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RHEFAFM/DIRAFMIC FT DETRICK MD//MA-1A//

UNCLAS SECTION 01 OF 04 HANOI 000923 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
STATE FOR EAP/MLS, EAP/MTS, EAP/EP, INR, OES/STC, OES/IHA 
STATE PASS TO AIAG ("PAT" PATTERSON, KIETH, AMB LANGE) 
STATE PASS TO HHS/OGHA (STIEGER, BELL AND BHAT) 
STATE PASS TO CDC (COX AND MOHEN) 
STATE PASS TO USAID FOR ANE AND GH 
STATE PASS TO USDA/FAS (HIGGISTON, M. ROSENBLUM, MOLSTEAD) 
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (STERN) 
BANGKOK FOR RMO, CDC, USAID (MACARTHUR AND BRADY) 
ROME FOR FAO 
 
E.O. 12958: N/A 
TAGS: TBIO ECIN KFLU APECO PINR SOCI VM
SUBJECT: APEC Workshop, Implementation Action Plan on Influenza 
Pandemics: Progress Review and Building Capacity for Future Work; 
May 7-8, Hanoi, Vietnam 
 
 
HANOI 00000923  001.2 OF 004 
 
 
SENSITIVE BUT UNCLASSIFIED 
 
REF: 2006 State 77562 
 
¶1. (U) Summary: Representatives from APEC member economies, the U.N. 
Systems Influenza Coordinator, the World Health Organization, the 
UNDP-supported Partnership for Avian and Human Influenza (Vietnam), 
and the Asian Development Bank met May 7 and 8 in Hanoi to discuss 
progress and future directions for implementing the APEC Avian 
Influenza Action Plan.  The Action Plan, which describes 32 action 
items to establish long-term, sustainable efforts to prepare for, 
prevent and respond to avian and pandemic influenza (API), was 
developed and endorsed by APEC Ministers Responsible for Avian 
Influenza in Danang, May 2006, and endorsed by APEC Leaders in 
Hanoi, November 2006 (reftel and APEC Leaders' Declaration). 
Participants shared experiences in implementing the Action Plan, 
learned of U.N. activities to build capacity in the region and 
charted future priorities for APEC and member economies to improve 
API regional preparedness and response capacity.  Outcomes will be 
considered by the APEC Health Task Force (HTF) meeting in Sydney, 
June 5-6, by the APEC Health Ministers in Sydney, June 7-8 and by 
APEC Leaders in Sydney, September 8-9. 
 
(U) Major conclusions from the meeting included the continuing 
importance of strengthening the capacity of the animal health 
sector, acknowledging that improving the ability to detect, monitor, 
report and respond to H5N1 influenza also requires focus on 
infectious diseases more generally; recognizing the importance of 
non-medical interventions, including effective and consistent 
communications to all segments of society; and, reaffirming the 
critical importance of engaging a broad spectrum of stake-holders, 
especially the private sector.  Coordination between the public and 
private sector was acknowledged as the most poorly developed element 
of the Action Plan.  It was also noted that APEC must identify areas 
in which it can uniquely add value, such as through its strong 
multisectoral connections and capacity to quickly raise the 
political profile of issues.  Health Attache, Embassy Hanoi, led the 
delegation, which consisted of representatives from HHS/CDC, 
USDA/APHIS, USAID, and DOS.  Delegation members contributed to this 
report.  End Summary. 
 
(U) On May 7-8, the Government of Vietnam's Ministries of Foreign 
Affairs (MFA), Health (MOH) and Agriculture and Rural Development 
(MARD) hosted the "APEC Workshop on the Implementation of the APEC 
Action Plan on the Prevention and Response to Avian and (Human) 
Influenza Pandemics: Progress Review and Building Capacity for 
Future Work."  The meeting was opened by Mr. Le Cong Phung, First 
Deputy Minister, MFA, who reminded participants that even though 
there has been much progress made since the endorsement of the 
Action Plan last May, there was still much work to be done by APEC 
economies, both individually and collectively, to improve regional 
preparedness and response capacity to the on-going threat of API. 
He stated that given the different economic status of economies, 
more investment is needed in the developing economies.  Sixteen APEC 
member economies; Australia, Brunei Darussalam, Canada, the People's 
Republic of China, Hong Kong-China, Indonesia, Japan, Malaysia, 
Papua New Guinea, the Philippines, Russia, Chinese Taipei, Thailand, 
the United States, and Vietnam were represented. 
 
-------------------------- 
Indonesia discusses challenges to implementing the Action Plan 
-------------------------- 
 
HANOI 00000923  002.2 OF 004 
 
 
 
(SBU)  During the course of the meeting, Dr. Erna Tresnaningsih 
Suharsa, Director for Zoonosis Disease Control, Ministry of Health, 
Indonesia, highlighted the difficulties the Government of Indonesia 
has faced in building capacity to prepare for and respond to API. 
She noted difficulties in developing a sense of urgency among the 
population, given the more obvious impact of diseases such as 
malaria and tuberculosis and the perception that API is nothing to 
worry about.  She also noted the challenge of directing governors 
and officials of autonomous provinces and districts to heed the 
recommendations and directives of the central government, and the 
failure of donors to follow through on commitments of assistance to 
Indonesia. 
 
(SBU)  Other than in the U.S. presentation, the issue of sample 
sharing, and Indonesia's continued lack thereof, was not directly 
raised.  The HTF Chair, Ms. Bersabel Ephram, noted that APEC 
economies should continue to strive for "prompt reporting and 
sharing of biological specimens" and "promote greater access to 
medicine in times of pandemic."  Dr. Suharsa asked at this point, 
"why must we wait for a pandemic to receive the medicine; we need it 
now."  Ms. Ephram simply noted that this was the way it was written 
in the plan and it was not discussed further. 
 
-------------------- 
U.S. Presentation-Broadening Surveillance Capacity 
-------------------- 
 
(U)  HHS Health Attache, Embassy Hanoi, presented a cleared U.S. 
Delegation presentation on U.S. recommendations for future actions 
for APEC to enhance API preparedness and response.  Drawing on 
experiences and examples from Vietnam, the main messages were that 
effective capacity building in surveillance, monitoring and 
reporting will depend on strengthening the seasonal influenza 
surveillance systems of APEC member economies, not just focusing 
efforts on H5N1.  Not only will this improve H5N1 detection, but it 
will provide valuable baseline data on the disease burden of 
seasonal influenza and provide a baseline to detect shifts in 
influenza-like illnesses (ILI's) that could warn of an emerging 
pandemic.  He emphasized the need for continued improvements of 
monitoring and evalutation (M&E)  programs, and investment in basic 
research, epidemiological and otherwise.  He briefly discussed the 
CDC's "Interim Pre-pandemic Planning Guidance: Community Strategy 
for Pandemic Influenza Mitigation in the United States," which 
provides recommendations for use of non-pharmacological 
interventions to mitigate the effects of a pandemic their links to 
the case fatality based Pandemic Severity Index (PSI). 
 
-------------------------- 
Future of APEC-value added and complementary, not duplicating 
-------------------------- 
 
(U) Identifying the future priorities for work in APEC and the 
Health Task Force was the main goal of the conference  Continued 
efforts to engage stakeholder in a multisectoral manner, including 
maintaining and improving collaboration between Ministries of Health 
and Agriculture, was considered to be vital.  Australia described 
their efforts to promote the concept "Functioning Economies in Times 
of Pandemics," which is a multisector approach to ensuring continued 
trade, commerce and essential services in the region in the event of 
a pandemic.  The United States and others echoed the HTF chair's 
observation that engagement with the private sector was the least 
 
HANOI 00000923  003.2 OF 004 
 
 
developed of the recommended actions from the action plan and that 
continued and improved interactions with the APEC Business Advisory 
Council (ABAC) and other regional business organizations and civil 
society will be necessary to close this gap. 
 
(SBU) The WHO representative warned APEC to avoid duplicating the 
work of other organizations and contributing to the "pandemic of 
meetings" that has sapped economies' of their experts and leaders 
when they are most needed at home. 
 
(U) However, UNSIC representative Mr. Koji Nabae, noted that APEC 
can play a valuable role as a unique combination of economies 
sharing information, a multisectoral organization with 
institutionalized arrangements for cross sector coordination, and 
ready access to senior political decision makers.  APEC provides a 
mechanism to both promote health security as an important element of 
economic development and security, as well as draw in expertise from 
outside the public and animal health sectors to discuss the 
non-medical elements of public health and animal health emergencies, 
such as API.  The State Department representative urged the HTF, as 
it transitions to become a "Health Working Group" to maintain its 
focus on relatively short-term achievable objectives that are 
directly responsive to APEC Senior Officials, Foreign and Trade 
Ministers and Leaders. 
 
(SBU) In side line conversations with the Health Task Force Chair, 
Ms. Bersabel Ephram of Canada and Vice-Chair, Dr. Li Shichuo of PRC, 
the issue of quality control and relevance was discussed.  Canada, 
China and the U.S. agreed that there is a problem with how APEC 
funded project proposals are considered and developed.  Dr. Li 
suggested a "board" that would evaluate projects and make 
recommendations to the proponents before they've been formally 
presented to member economies.  Dr. Ragland of the U.S. agreed, and 
noted that the upcoming review of the Terms of Reference might be 
used to explore this idea.  However, he also noted that this would 
be departure from APEC norms and would require the consent of all 
economies.  Additionally, Canada suggested in plenary that economies 
collaborate more effectively in advance of proposing capacity 
building projects to get the greatest possible buy-in, expert input 
and impact.  Again, the United States agreed.  Finally, the United 
States recommended that economies, either individually or 
collaboratively, consider specific goals and objectives that a 
series of activities would aim to achieve, rather than simple 
"one-off" conferences that are the norm. 
 
-------------------- 
Conference outcomes and APEC Health Minister Meeting 
-------------------- 
 
(U) The Vietnamese economy will develop a draft outcomes report for 
consideration by the next meeting of the APEC Health Task Force, 
June 5-6 in Sydney.  Recommendations from the workshop will be 
refined and endorsed and presented to APEC Health Ministers at their 
meeting June 7-8, also in Sydney. 
 
(U) Australia briefed the participants on plans for the Ministerial 
and provided an updated draft agenda.  The meeting details are also 
available on Australia's APEC Internet site http://www.apec2007.org 
(link to "administrative circulars" under "Delegates" under "APEC 
and Australia").  A draft Minister's communique will be circulated 
shortly for member economy comment in advance of the Sydney meeting. 
 Recommendations from the Ministers' meeting will be considered by 
 
HANOI 00000923  004.2 OF 004 
 
 
APEC Foreign and Trade Ministers and Leaders at the Summit meeting, 
September 5-9, also in Sydney. 
 
--------------------- 
Economy Reports 
--------------------- 
 
(U) All economies present except the Philippines and Russia 
presented on their economies' progress to implement the Action Plan. 
 Most focused on domestic programs and policies implemented over the 
last several years.  The United States focused entirely on 
international efforts, referring those interested in our domestic 
measures to refer to www.pandemicflu.gov.   Written economy reports 
will be presented to APEC Senior Officials at the 3rd Senior 
Officials Meeting in Cairns, June by the APEC Health Task Force as 
part of the Minister's mandated progress report on implementing the 
Action Plan. 
 
(U) All presentations and documents presented at the meeting will be 
posted on the APEC Meeting Document Database at 
 
http://aimp.apec.org/MDDB/pages/browseGroup.a spx under the Health 
Task Force. 
 
Contact EAP/EP, Jared Ragland at RaglandJW@State.gov; 202-647-2089 
for any further information. 
 
MARINE