VZCZCXRO5016
PP RUEHCHI RUEHDT RUEHHM RUEHLN RUEHPB
DE RUEHHI #1070/01 1250847
ZNR UUUUU ZZH
P 050847Z MAY 06
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC PRIORITY 1761
INFO RUEHHM/AMCONSUL HO CHI MINH CITY PRIORITY 1075
RUEHZS/ASEAN REGIONAL FORUM COLLECTIVE PRIORITY
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE PRIORITY
RUEHUL/AMEMBASSY SEOUL PRIORITY 2923
RUEHKO/AMEMBASSY TOKYO PRIORITY 5496
RUEHHK/AMCONSUL HONG KONG PRIORITY 0897
RUEHGZ/AMCONSUL GUANGZHOU PRIORITY 0671
RUEHCN/AMCONSUL CHENGDU PRIORITY 0230
RUEHRO/USMISSION UN ROME PRIORITY
RUEHIN/AIT TAIPEI PRIORITY 1366
RUEAIIA/CIA WASHDC PRIORITY
RUEHPH/CDC ATLANTA GA PRIORITY
RUEAUSA/DEPT OF HHS WASHDC PRIORITY
RUEHRC/USDA WASHDC PRIORITY
RUEKJCS/SECDEF WASHINGTON DC//USDP/ISA/AP// PRIORITY
RUEKJCS/CJCS WASHINGTON DC//J2/J3/J5//
RUEKDIA/DIA WASHINGTON DC//DHO-3//
RHHMUNA/CDR USPACOM HONOLULU HI//J00/J2/J3/J5//
RHEFAFM/DIRAFMIC FT DETRICK MD//MA-1A//

UNCLAS SECTION 01 OF 04 HANOI 001070 
 
SIPDIS 
 
STATE FOR G, CA/OCS/ACS/EAP, EAP/EX, EAP/MLS, EAP/EP, INR, 
OES/STC (PBATES), OES/IHA (DSINGER AND NCOMELLA), AND MED 
STATE PASS TO USAID FOR ANE AND GH (DCARROLL, SCLEMENTS AND 
PCHAPLIN) 
STATE PASS TO USTR (EBRYAN) 
STATE PASS TO HHS/OGHA (WSTIEGER, EELVANDER AND ABHAT) 
USDA PASS TO APHIS 
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (LSTERN) 
BANGKOK FOR RMO, CDC, USAID (MFRIEDMAN, JMACARTHUR AND MBRADY) 
ROME FOR FAO 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: TBIO KFLU AMED AMGT CASC EAGR PINR SOCI VM
SUBJECT: VIETNAM - RESULTS OF AVIAN INFLUENZA JOINT ASSESSMENT 
MISSION 
 
 
HANOI 00001070  001.2 OF 004 
 
 
SENSITIVE BUT UNCLASSIFIED - DO NOT POST ON INTERNET 
 
 
¶1.    (SBU) Summary.  A Joint Assessment Mission (JAM) to 
evaluate the Government of Vietnam's (GVN) Integrated Operational 
Program for Avian and Human Influenza (AHI), commonly referred to 
as the "Green Book," concluded on April 28, 2006.  The Green Book 
sets forth a detailed medium- to long-term plan to control AHI, 
plan for a pandemic and establish frameworks for enhanced 
government coordination and donor financing.  The total estimated 
cost for 2006-2010 is USD 225 million, which does not include 
costs of poultry industry restructuring or responding in the 
event of an actual pandemic.  The Green Book was finalized for 
presentation at the APEC Avian Influenza (AI) Ministerial meeting 
in Danang on May 4-6.  A follow-up donor conference will be held 
in June or July to coordinate donor activities and funding. 
 
Joint Assessment Mission 
 
¶2.    (U) From April 17 through April 28, 2006, a Joint 
Assessment Mission (JAM) convened to evaluate the Vietnam 
Integrated Operational Program for Avian and Human Influenza (the 
"Green Book").  The JAM included approximately 34 members from 
the UN (FAO, WHO, UNICEF, UNDP), bilateral donors (AFD, DANIDA, 
NZAID, USAID), multilateral development banks (ADB, WB) and the 
EC.  It worked in collaboration with the GVN's AI Task Force, 
which includes representatives from 11 Ministries but most 
prominently the Ministry of Agriculture and Rural Development 
(MARD) and the Ministry of Health (MOH).  (Note: Details provided 
in this cable were provided by Ms. Molly Brady, AI Advisor, USAID 
Regional Development Mission/Asia, who participated in the JAM. 
End note.) 
 
¶3.    (U) The Green Book is based on the Integrated National Plan 
for Avian Influenza Control and Prevention (the "Red Book") that 
was presented by the GVN at the Beijing pledging conference in 
January 2006.  The Green Book outlines the shift from an 
emergency to a medium- to long-term response to animal and human 
influenza (AHI), covers a time frame of 2006 to 2010, and is 
geared towards policymakers and donors.  Its main purpose is to 
develop AHI control and pandemic prevention programs to be 
implemented by the GVN, enhance an integrated approach to AHI 
control, and provide frameworks for coordination and donor 
financing. 
 
Schedule of Activities 
 
¶4.   (U) The assessment team was divided into three groups: 
animal health and livestock production, human health and 
institutional and financial frameworks.  A cross-cutting team 
also focused on public awareness and behavior change activities. 
Each team met with government counterparts from central, 
provincial, district, commune and village levels in meetings in 
Hanoi and during field visits. 
 
Animal Health and Livestock Production 
 
¶5.    (SBU) Vietnam has had no official outbreaks in poultry 
since December 2005.  However, the JAM believes that small 
outbreaks are most probably ongoing along the border with China. 
Two rounds of vaccination of chickens and ducks have been 
 
HANOI 00001070  002.2 OF 004 
 
 
completed.  In the Green Book, the animal health group proposed a 
strategy moving from control to consolidation to eradication, 
predicated on strengthening veterinary services in order to 
control highly pathogenic avian influenza (HPAI) and other 
potential zoonotic diseases, along with risk-based instead of 
blanket interventions.  Recommended activities included expanding 
the capacity of the laboratory network, improving epidemiological 
expertise through training, implementing an early warning and 
response system to identify and respond to outbreaks quickly, and 
implementing a targeted vaccination strategy.  In addition, 
operational research on surveillance and vaccination, 
strengthened control of poultry movement in markets and across 
international borders, improving biosecurity measures, and 
exploring mechanisms for compartmentalization were suggested as 
part of the animal health strategy. 
 
¶6.    (SBU) The JAM advised the GVN to take into account the 
importance of (and demand for) poultry production in small scale 
producers and backyard farmers when further developing its 
strategy to industrialize poultry farming, slaughtering and 
processing.  Proposed activities for livestock production in the 
Green Book include only those related to AHI control, and not the 
implementation of the GVN's entire poultry sector 
industrialization strategy.  Recommended activities include 
capacity building in the Department of Livestock Production and 
commune teams, support for alternative livelihoods, and poultry 
development pilot projects that meet economic, social and 
environmental criteria. 
 
Human Health 
 
¶7.    (SBU) Vietnam has had no new human cases of H5N1 since 
November 2005 and is now focusing on reducing the risk and 
potential impact of a human pandemic by strengthening preventive 
medicine and curative care.  The human health team recommended 
including activities in the Green Book such as improving routine 
surveillance, expanding research, implementing an early warning 
and response system, expanding laboratory capacity and improving 
case management.  Curative care capacity should be enforced 
within the existing system by strengthening intensive care 
capacity in hospitals, the referral network and infection control 
procedures.  In addition, pandemic response plans should be 
prepared at all hospitals to address surge capacity, staff 
responsibilities and patient flows.  Funds for response to an 
actual pandemic were not included in the totals for the Green 
Book. 
 
Institutional and Financial Framework 
 
¶8.   (SBU) A new coordination network was proposed in the Green 
Book that expands the mandate of the National Steering Committee 
for Avian and Human Influenza and adds other ministries, such as 
the Ministry of Education, to the committee.  Sectoral 
responsibilities would then be addressed through a new sub- 
committee in MARD and an existing sub-committee in MOH.  Cross- 
cutting working groups on public awareness and behavior change, 
monitoring and evaluation, and capacity building would also be 
formed.  Donor coordination would be strengthened through the 
establishment of a multi-donor financing framework that would 
coordinate donor activities and contributions from grants, loans 
and credits. 
 
HANOI 00001070  003.2 OF 004 
 
 
 
Challenges 
 
¶9.   (SBU) The JAM identified certain challenges that might occur 
in implementing this medium- to long-term strategy.  Vigilance 
and internal and external support may decrease over time, 
especially as outbreaks are halted and AHI is seen as an on-going 
(and not emergency) problem.  Absorptive capacity remains a 
challenge, as there are current limits on human staffing 
capacity, within the government and within agencies providing 
technical assistance, and infrastructure.  Ongoing effort is 
needed to ensure cooperation between veterinarian and human 
health systems.  Decentralization presents a continued challenge 
of implementation and budgetary coordination between different 
levels.  More specifically, poultry industry restructuring will 
need to take into account social, economic and environmental 
criteria as well as keep pace with changes needed to the 
regulatory framework.  With increased diagnostic capacity in 
animal and human health sectors comes the need for continual 
quality assurance and bio-safety, and the increased training and 
recurrent costs this incurs. 
 
Outcome 
 
¶10.   (SBU) The Green Book will be presented at the APEC 
Ministerial Meeting on HPAI in Danang, Vietnam on 4-6 May 2006, 
followed by a donor conference in June/July 2006 to coordinate 
inputs and activities.  The total estimated Green Book budget, 
which may change, is USD 225 million for the period 2006-2010. 
This includes USD 31.2 million for enhanced coordination 
activities, USD 91.9 million for the animal health sector and USD 
102.4 million for the human health sector.  Of the total budget, 
the GVN will contribute approximately 50%.  The overall donor 
commitment, as of January 2006, is USD 47 million. The Green Book 
budget does not include the USD 225 million of government and 
private sector costs for poultry industry restructuring, most of 
which is to provide low-interest loans to poultry farmers to 
upgrade their farms. 
 
Lessons Learned 
 
¶11.    (SBU) Comment: This was the first coordinated assessment 
of a national AHI control plan.  The attempt to be inclusive was 
a valiant one.  However, in part because the team was so large, 
much time was spent on internal discussions and debate.  In 
addition, the deadline of May 4 contributed to the rushed process 
of adequately consulting with GVN authorities at all levels.  The 
Green Book ended up being almost entirely rewritten from an 
earlier draft presented by the GVN on April 12.  The assessment 
process was rather hasty given that the entire first week was 
devoted to official meetings with GVN counterparts.  While the 
"final" draft will be presented in a the APEC Ministerial in 
Danang, the costing section will be revised in the coming weeks, 
the activities will need to be further elaborated and donor 
activities and funds still remain to be coordinated.  From a 
regional perspective, however, the JAM process, and more 
importantly the outcome it produced, provides one of the best 
examples of how a developing host country government can work 
together with bilateral donors and international agencies to 
develop a closely coordinated, technically sound strategic plan 
for AI.  End Comment. 
 
HANOI 00001070  004.2 OF 004 
 
 
 
Marine