VZCZCXRO6687
RR RUEHDU RUEHGI RUEHJO RUEHMR
DE RUEHKI #0357/01 0621159
ZNR UUUUU ZZH
R 031159Z MAR 06
FM AMEMBASSY KINSHASA
TO RUEHC/SECSTATE WASHDC 3308
INFO RUEHXR/RWANDA COLLECTIVE
RUCNSAD/SOUTHERN AFRICAN DEVELOPMENT COMMUNITY
RUEAUSA/DEPT OF HHS WASHDC

UNCLAS SECTION 01 OF 03 KINSHASA 000357 
 
SIPDIS 
 
SIPDIS 
 
DEPT ALSO PASS USAID FOR AID/W/AFR MHARVEY AND KODONNELL 
HHS FOR AVIAN FLU OFFICER 
 
E.O. 12958: N/A 
TAGS: TBIO KFLU EAID EAGR ECON SENV SOCI CG
AVIAN FLU 
SUBJECT: DRC: AVIAN INFLUENZA UPDATE 
 
REF: KINSHASA 1939 
 
¶1. (U) Summary.  The GDRC Avian Influenza Commission, 
composed of representatives from the Ministries of 
Agriculture, Health, External Commerce, and Environment, 
released the DRC Country Contingency Plan (CCP) on February 
¶24.  The CCP seeks over USD 16M to prepare for and respond 
to the anticipated arrival of Highly Pathogenic Avian 
Influenza (HPAI) in the DRC.  The pre-pandemic phase 
focuses on surveillance, equipment, and training; the 
approach/onset phase focuses on containment to slow 
transmission; and the declared pandemic phase includes 
case-tracking and treatment.  The plan highlights the DRC's 
lack of capacity to monitor, detect, and respond to HPAI, 
and notes that conditions in the DRC are conducive to rapid 
bird-to-bird, bird-to-human, and possibly human-to-human 
transmission of the virus, once introduced.  In a related 
development, a report out of south-central DRC says that 
migratory swallows, coming from European countries where 
confirmed cases of HPAI exist, are being captured and 
consumed in the DRC.  End summary. 
 
------------------------ 
DRC Avian Flu Commission 
------------------------ 
 
¶2. (U) The GDRC created an Avian Flu Commission (AIC) in 
late 2005, chaired by the Minister of Agriculture and 
composed of representatives from the Ministries of Health 
(Directorates of Disease Prevention and Border Health, 
National Institute of Bio-medical Research), Agriculture 
(Directorate of Animal Production and Health, Veterinary 
Laboratory of Kinshasa), External Commerce (Congolese 
Office of Control and its laboratory), and Environment 
(Directorate for the Protection of Flora and Fauna, 
National Institute for the Conservation of Nature).  The 
Commission resolved to reinforce the number of sanitary 
inspectors and police at all official border crossings and 
to strengthen sanitary measures on commercial poultry farms 
while monitoring those farms for signs of Highly Pathogenic 
Avian Influenza (HPAI).  The Ministry of Agriculture was 
charged with the monitoring, detection, and diagnosis of 
HPAI in the DRC.  The Commission charged the Ministry of 
Environment with the issue of migratory bird transmission 
of HPAI.  The plan was to work with the World Organization 
for Animal Health (OIE) and the World Health Organization 
(WHO) to identify and respond to suspected bird and human 
cases of the disease. 
 
-------------------------------- 
The DRC Country Contingency Plan 
-------------------------------- 
 
¶3. (U) On February 25, the AIC released its Country 
Contingency Plan (CCP) at a ceremony attended by high-level 
representatives from donor countries, the UN Mission to the 
DRC (MONUC), the World Bank, FAO, UNICEF, WHO, and other UN 
agencies.  The meeting was co-chaired by the Ministries of 
Agriculture, Health, and External Commerce. The CCP points 
out that the DRC lies along the path of many migratory bird 
species that come to Africa during the northern hemisphere 
winter in Europe and Asia, including many countries with 
HPAI. It estimates that there are over 20 million poultry 
(mostly chickens, but also ducks, turkeys, geese, and 
guinea fowl) in the DRC, 80 percent of which are 
free-range.  The document notes that many Congolese live in 
close proximity with their poultry, sometimes in the same 
house, and that this, combined with general lack of 
sanitation, could result in easy bird-to-bird, 
bird-to-human, and human-to-human transmission. 
 
---------------------- 
Health Sector Capacity 
---------------------- 
 
¶4. (U) In principle, the DRC is covered by 515 health 
zones, each with a central office, a referral hospital, and 
health centers.  The CCP notes, however, that the majority 
of these health zones do not have the capacity to provide 
even primary health care services.  Since 2000, with the 
start-up of the nationwide polio eradication program, a 
surveillance system has been in place that can alert 
authorities to outbreaks of certain infectious diseases. 
The CCP reports that there is also a viable system for the 
collection and transport of medical samples, but that DRC 
medical laboratories are not capable of testing for the 
HPAI virus strains.  The DRC, a post-conflict country, has 
 
KINSHASA 00000357  002 OF 003 
 
 
poor health infrastructure in general, little or no medical 
resources of its own, and is almost entirely dependent upon 
outside assistance for provision of health care services. 
 
--------------------------- 
Agriculture and Environment 
--------------------------- 
 
¶5. (U) The Ministry of Agriculture Directorate of Animal 
Production and Health, according to the CCP, suffers from 
insufficient personnel, logistical support, communication, 
and general capacity, especially at border posts far from 
large towns and cities.  The CCP is pessimistic that 
Ministry of Agriculture personnel would be able to monitor, 
detect, or react to the appearance of HPAI in the DRC.  The 
report concedes that the two functioning veterinary labs in 
Kinshasa and Lubumbashi have no ability to determine 
whether the H5N1 variety of HPAI is present in suspected 
samples. The CCP says that an E.U.-funded entity called the 
Pan-African Program for the Control of Epizootic Diseases 
(PACE), concerned mainly with cattle diseases such as 
rinderpest, might provide some monitoring and detection of 
HPAI in the DRC.  The report also cites the Environment 
Ministry's National Institute for the Conservation of 
Nature as a possible monitor for wild bird transmission of 
HPAI, but only in the small number of wildlife reserves and 
protected areas in the DRC.  The CCP notes that an informal 
radio network of GDRC ministries, NGOs, and UN agencies 
across the DRC could be called upon to provide nationwide 
emergency communication, even down to the village level. 
 
----------------------- 
Phase One: Pre-Pandemic 
----------------------- 
 
¶6. (U) The CCP divides the national approach to a possible 
HPAI pandemic into three phases: pre-pandemic, 
approach/onset of the pandemic, and a declared pandemic. 
The pre-pandemic phase is defined as the period during 
which there is the possibility of animal infection with the 
associated risk of transmission to humans.  Beginning 
March 2006, the CCP lays out immediate objectives and 
indicators, designates which GDRC ministry or international 
partner will be responsible for each program activity, and 
indicates the timeline for each activity.  The total budget 
for the pre-pandemic phase, from March through end April, 
is USD 13,720,000. Strategies include better communication; 
better monitoring of animal and human health; compensation 
for affected farmers; training for monitors and first 
responders; placement of equipment for rapid detection, 
transport, and analysis; and determination of needs for 
medicines and other treatments. 
 
------------------------------------- 
Phase Two: Approach/Onset of Pandemic 
------------------------------------- 
 
¶7. (U) The CCP approach/onset phase of the pandemic is 
defined as the period when human infections by HPAI are 
first noted in a localized area of infection, possibly with 
limited human-to-human transmission.  The specific CCP 
objective of this phase is stopping or slowing the 
transmission of the disease in humans.  Strategies include 
heightened surveillance for animal and human cases; support 
for prevention, treatment, and care of emergent cases; and 
provision of protective equipment to technical and at-risk 
personnel.  This phase is budgeted at USD 1,857,700 and was 
left open as a period of indeterminate length, depending 
upon the evolution of the epidemic. 
 
------------------------------ 
Phase Three: Declared Pandemic 
------------------------------ 
 
¶8. (U) The final phase of the CCP, during which 
human-to-human transmission is confirmed and the already 
large number of human cases continues to rise, aims to 
reduce morbidity, mortality, and "social disorganization," 
while the DRC supports research activity aimed at ending 
the pandemic.  Strategies include heightened animal and 
human surveillance; increased prevention efforts; support 
for care and research; and follow-up and evaluation.  This 
phase, with no timeline indicated, is budgeted for USD 
433,500.  The total budget for the three phases is USD 
16,011,200. 
 
---------------------------------------- 
 
KINSHASA 00000357  003 OF 003 
 
 
Ministry of Agriculture: Little Capacity 
---------------------------------------- 
 
¶9. (U) EconCouns met with the Ministry of Agriculture 
Secretary General Hubert Ali, a doctor of veterinary 
 
SIPDIS 
medicine.  Ali confirmed that the two functioning 
veterinary laboratories in the DRC, in Kinshasa and 
Lubumbashi, are not equipped to detect flu viruses of the 
highly pathogenic H5N1 variety.  As in Nigeria, samples 
would have to be flown to a laboratory outside the DRC, and 
it would be days before the results were known.  Ali 
admitted that preventing the entry of and detecting any 
outbreak of HPAI in the DRC would be extremely difficult, 
given the size of the country (DRC is approximately the 
size of the U.S. east of the Mississippi River) and the 
thousands of miles of land borders with its nine 
neighboring countries.  PACE (see para 5), he said, has 
hundreds of personnel in the DRC, including in the Bas 
Congo, Bandundu, and Equateur provinces that border on 
Congo Brazzaville. PACE radio and internet connections 
might allow for news of rural poultry or wild bird die-offs 
to be transmitted quickly to Kinshasa.  Ali, however, 
pointed out that Congolese villagers would be very reticent 
to report poultry die-offs and would be even more resistant 
to the voluntary culling of backyard flocks. 
 
----------------------------------- 
Migratory Birds in Southwestern DRC 
----------------------------------- 
 
¶10. (U) MONUC reported on February 24 that a joint OIE/WHO 
team traveled to Eastern Kasai province in mid-February 
in response to reports that banded migratory birds were in 
this area of south-central DRC, near the Angolan border. 
The team located and identified the remains of eight birds 
classified as swallows, all of which had carried bands 
identifying their points of origin in Europe.  Four had 
been banded in Hungary, two in Germany, one in Poland, and 
one at the British Museum in London.  All eight had 
apparently fallen prey to a common practice: during peak 
migration months (October through January, also a local 
"hungry season"), hunters place glue on branches where the 
birds roost at night.  Unable to fly away the next morning, 
the birds are collected by hand and consumed by local 
villagers.  The researchers were only able to retrieve the 
information contained on the bands, since the villagers 
believe that the bands themselves contain some magic power. 
There was no indication that any of the hundreds of 
swallows captured and consumed had died en route or been 
sickly.  Post has no information about whether there were 
plans to test swallows or their remains for HPAI.  The 
team's WHO physician found that infectious respiratory 
diseases were second only to malaria as the most common 
ailment in local health centers. 
 
¶11. (U) Comment.  The GDRC has been proactive on HPAI, 
given the potential here for the transmission and 
socioeconomic consequences of HPAI.  The DRC has previous 
experience in dealing with outbreaks of Ebola and Marburg 
virus.  DRC was one of the first sub-Saharan African 
countries to ban poultry products from countries with 
confirmed HPAI (reftel).  Poultry imports are now banned 
from nearly 30 countries with the recent addition of 
Nigeria, Italy, France, Germany, and Niger.  The DRC 
Country Contingency Plan is complete and well-thought-out, 
but also completely dependent upon outside resources that 
may not be forthcoming.  The CCP budget declines 
significantly from phase to phase when it should actually 
increase, since tracking and treatment are more expensive 
than standard surveillance.  The size of the country, its 
porous borders, the dependence of many of its citizens on 
backyard poultry flocks, and the inability of GDRC 
authorities to detect the arrival of HPAI may conspire to 
prevent a timely response and allow the virus to spread 
unchecked across the country. GDRC compensation for culled 
poultry and/or a nationwide poultry vaccination campaign 
are not realistic options.  The best approach to avoid 
socioeconomic disaster and a possible human pandemic will 
be to engage all possible entities, governmental and 
non-governmental, in an HPAI monitoring/detection campaign, 
limit the geographical spread of the virus after it is 
detected, and emphasize appropriate measures to prevent 
bird-to-human and human-to-human transmission.  End 
comment. 
DOUGHERTY