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Viewing cable 07HANOI1727, REVISION OF VIETNAM'S AVIAN INFLUENZA ACTION PLAN

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Reference ID Created Released Classification Origin
07HANOI1727 2007-10-01 14:17 2011-08-25 00:00 UNCLASSIFIED//FOR OFFICIAL USE ONLY Embassy Hanoi
VZCZCXRO2887
RR RUEHCHI RUEHDT RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD
DE RUEHHI #1727/01 2741417
ZNR UUUUU ZZH
R 011417Z OCT 07
FM AMEMBASSY HANOI
TO RUEHC/SECSTATE WASHDC 6433
INFO RUEHHM/AMCONSUL HO CHI MINH 3748
RUEAUSA/DEPT OF HHS WASHINGTON DC
RUEHZS/ASEAN REGIONAL FORUM COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEAIIA/CIA WASHINGTON DC
RUEHPH/CDC ATLANTA GA
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUEKJCS/SECDEF WASHINGTON DC//USDP/ISA/AP//
RHMFISS/CJCS WASHINGTON DC//J2/J3/J5//
RHEFDIA/DIA WASHINGTON DC//DHO-3//
RHMFIUU/CDR USPACOM HONOLULU HI//J00/J2/J3/J5//
RHEFAFM/DIRAFMIC FT DETRICK MD//MA-1A//
RUEHSUN/USUN ROME IT
UNCLAS SECTION 01 OF 03 HANOI 001727 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
STATE FOR EAP/MLS, OES/IHA 
STATE PASS TO HHS/OGHA (STIEGER/VALDEZ/BELL/HICKEY) 
CDC FOR OGHA (BLOUT/MCCALL) AND DIV-FLU (COX/MOHEN) 
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP (STERN) 
HHS PASS TO FIC/NIH (GLASS) 
USDA PASS TO APHIS, FAS (OSTA AND OCRA), FSIS 
BANGKOK FOR RMO, CDC (MALISON), USAID (MACARTHUR/BRADY) 
BEIJING FOR HHS HEALTH ATTACHE (ROSS) 
PHNOM PENH FOR CDC INFLUENZA COORDINATOR(BRADY) 
ROME FOR FAO 
VIENTIANE FOR CDC INFLUENZA COORDINATOR (CORWIN) 
 
E.O. 12958: N/A 
TAGS: TBIO AMED EAGR CASC KFLU VM
SUBJECT: REVISION OF VIETNAM'S AVIAN INFLUENZA ACTION PLAN 
 
REF A: HANOI 1551, REF B: HANOI 687 
 
HANOI 00001727  001.2 OF 003 
 
 
1. (U) Summary:  The Ministry of Health (MOH) recently organized a 
workshop to discuss revisions of the Government of Vietnam (GVN) 
action plan on the prevention and control of human influenza.  Under 
the cooperative agreement between U.S. Centers for Disease Control 
(CDC) of the Department of Health and Human Services (DHHS) and MOH, 
CDC supported the workshop, which focused on means to better 
coordinate and communicate between the animal and human health 
sectors and to more effectively use available resources.  The GVN 
intends to take the recommendations from this workshop and from 
additional CDC supported gatherings as one set of inputs into the 
GVN process to revise the plan under the National Steering Committee 
on Avian Influenza (NSCAI). CDC and DHHS welcomed the opportunity to 
provide input and suggested that the GVN maintain a robust and open 
process to strengthen the plan and increase donor support.  A 
successful amended action plan should more strongly emphasize 
monitoring and evaluation and better focus training for health care 
providers.  End Summary. 
 
Vietnam Action Plan 
------------------- 
 
2.  (U) Three documents set forth GVN planning on avian influenza 
and pandemic preparedness.  In November 2005, in response to global 
and national outbreaks of avian influenza, Vietnam developed a 
"National Plan of Action on Human Influenza Pandemic Prevention and 
Control in Vietnam," which only pertains to the human sector. 
Essential elements of this national action plan are contained in two 
widely distributed documents, both of which address both the human 
and animal sectors: Vietnam's Integrated National Plan for Avian 
Influenza Control and Human Pandemic Influenza Preparedness and 
Response, 2006-2008 (also known as the "Red Book") and the Vietnam 
Integrated National Operational Programme for Avian and Human 
Influenza (OPI), 2006-2010 (known as the "Green Book") (See Ref B 
for additional details). The national action plan, together with the 
Red Book and the Green Book, contributed to the successful control 
of outbreaks of avian influenza and resultant isolated cases of 
human infection. However, after two years of implementation, the GVN 
and its donor partners have discovered gaps in coverage.  Both agree 
that the national action plan needs modification to better address 
ongoing challenges and to recognize that Vietnam's response to avian 
influenza has switched from basic crisis management to a new stage, 
i.e., emergency preparedness. 
 
Ministry of Health Avian Influenza Workshop 
------------------------------------------- 
 
3. (U) On September 11, 2007 in Ho Chi Minh City, the MOH's Vietnam 
Administration of Preventive Medicine (VAPM) organized a workshop to 
revise the national action plan to prevent and control human 
influenza.  CDC supported the workshop, which included participants 
from MOH, regional institutes of hygiene and epidemiology, central 
hospitals, 20 southern provincial health services and preventive 
medicine centers, university and research institutes.  Pursuant to a 
cooperative agreement with the MOH to assist GVN efforts to amend 
its national action plan, CDC will fund additional GVN-led 
workshops, including one in Hanoi on October 5 to obtain input from 
a wider selection of interested parties. 
 
GVN Strategy to Revise the National Action Plan 
--------------------------------------------- -- 
 
4.  (SBU) MOH/VAPM convened this workgroup as part of the GVN 
process to revise the national action plan, pursuant to the 
Partnership Framework for Avian and Human Influenza (PAHI), the 
non-binding partnership between the GVN, donors and NGOs signed in 
 
HANOI 00001727  002.2 OF 003 
 
 
November 2006 and which provides the overall framework for donor 
coordination to support the GVN's Avian Influenza efforts.   An 
earlier September meeting, hosted by the Ministry of Agriculture and 
Rural Development (MARD) and the U.N. Food and Agricultural 
Organization, also provided comments on how to best update the 
national action plan (Ref A).  According to PAHI staffers and the 
CDC Influenza Coordinator, this process will include additional 
workshops to collect information and solicit opinions from other 
stakeholders, experts, and consultants.  These workshops are 
principally supported by CDC's cooperative agreement with VAPM, 
"Surveillance and Response to Avian and Pandemic Influenza in 
Vietnam." 
 
5. (SBU) Following the end of this workshop, participants continue 
to work on VAPM draft changes and workshop suggestions, which will 
then circulate within MOH for comments.  The GVN will use input from 
these workshops (along with information from GVN agencies, field 
interviews and consultants) in its internal deliberations on how 
best to modify the national action plan.  Specifically, working 
level officials from the MARD and MOH will analyze workshop 
suggestions (and follow on comments), synthesize them, and then plug 
in selected and vetted ideas from these meetings into deliberations 
by the NSCAI, chaired by MARD Minister Cao Duc Phat. 
 
6.  (SBU) Once a subcommittee of NSCAI has compiled a draft amended 
plan, the document will be circulated to relevant GVN agencies for 
official comment, but will not include comments from donors and 
other interested parties.  The Minister of Health needs to sign off 
on the final revisions before implementation.  The GVN expects to 
produce a final version of the new, amended plan in 2008, which will 
then be released to bilateral and international partners. 
 
Gaps in the Action Plan 
----------------------- 
 
7.  (SBU) Workshop participants noted gaps in coverage that 
prevented fully effective action and emphasized the need to modify 
the plan to reflect the current situation.  Contributors 
specifically highlighted the need to improve coordination between 
the health and agricultural sectors, the importance of providing 
updated knowledge about AI to health workers, more effective use of 
health care facilities and medications, greater attention to border 
and remote areas, and more timely provision of funds.  HHS attendees 
commented that the draft reviewed at the workshop did not yet 
provide for sufficient monitoring and evaluation and did not 
adequately match proper training to specific groups of health care 
practitioners.   Importantly, several participants urged the GVN to 
better explain to the general public and affected individuals the 
necessity of continued preparations and research even though a 
pandemic has not yet occurred. 
 
Suggested Modifications 
----------------------- 
 
8. (U) Led by VAPM, workshop participants agreed to several possible 
revisions to the national action plan, tied to a Vietnamese proposal 
to add an additional stage to the WHO system of pandemic stages in 
order to cover the possibility of human pandemic influenza first 
occurring in another country and the GVN's need to organize a 
response to prevent the spread of the pandemic into Vietnam. 
Participants supported proposed language focusing on animal to human 
transmission of pandemic influenza and the concurrent need to better 
link the human health and animal health sectors.   All agreed to 
include language on linkages between the four cross cutting areas of 
preventive medicine, communication, treatment, and financial 
resources, along with the need to stress on-site containment and 
treatment and district-level taskforces.  Other agreed to changes in 
 
HANOI 00001727  003.2 OF 003 
 
 
the action plan include more investment for facilities, training, 
and communication materials for district hospitals and preventive 
medicine units.  The draft amended action plan also highlights the 
importance of international partnership. 
 
9. (SBU) Comment: While there will be no formal "review period" for 
international comment, USG agencies at post have helped drive this 
revision process from before "day one."  We are confident that, 
while a GVN product, it will reflect our concerns and result in a 
stronger plan.  The "emergency preparedness" phase of the AI 
response is more complicated in some ways than the initial "crisis 
response" phase.  By better coordinating the human and animal health 
sides of the issue, and by focusing greater attention on building 
long-term capacity in both, the new plan should help Vietnam build a 
sustainable capacity across critical areas, which will add strength 
to the national response, while enhancing the system's ability to 
respond flexibly to new situations.  We will continue to help direct 
and closely monitor this process. 
 
MICHALAK