VZCZCXRO1855
PP RUEHCI
DE RUEHKT #1488/01 2180555
ZNR UUUUU ZZH
P 060555Z AUG 07
FM AMEMBASSY KATHMANDU
TO RUEHC/SECSTATE WASHDC PRIORITY 6781
INFO RUEHBJ/AMEMBASSY BEIJING PRIORITY 6011
RUEHLM/AMEMBASSY COLOMBO PRIORITY 6313
RUEHKA/AMEMBASSY DHAKA PRIORITY 1556
RUEHIL/AMEMBASSY ISLAMABAD PRIORITY 4334
RUEHLO/AMEMBASSY LONDON PRIORITY 5609
RUEHNE/AMEMBASSY NEW DELHI PRIORITY 1786
RUEHCI/AMCONSUL KOLKATA PRIORITY 3732
RUEKJCS/SECDEF WASHDC PRIORITY
RHEHNSC/NSC WASHDC PRIORITY
RUEAIIA/CIA WASHDC PRIORITY
RHEFDIA/DIA WASHDC PRIORITY
RHMFIUU/CDR USPACOM HONOLULU HI PRIORITY

UNCLAS SECTION 01 OF 02 KATHMANDU 001488 
 
SIPDIS 
 
SIPDIS 
 
E.O. 12958: N/A 
TAGS: TBIO CASC KFLU AID SOCI WHO NP
SUBJECT: AI CONSIDERED UNDETECTED IN NEPAL 
 
Summary 
------- 
 
¶1.  At an August 2 meeting of Post's avian influenza (AI) 
working group, Dr. Zandra Andre from USAID's Health and Child 
Survival Fellows Program briefed post on the spread of AI in 
South Asia and the level of Nepal's preparedness.  With 
reported outbreaks in India, Burma, and Bangladesh, Nepal was 
now considered an "un-detected out break" country.  USAID was 
exploring the possibility of expanding the individual country 
programs in Nepal, Bangladesh and India into a regional 
program.  Nepal's ability to respond to an outbreak was 
questionable.  Dr. Andre noted that there was low awareness 
of AI in Nepal, which deterred early detection; long and 
inadequate response times; little awareness of bio-safety 
issues; and inadequate capacity to mitigate the affects of an 
AI outbreak.  While the World Bank has committed 18 million 
dollars to an AI project in Nepal, it would take at least six 
months for the project to begin.  Dr. Andre stressed that 
Nepal did not have that much time and that work needed to 
begin now. 
 
Nepal Considered an Un-Detected Outbreak Country 
--------------------------------------------- --- 
 
¶2.  At an August 2 meeting of Post's avian influenza (AI) 
working group, Dr. Zandra Andre from USAID's Health and Child 
Survival Fellows Program briefed post on the spread of AI in 
South Asia.  She stated that, with reported outbreaks in 
India, Burma and Bangladesh, Nepal was now considered an 
"un-detected outbreak" country.  Since March 2007, there have 
been on-going outbreaks in Bangladesh affecting 17 out of 64 
districts, and last month, India reported an outbreak in the 
district of Manipur.  Dr. Andre is based in the USAID Global 
Health Office Avian Influenza Unit and was on TDY in 
Bangledesh.  She visited Nepal for one week to make an 
initial assessment of the country's ability to detect and 
respond to an outbreak.  Dr. Andre explained that the AI 
program in Nepal was currently focused on the Terai and other 
border areas with China and India, but she emphasized that 
USAID was exploring the possibility of expanding the 
individual country programs in Nepal, Bangladesh and India 
into a regional program.  She stressed that a regional 
program would facilitate a much more effective response to 
the spread of the virus. 
 
Awareness Critical 
------------------ 
 
¶3.  Dr. Andre stated that, with AI, there were five areas 
that the Center for Disease Control focused on, including 
planning and preparedness, early surveillance, response, 
recovery and communication.  At this time, she explained, the 
main concern in Nepal was information sharing.  She 
emphasized that a public awareness campaign was considered 
critical as the successful detection and containment of the 
disease would depend largely on reporting from communities. 
Dr. Andre also noted that it was important to consider the 
contribution of wild birds.  There was large populations of 
wild birds in the Sunsari and Saptari Districts and, Dr. 
Andre emphasized, surveillance needed to be established in 
these areas where there was a major risk of transmission from 
wild birds to domestic fowl such as ducks and chickens. 
 
Detection, Prevention and Mitigation - Cause For Concern 
--------------------------------------------- ----------- 
 
¶4.  Dr. Andre stated that the Government of Nepal's (GON) 
detection capabilities were a cause for concern.  Dr. Andre 
explained that a country should be able to respond to a 
reported outbreak within 48 hours.  In Nepal, it currently 
took 72 hours just to get sample test results.  It would take 
many more days to stage an appropriate response.  Rapid 
response testing kits needed to be distributed throughout the 
country.  USAID had provided some kits, but they had not yet 
been distributed into the field.  Dr. Andre also noted 
concern about the GON's ability to mitigate the affects of an 
outbreak on the poultry industry, which makes up four percent 
of the economy. 
 
Virus Won't Wait for the World Bank Project to Get Underway 
 
KATHMANDU 00001488  002 OF 002 
 
 
--------------------------------------------- -------------- 
 
¶5.  The USD 18 million World Bank AI project was moving very 
slowly, according to Dr. Andre.  She warned that it could 
likely take six months for the World Bank project to get 
started, and the disease would not wait that long.  USAID had 
USD 750,000 and, working with its partners - Winrock, the 
Food and Agriculture Organization (FAO) and the World Health 
Organization (WHO) - was seeking to build local capacity, as 
well as begin critical initiatives, many of which could be 
turned over to the World Bank later.  Nepal needed technical 
assistance now.  In addition, Dr. Andre highlighted the need 
for compensation to farmers for culled fowl.  Farmers would 
only be willing to report suspected outbreaks if they knew 
they would be compensated for their birds. 
 
Comment 
------- 
 
¶6.  If AI is already in Nepal, detection efforts need to be 
stepped up immediately.  Post strongly supports the expansion 
of the USAID country specific AI programs into a larger 
regional project that can respond more effectively to the 
present risk.  Existing resources need to be used carefully 
to support detection and prevention efforts.  Taking action 
now could be essential in preventing a crisis in the near 
term. 
HUGINS