, the Jamaica Constabulary Force (JCF, 
the police) would lack the credibility and professionalism 
to complete the task. 
 
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Comment 
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¶4. (U) Given the large number of U.S. tourists that frequent 
Jamaica, poor preparedness and limited detection and 
management capabilities could quickly have an impact on the 
United States and the spread of AI among U.S. citizens.  At 
the same time, however, restrictions on travel to Jamaica 
would have a devastating effect on Jamaica's economic 
situation.  Post will continue to encourage the GOJ to raise 
awareness of the disease among the population, especially in 
rural areas, and to place management of a potential pandemic 
at a higher priority level in the national agenda.  The 
GOJ's limited financial resources and currently perceived 
low risk may preclude this at present. 
 
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End Comment 
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¶5. (U) Post will continue to follow this issue and will 
update accordingly. 
 
TIGHE