VZCZCXYZ0021
RR RUEHWEB

DE RUEHAM #2068/01 0810618
ZNR UUUUU ZZH
R 220618Z MAR 06
FM AMEMBASSY AMMAN
TO RUEHC/SECSTATE WASHDC 9053
RUEHPH/CDC ATLANTA GA
RUEHRC/USDA FAS WASHDC
RUEHNC/AMEMBASSY NICOSIA 0855
RUEHAK/AMEMBASSY ANKARA 0402
RUEHFR/AMEMBASSY PARIS 1199
RUEHLO/AMEMBASSY LONDON 1020
RUEHRO/AMEMBASSY ROME 1364
RUEHIT/AMCONSUL ISTANBUL 0099
RUEHTV/AMEMBASSY TEL AVIV 4089
RUEHDM/AMEMBASSY DAMASCUS 3237
RUEHEG/AMEMBASSY CAIRO 2262
RUEHBY/AMEMBASSY CANBERRA 0086
RUEHJM/AMCONSUL JERUSALEM 3790
RUEHBS/AMEMBASSY BRUSSELS 0205
RUEHGV/USMISSION GENEVA 0484

UNCLAS AMMAN 002068 
 
SIPDIS 
 
STATE PASS USAID FOR GLOBAL HEALTH/K HILL, D CARROLL 
USDA FOR APHIS 
STATE FOR M/MED DASHO DR. TRIPLET 
GENEVA FOR WHO REPRESENTATIVE 
ROME PASS US MISSION FAO 
OES FOR SINGER, DALEY 
NEA FOR RA/LAWSON 
 
SENSITIVE 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: TBIO KFLU XF JO
SUBJECT: AI Task Force Meets With Diplomatic Community, 
Jordan Officials 
 
REF: A) Amman 905 
B) Amman 457 
C) 05 Amman 9923 
D) 05 Amman 9093 
 
SENSITIVE BUT UNCLASSIFIED.  HANDLE ACCORDINGLY. 
 
¶1.  (SBU) Summary:  Embassy Amman's Avian Flu Task Force met 
with representatives from other embassies, Amman-based UN 
organizations and the Government of Jordan (GoJ) on March 2, 
2006 to share information on avian flu preparedness.  All 
participants are following similar lines of action: 
stocking Tamiflu, tracking the progress of avian flu, 
informing their staff and community, and evaluating 
contingency plans for staff drawdowns.  WHO representative 
said that Jordan is among the best-prepared countries in the 
region.  The GoJ reported minimal contact with the 
Government of Syria on avian flu, despite overtures.  End 
Summary. 
 
¶2.  (U) The following minutes were developed from the 
discussion at the meeting, and were distributed on March 14 
to all participants and to Embassy Amman's Avian Flu Task 
Force.  All information below was current as of early March; 
some may now be incomplete (e.g., AI outbreak in Israel) or 
otherwise OBE'd. 
 
BEGIN MINUTES OF MARCH 2 MEETING: 
 
--------------------------------------------- -------- 
Current Status of Avian Flu in Birds and in Animals 
--------------------------------------------- -------- 
 
¶3.  (SBU) Dr. Scott Kennedy (U.S. Regional Medical Officer) 
gave an overview of the avian influenza outbreak.  There 
have been 169 human cases, with a mortality rate of nearly 
50%.  H5N1 avian flu has been found in 28 countries, 
including human cases in nearby Turkey and Iraq.  The 
potential for a major pandemic is increasingly real, but 
there has been no sustained human-to-human transmission to 
date.  H5N1 in birds is almost inevitable in Jordan, he 
said, but the GoJ is doing a great job in preparing, a 
sentiment echoed by Dr. M.Z. Ali Khan of WHO.  Little is 
known about avian flu preparedness in Syria, which is a 
major concern.  Dr. Adel Belbessi, Director of Disease 
Control at the  Jordanian Ministry of Health, said Jordan 
has almost no contact with Syria on avian flu, despite 
requests to Syria for cooperation.  His contacts with the 
Palestinian Authority and Israel are much better. 
 
¶4.  (U) Dr. Kennedy noted concern over secondary infections 
from bacterial pneumonia following an avian flu outbreak, 
and suggested that organizations and governments purchase 
appropriate vaccines, which have a long shelf life. 
 
¶5. (U) Dr. Neyla Gargouri Darwaza, Head of Surveillance, 
Jordanian Ministry of Health, said that a vaccine for human 
H5N1 is unlikely to be available in time for an outbreak. 
Dr. Kennedy said that H5N1 vaccine research is promising, 
and resulting vaccines may offer at least partial 
protection. 
 
------------------------- 
U.S. Embassy Preparations 
------------------------- 
 
¶6.  (U) The American Embassy has created an Avian Influenza 
 
Task Force and has generated "tripwires" to assist with 
contingency planning.  The embassy needs to determine what 
it can do and what is beyond its control.  Good planning may 
help to delay and contain the onset of pandemic flu, which 
would be a major benefit.  More cases mean a higher chance 
of reassortment and an easily transmissible version. 
 
¶7.  (U) The U.S. Embassy is emphasizing two things: basic 
knowledge about H5N1, and practical preparedness measures 
related to health and hygiene.  There is no double standard 
or "inside" information: the same information is available 
to the American citizen community and the Embassy staff. 
Self-quarantining, with adequate food, supplies and 
water, is an effective countermeasure, although there are 
security concerns about that policy.  People should also 
have a long-term supply of their personal medications.  A 
community-wide response is needed. 
The Embassy has contingency plans for reducing staff, but no 
one knows whether commercial air transportation will be 
possible in an outbreak. 
 
--------------------------------------------- ------------ 
Jordan's Actions on Avian Flu Prevention and Preparedness 
--------------------------------------------- ------------ 
 
¶8.  (U) Dr. Salwa Qteit (USAID Development Assistant 
Specialist, Population and Health Section) gave an overview 
of avian flu preparations by the Government of Jordan (GoJ). 
Jordan has been preparing seriously for avian flu.  It has 
an interagency avian flu steering committee at the minister 
level that is chaired by the Prime Minister.  There is also 
an interagency technical committee on avian flu, chaired by 
the Minister of Health.  The GoJ has developed an avian 
influenza preparedness plan.  The first version was printed 
in September 2005 and it has been updated regularly since 
then.  The GOJ has allocated JD 6 million to implement that 
plan, which addresses interagency coordination, 
responsibilities, health services, treatment, equipment, 
outreach and education. 
 
¶9.  (U) Dr. Belbessi acknowledged that the lack of funds to 
compensate farmers whose flocks would have to be destroyed 
because of H5N1 is a major issue.  Funds have been 
requested.  The Royal Society for the 
Conservation of Nature has banned hunting in Jordan and is 
collecting dead wild birds for testing by appropriate 
laboratories. 
 
¶10.  (U) The Ministry of Health has six epidemiologists 
trained by the U.S. Centers for Disease Control's Field 
Epidemiology Training Program (FETP).  Those six people 
supervise 18 district-level surveillance teams.  The 
Ministry of Health has 16 labs across the country with two 
trained persons per lab.  Those labs can do a rapid test for 
H5N1 in 15 minutes.  Three labs (Ministry of Health, Jordan 
University of Science and Technology - JUST, Ministry of 
Agriculture) can do Polymerase Chain Reaction (PCR) tests, 
which are used as the definitive test, required before the 
GoJ will confirm presence of H5N1.  If the PCR test is 
positive, the lab will send a sample to the U.S. Embassy's 
Naval Medical Research Unit (NAMRU-3) in Cairo.  The 
Ministry of Health has designated a point-of-contact at each 
hospital to be the focal point for avian flu information and 
programs. 
 
¶11. (U) The Ministry of Agriculture has three labs (north, 
central, south).  There are animal health surveillance teams 
 
in each governorate, and they collect 750 samples a month. 
Processing these samples imposes a significant burden on the 
laboratories.  MOA has sent staff to Italy for advanced 
training in avian flu. 
 
¶12. (U) The Ministry of Health has allocated JD 3.7 million 
for purchase of Tamiflu.  They have 50,600 courses of 
Tamiflu in stock now.  Another 250,000 courses will be 
delivered in August 2006.  Dr. Belbessi said that the 
Ministry of Health asked for JD 10 million and was given JD 
6 million.  Of this amount, the Ministry of Health was 
allocated JD 5 million and the Ministry of Agriculture JD 1 
million.  In addition to the JD 3.7 million for Tamiflu, the 
Ministry of Health spent JD 1 million to purchase personal 
protective equipment.  Most of the rest has been spent on 
training, he said.  The Ministry has adequate supplies for 
now, but both staff and materials would be in short supply 
during an outbreak.  The Food and Agriculture Organization 
has ordered additional PCR testing kits for Jordan, but Dr. 
Belbessi was not sure of the quantity. 
 
¶13.  (U) Dr. Belbessi said that the Ministry of Health and 
the Ministry of Agriculture are planning an on-the-ground 
simulation exercise on avian flu response.  This will be 
announced. 
 
¶14.  (U) Dr. Naffa (WHO) said that a committee is evaluating 
all of Jordan's health labs and that a report will be out 
soon.  There has also been a program to identify all of 
Jordan's medical assets, both human and physical resources. 
 
----------------------------- 
Jordan's Public Outreach Plan 
----------------------------- 
 
¶15.  (U) Dr. Qteit said that the Ministry of Health has a 
USAID-funded program with Johns Hopkins University on health 
communication, and they are working on avian flu.  The main 
goals of the program are fear alleviation, and building 
awareness among professional groups and the public.  The 
project has disseminated health tips to TV and newspapers, 
provided background material for journalists, had panel 
discussions, established hotlines and provided material for 
television broadcasts.  Dr. Belbesi clarified that the broad 
outlines of the public education campaign are done, but it 
is not yet finalized.  The goal is to reach the public to 
minimize risk and dangers.  Dr. Darwaza said that the 
preparedness plan is divided into two sections, pre-pandemic 
and pandemic, and that they are still working on the section 
for pre-pandemic communication. 
 
------ 
Rumors 
------ 
 
¶16.  (U) In response to a question about rumored H5N1 
outbreaks, Dr. Belbessi said categorically that there have 
been no confirmed H5N1 cases in birds or people in Jordan. 
He assured that Jordan would transparently inform the media 
of any cases.  Dr. Darwaza said there was recent culling for 
Newcastle disease, perhaps giving rise to the rumors. 
Routine testing of dead birds may also create rumors. 
 
------------------------------ 
WHO Office Role and Activities 
------------------------------ 
 
¶17.  (U) Acting WHO Representative Dr. M. Z. Ali Khan said 
that WHO is the lead on avian flu for the UN Country Team. 
There is a UN Country Plan for avian flu in Jordan that is 
based on WHO's global plan that focuses on staff and 
families.  Vaccines, drugs and protective equipment are 
available for staff.  Dr. Sana Naffa, UNAIDS Country 
Officer, WHO is the focal point.  WHO's role in Jordan is to 
strengthen the capacity of the Jordanian health sector on 
avian flu, in coordination with the Ministry of Health and 
the Ministry of Agriculture.  WHO publishes bulletins on 
avian flu.  WHO has avian flu teams in Geneva and Cairo that 
can be mobilized to respond to outbreaks.  WHO Geneva has a 
stockpile of Tamiflu that can be used to address "hot 
spots."  Both WHO Geneva and WHO Cairo have avian flu 
websites. 
 
¶18.  (U) WHO had an avian flu mission to Jordan on February 
6-10, and the findings are being finalized.  Jordan can 
prepare a proposal to the WHO's Cairo office for further 
assistance.  WHO works with the Food and Agriculture 
Organization (FAO) and the World Animal Health Organization 
(OIE) on a joint avian flu task force.  WHO is assessing 
preparedness in each country. 
 
------------------------------- 
Preparedness at Other Embassies 
------------------------------- 
 
¶19.  (U) Mr. Frederic Bontemps (First Secretary, French 
Embassy) said that France has a national plan that includes 
overseas citizens.  His embassy has passed information on 
avian flu to the French community in Jordan.  The French 
Embassy has an avian flu hotline, and a procedure in place 
for providing Tamiflu to French citizens and embassy staff 
and their families who request it from the Embassy's 
stockpile. 
 
¶20.  (U) Ms. Angelina Eichhorst (EU Mission Public Health 
Advisor) said that the European Delegation has Tamiflu 
available for its local and expatriate staff.  The EU is 
prepared to assist countries on avian flu projects, but has 
not received any proposals from Jordan.  Specific proposals 
for assistance from the EU are welcome.  The EU is 
contributing to the World Bank's Trust Fund for avian 
influenza.  Dr. Darwaza said that Jordan is working on a 
proposal to the World Bank to assist with Jordan's needs. 
 
¶21.  (U) Ms. Alison Banks (Management Officer, UK Embassy) 
said that the UK Embassy has a Jordan contingency plan that 
was developed from a template sent from London and which 
follows the WHO model.  Staff and dependents have been 
inoculated for flu.  When the WHO alert level on avian flu 
reaches four, the Embassy will begin repatriating staff. 
 
¶22.  (U) Ms. Roz McKenzie (Second Secretary, Australian 
Embassy) said that Australian Embassy preparations were 
similar to those of the UK Embassy.  There are no local 
stockpiles of drugs or protective equipment; stockpiles are 
kept in Australia and will be sent on an as-needed basis 
around the world. 
 
------------------------- 
Status of Poultry Imports 
------------------------- 
 
¶23.  (U) The EU's Ms. Eichhorst asked about the status of 
poultry imports and whether there was a total ban.  Embassy 
 
 
Econ Counselor Richard Eason said he believed that a total 
ban was applied initially, and that since then, exceptions 
have been made to allow imports from areas free of avian 
flu. 
 
---------- 
Outcomes 
---------- 
 
¶24.  (U) Several participants noted the value of cooperation 
within Jordan between embassies, UN organizations and the 
Government of Jordan.  Dr. 
Kennedy suggested that a regional conference in Amman would 
be particularly useful. 
 
¶25.  (U) Meeting minutes and a list of participants were 
distributed to everyone who was at the meeting. 
 
----------------- 
Participants 
----------------- 
 
¶26.  (U) Delegation of the European Union (Mr. Michel Laloge 
and Ms. Angelina Eichhorst; Second Secretary, Embassy of 
Australia (Ms. Roz McKenzie); First Secretary, Embassy of 
France (Mr. Frederic Bontems); Management Officer, Embassy 
of the United Kingdom (Ms. Alison Banks); Embassy of the 
United States (Mr. Richard Eason, Economic Counselor, Mr. 
Dan Goodspeed, Consul General, Dr. Scott Kennedy, Regional 
Medical Office, Dr. Salwa Qteit, US AID Development 
Assistant Specialist, Ms. Rana Safadi, Regional Environment 
Office, Mr. Jock Whittlesey, Regional Environment Office, 
Mr. Bill Densmore, Regional Security Office, Ms. Alison 
Kilani, Regional Medical Office, Ms. Jenny Gilbert, Regional 
Medical Office, Ms. Laurene Abu Anza, Peace Corps, Mr. Samir 
Dahshan, Peace Corps); Government of Jordan (Dr. Adel 
Belbessi and Dr. Neyla Gargouri Darwaza); World Health 
Organization (Dr. M. Z. Ali Khan and Dr. Sana Naffa). 
 
HALE