VZCZCXYZ0004
RR RUEHWEB

DE RUEHAM #1276/01 0800413
ZNR UUUUU ZZH
R 210413Z MAR 07
FM AMEMBASSY AMMAN
TO RUEHC/SECSTATE WASHDC 7735
INFO RUEAUSA/DEPT OF HHS WASHDC
RUEHPH/CDC ATLANTA GA
RUEHRC/USDA FAS WASHDC
RUEHNC/AMEMBASSY NICOSIA 0902
RUEHAK/AMEMBASSY ANKARA 0492
RUEHFR/AMEMBASSY PARIS 1426
RUEHLO/AMEMBASSY LONDON 1115
RUEHRO/AMEMBASSY ROME 1461
RUEHIT/AMCONSUL ISTANBUL 0140
RUEHTV/AMEMBASSY TEL AVIV 0498
RUEHDM/AMEMBASSY DAMASCUS 3539
RUEHEG/AMEMBASSY CAIRO 3035
RUEHBY/AMEMBASSY CANBERRA 0092
RUEHJM/AMCONSUL JERUSALEM 4377
RUEHBS/USEU BRUSSELS
RUEHGV/USMISSION GENEVA 0583

UNCLAS AMMAN 001276 
 
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 
NEA FOR RA/LAWSON 
 
SIPDIS 
 
SENSITIVE 
 
E.O. 12958: N/A 
TAGS: TBIO KFLU XF JO
SUBJECT: Embassy AI Task Force Meets With Diplomatic Community, 
Jordanian Officials 
 
REF: Amman 1036 
 
¶1.  (SBU) Summary: Embassy Amman's Avian Influenza (AI) Task Force 
met with representatives from other embassies, Amman-based UN 
organizations, and Government of Jordan (GoJ) officials on March 7 
to share information on avian flu preparedness.  The GoJ is focusing 
now on pandemic preparedness, and is confident they can manage the 
types and numbers of cases that might emerge at the current stage of 
the disease.  The GOJ reported that they are cooperating with Israel 
and the Palestinian Authority on AI.  Agriculture officials and 
poultry industry representatives are worried about backyard flocks, 
not industrial producers.  End Summary. 
 
--------------------------- 
Current Status of Avian Flu 
--------------------------- 
 
¶2.  (U) Dr. Russ Gerber, Centers for Disease Control (CDC) Resident 
Advisor in Jordan, opened the meeting with an overview of the avian 
influenza situation.  WHO categorizes AI as phase "3" on its 1-6 
pandemic alert scale, meaning there is little to no human-to-human 
transmission.  Dr. Gerber said that avian flu has spread widely in 
poultry and wild birds, but there have been only 277 confirmed human 
cases of AI since 2003, of which 167 have been fatal.  He said Egypt 
is emerging as a country of concern and that avian flu in birds has 
recently been found in Kuwait.  In 2007, confirmed H5N1 avian flu 
human cases have been found in China, Laos, Indonesia, Egypt, and 
Nigeria, but there has been no sustained human-to-human 
transmission. 
 
----------------------------------- 
Government Preparing for Worst Case 
----------------------------------- 
 
¶3. (U) Dr. Neyla Gargouri Darwaza, Head of Surveillance at the 
Jordanian Ministry of Health, said the Minister of Health chairs an 
interagency avian flu steering committee at the ministerial level. 
There is also an interagency technical committee on avian flu that 
includes university, industry and professional representatives.  The 
technical committee meets monthly.  The GoJ continues to update 
regularly an avian influenza preparedness plan that was first 
printed in September 2005.  Dr. Darwaza stated that Jordan has 3 
million Tamiflu capsules, enough for 300,000 treatments.  She added 
that Jordan has done case management training and outbreak training, 
and has received valuable commodity support from USAID (see para 
11). 
 
¶4.  (SBU) Dr. Adel Belbessi, Director of Disease Control at the 
Jordanian Ministry of Health, said that the GOJ is not afraid of the 
current stage (Phase 3), but fears the next stages where the disease 
would become pandemic.  He confirmed that Jordan has not had any 
case of avian flu in humans, except one incident last year with an 
Egyptian worker who had the disease prior to coming to Jordan. 
Jordan has PCR testing capability and has established a biosafety 
level "3" laboratory, with the assistance of the USG's NAMRU-3 in 
Cairo.  He added that sharing samples, e.g. with NAMRU-3, is "not a 
problem." 
 
¶5.  (U) The Ministry of Health Disease Control Directorate posts 
information on avian flu and other diseases on its website at 
http://www.dcd.gov.jo/Eindex.asp. 
 
--------------------------------------------- - 
Regional Cooperation with Israel, Palestinians 
--------------------------------------------- - 
 
¶6.  (SBU) Dr. Belbesi said the GOJ has had no direct contact with 
Syria on avian flu.  However, the GOJ has been in touch with the WHO 
and Gulf countries, as well as the Palestinian Authority and Israel, 
with whom they recently met.  Jordan, Israel and the Palestinians 
have been working together on AI with the assistance of the NGO 
"Nuclear Threat Initiative" and a $1 million World Bank grant, he 
said.  Their common goal is to develop a regional "plan of attack" 
in the event of a pandemic.  This collaboration will run another 18 
months, Belbessi said. 
 
----------------------------- 
Jordan's Public Outreach Plan 
----------------------------- 
 
¶7.  (U) Dr. Darwaza informed the group that the Ministry of Health 
(MOH) has utilized a USAID-funded program with Johns Hopkins 
University on health communication.  The MOH has developed a 
comprehensive multi-media communication strategy for avian flu which 
targets the general public.  The goal is to minimize risk through 
behavior change and to build awareness. 
 
----------------------- 
Ministry of Agriculture 
----------------------- 
 
¶8.  (U) Dr. Hisham Al-Maaytah, Director of the Veterinary Lab at the 
Ministry of Agriculture (MOA) said that the Ministry has three labs 
(north, south and central Jordan), with PCR capability at the 
central lab.  MOA collaborates with other reference labs, such as 
NAMRU-3 in Cairo and an international lab in Italy.  There are 
animal health surveillance teams in each governorate.  Nationwide, 
they visit 10% of all farms per month and collect 750 samples a 
month.  Processing these samples imposes a significant burden on the 
laboratories.  He mentioned later in the meeting that the logistics, 
communication and transportation for the surveillance impose 
significant costs on the MOA. 
 
¶9.  (U) MOA has sent staff to Italy for advanced training in avian 
flu.  The MOA is also conducting drills to train their staff, as 
well as staff of other ministries, to deal with AI.  They have 
already done drills in Mafraq and Zarqa (see reftel) and will hold a 
third drill in Tafila (in southern Jordan - date TBD). 
 
-------------------------------------------- 
Compensation Fund - Focus is Backyard Flocks 
-------------------------------------------- 
 
¶10.  (U) Dr. Al-Maaytah noted that 60-70% of the birds have been 
vaccinated so far, and the MOA will vaccinate all local birds in 
"backyard" flocks.  Dr. Ayman Al-Salti, Head of the Poultry Division 
at the MOA, said that there is a fund available to compensate 
farmers if their flocks are culled because of H5N1.  The culling 
around Ajloun following the March 2006 case in turkeys was 100% 
compensated, as was subsequent preventive culling in the Jordan 
Valley.  The fund is not large (about $1.7 million), he said, 
because the risk of H5N1 is biggest for small, backyard flocks, not 
large commercial flocks which are isolated from wild birds and 
outside contact.  Jordan has few backyard flocks (about 100,000 
birds) compared to Egypt, he said.  The Royal Society for the 
Conservation of Nature has banned most hunting in Jordan and is 
collecting dead wild birds for testing. 
 
---------------- 
USAID Assistance 
---------------- 
 
¶11.  (U) Dr. Salwa Qteit (USAID Development Assistant Specialist, 
Population and Health Section) gave an overview of the supplies and 
equipment that USAID/Jordan is giving to MOH.  The assistance 
includes Personal Protective Equipment (PPEs) and lab and 
surveillance kits.  Four thousand PPEs have been received, and 
another 4,000 sets are expected.  Dr. Qteit said that USAID/Jordan 
has trained Ministry of Health and Ministry of Agriculture experts 
on the use of PPEs and sampling kits.  USAID will soon provide 
additional technical assistance to the GOJ for an evaluation of the 
GOJ pandemic preparedness plan related to training. 
 
------------------------------ 
WHO Office Role and Activities 
------------------------------ 
 
¶12.  (U) World Health Organization (WHO) Representative Dr. Hashim 
Al-Zain said WHO held the first meeting of its Influenza Pandemic 
Task Force in September 2006, and it should be fully up to speed by 
June 2007.  The Task Force categorizes and evaluates AI data.  It 
found that there is no need to change the present phase "3" level of 
pandemic alert.  It has started a project to define best practices 
for timely sharing of influenza virus samples and information on 
genetic sequences.  Dr. Al-Zein said WHO has issued a 2006-2007 
strategic action plan for pandemic influenza, and has developed 
information management systems to assist with tracking case-contact 
interactions.  WHO has sent nine missions to locations of confirmed 
outbreaks, sent 30 assessment teams to various locations around the 
world, and managed 45 reports of possible outbreaks. 
 
¶13.  (U) WHO received a donation of three million doses of the 
antiviral agent Tamiflu from Roche for stockpiling at six WHO 
regional offices.  The stockpiles are reserved for use by WHO for a 
rapid response and containment operation in the event of pandemic 
influenza.  Dr. Al-Zein also mentioned that there are protocols to 
guide rapid interventions in the event of the emergence of an 
influenza pandemic.  Avian flu investigation kits for rapid field 
investigation of suspected outbreaks are being dispatched to 116 WHO 
country offices.  WHO is assessing preparedness in each country and 
provides generic guidance to its Member States on national pandemic 
flu preparedness plans, as well as technical assistance to countries 
with limited resources.  He said 178 countries have AI preparedness 
plans. 
 
¶14.  (U) The Food and Agriculture Organization (FAO) has a modest 
$320,000 regional program to help with Personal Protective Equipment 
and surveillance systems. 
 
------------------------- 
U.S. Embassy Preparations 
------------------------- 
 
¶15.  (U) ECON Couns briefed the participants on Embassy 
preparations, particularly the creation of an Avian Influenza Task 
Force and "tripwires" to assist with contingency planning.  The 
Embassy is emphasizing two things: basic knowledge about H5N1, and 
practical preparedness measures related to health and hygiene such 
as the ability to "shelter in place."  He confirmed that there is no 
double standard or "inside" information: the same information is 
available to the American citizen community and all Embassy staff. 
The Embassy has a warden system to contact American citizens. 
Noting the huge economic impacts of a pandemic and the uncertainty 
of air transport, ECON/C said that "shelter in place" may be the 
best option during a pandemic. 
 
¶16.  (U) Dr. Belbessi from the Ministry of Health noted concern over 
air transport during a pandemic, and said that Jordan would follow 
WHO recommendations with respect to quarantines and border controls. 
 He said that WHO was promoting the use of non-pharmaceutical 
controls (non-drug measures such as restrictions on movement and 
large gatherings) to control a pandemic. 
 
---------------- 
Meeting Outcomes 
---------------- 
 
¶17.  (U) Several participants noted the value of cooperation within 
Jordan among embassies, UN organizations and the Government of 
Jordan.  Meeting minutes and a list of participants were distributed 
electronically to all participants following the meeting. 
 
------------ 
Participants 
------------ 
 
¶18.  (U) In addition to local USG entities (State, AID, CDC, Peace 
Corps), representatives from the embassies of Australia, Canada, 
Egypt, Israel, the Netherlands, and the EU attended the meeting, as 
did representatives from Jordan's Ministries of Health and 
Agriculture, the WHO, the FAO, and Jordan's Quality Poultry 
Producers Union. 
 
HALE