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Viewing cable 08GUANGZHOU47, Guangdong's AI Strategy: Expanding Vaccination and

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Reference ID Created Released Classification Origin
08GUANGZHOU47 2008-01-28 07:51 2011-08-23 00:00 UNCLASSIFIED//FOR OFFICIAL USE ONLY Consulate Guangzhou
VZCZCXRO2476
RR RUEHCHI RUEHCN RUEHDT RUEHGH RUEHHM RUEHLN RUEHMA RUEHNH RUEHPB
RUEHPOD RUEHVC
DE RUEHGZ #0047/01 0280751
ZNR UUUUU ZZH
R 280751Z JAN 08
FM AMCONSUL GUANGZHOU
TO RUEHC/SECSTATE WASHDC 6826
INFO RUEHOO/CHINA POSTS COLLECTIVE
RUCNASE/ASEAN MEMBER COLLECTIVE
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE
RUEAIIA/CIA WASHDC
RUEKJCS/DIA WASHDC
RUEHRC/DEPT OF AGRICULTURE WASHINGTON DC
RUEAUSA/DEPT OF HHS WASHDC
RHMFIUU/DEPT OF HOMELAND SECURITY WASHINGTON DC
RUEKJCS/SECDEF WASHINGTON DC//USDP/ISA/AP//
RUEKJCS/CJCS WASHINGTON DC//J2/J3/J5//
RHHMUNA/CDR USPACOM HONOLULU HI//J00/J2/J3/J5//
RUEORDA/DIRAFMIC FT DETRICK MD//MA-1A//
UNCLAS SECTION 01 OF 03 GUANGZHOU 000047 
 
SIPDIS 
 
SENSITIVE 
SIPDIS 
 
STATE FOR EAP/CM, CA/OCS/ACS/EAP, AIAG, OES/IHA, MED 
STATE PASS TO USAID FOR ANE AND GH 
CDC FOR OGHA AND DIV-FLU 
DEPARTMENT OF DEFENSE FOR OSD/ISA/AP 
HHS PASS TO FIC/NIH 
USDA PASS TO APHIS, FAS (OSTA AND OCRA), FSIS 
BANGKOK FOR RMO, CDC, USAID 
BEIJING FOR HHS HEALTH ATTACHE AND RMO 
PHNOM PENH FOR CDC INFLUENZA COORDINATOR 
VIENTIANE FOR CDC INFLUENZA COORDINATOR 
 
E.O. 12958: N/A 
TAGS: TBIO AMED AMGT CASC EAGR PINR KFLU CH
SUBJECT: Guangdong's AI Strategy: Expanding Vaccination and 
Enhancing Surveillance 
 
REF: A. Guangzhou 1048; B. Guangzhou 1070; C. Guangzhou 1075; D. 
Guangzhou 1279; E. Beijing 7401; F. Beijing 7567; G. Guangzhou 0043 
 
1. (U) Summary: As part of its five-point AI prevention strategy 
(Ref G), Guangdong is implementing a compulsory vaccination program 
which aims for 100 percent coverage of domestic poultry. 
Significant resources and manpower have been invested in this 
prevention strategy and to strengthening the testing and 
surveillance regime, but challenges remain, given the remoteness of 
many rural farms, the inability of ducklings to develop antibodies 
if vaccinated too soon and the quality control necessary for 
ensuring that vaccines are used prior to their expiry date. End 
Summary. 
 
------------------------------------- 
More than Just an Ounce of Prevention 
------------------------------------- 
 
2. (U) Following the 2004 H5N1 AI outbreaks, Guangdong implemented a 
compulsory vaccination program. This program, which calls for 
scheduled vaccinations, is more stringent than the national 
vaccination strategy which only requires emergency vaccinations in 
the event of an outbreak, as well as rapid culling.   The program is 
headed by the provincial Veterinary Center for Epidemic Prevention 
and Control (VCEPC), a component of the Department of Agriculture. 
Under this vaccination program, all farm-raised poultry, including 
broilers and breeders, will receive at least one vaccination before 
being sold in the market.   Breeders with a longer production cycle 
will receive two or possibly three vaccinations in order to maintain 
a healthy level of immunity.   In 2006, Guangdong VCEPC administered 
1.5 billion doses of H5N1 vaccines to a poultry population of 1.35 
billion, and claimed that the province achieved a 100% vaccination 
rate, based on the dose-to-poultry population ratio. 
 
3. (SBU) Thus far, Guangdong's provincial government has invested 
RMB 150 million (approx. USD 21.5 million) in its vaccination 
program, which is estimated to cost RMB 400-500 million (approx. USD 
57-71 million) a year.  According to YU Yedong, Director of the 
Guangdong VCEPC, the provincial, municipal and district governments 
pay for 80% of the total cost, with the remainder subsidized by the 
central government.  In contrast to Guangdong, other provinces with 
more limited resources normally receive a larger central government 
subsidy. 
 
--------------------------- 
Vaccine Efficacy is the Key 
--------------------------- 
 
4. (SBU) Under its current program, Guangdong province administers a 
recombinant inactivated H5N1 vaccine (extracted from chicken eggs) 
to farm-raised poultry.  The current vaccine targets the H5N1 virus 
of the 1996 Guangdong strain.   The same H5N1 vaccine is also widely 
used in other parts of China and purchased by Vietnamese 
authorities.   YU told us the Guangdong vaccine has proven to be 
effective in protecting all poultry if given sufficient time to 
develop immune response.   Thus far, there have been no indications 
that the H5N1 virus circulated in Guangdong has mutated in a way 
that would render the current vaccine ineffective.   Previously, an 
H5N2 vaccine and a Newcastle Disease Virus-H5N1 (ND-H5N1) vaccine 
were used in Guangdong; however, YU revealed that these vaccines are 
now less effective and no longer used. 
 
--------------------------------------------- --- 
Controlled Vaccine Manufacturing and Procurement 
--------------------------------------------- --- 
 
5. (U) Vaccines administered as part of the AI vaccination program 
adhere to stringent supply controls.  For example, vaccines are only 
 
GUANGZHOU 00000047  002 OF 003 
 
 
procured from seven Chinese Ministry of Agriculture-approved H5N1 
vaccine manufacturers, two of which are located in Guangdong 
province.  Guangdong Department of Agriculture uses vaccines from 
three of the seven approved locations, Harbin Veterinary Research 
Institute, Zhaoqing Dahuanong Biological Medicine Company, and 
Guangdong Yongshun Bio-pharm Company Ltd.  This strategy safeguards 
against shortages and production or storage failure. 
 
6. (U) Under Guangdong's AI vaccination program, the government pays 
for the procurement, storage, distribution, and administration of 
the vaccines.   Veterinary vaccine supply stations, scattered 
throughout the province, maintain cold chain supplies.  In 
constructing this distribution infrastructure, Guangdong provincial 
government invested RMB 20 million (USD 2.8 million), which included 
importing mobile storage units from the United States.   In general, 
large poultry farms obtain their AI vaccines from these supply 
stations and employ their own veterinary technicians to administer 
the vaccines.   In the countryside, government-trained grassroots 
workers administer vaccines for small-scale poultry farmers. 
Distributing and administering vaccines prior to their expiration 
date remains a constant challenge. 
 
7. (U) AI vaccines are regulated under the national laws for 
"Management Methods in Business with Veterinary Bioproducts", 
"Animal Epidemic Prevention Law", and the "Regulations on 
Administration of Veterinary Drugs".   AI vaccine production must 
comply with the requirements of the Good Manufacturing Practice 
(GMP) standards for animal vaccines, regulated by China Institute of 
Veterinary Drug Control (CIVDC) under the Ministry of Agriculture. 
Each production batch must meet the criteria established by CIVDC 
for H5N1 vaccine and pass inspection for safety and efficacy.  The 
Guangdong Department of Agriculture and the Veterinary Drug 
Inspection Department of the Ministry of Agriculture (Beijing) 
station inspectors in vaccine factories to monitor the production 
and product release processes. 
 
--------------------------------------------- --- 
Enhancing Veterinary Monitoring and Surveillance 
--------------------------------------------- --- 
 
8. (SBU) Approximately 20,000 certified animal disease prevention 
and treatment workers provide technical support and vaccinations in 
village areas. These grassroots workers, subsidized by the 
government, are trained by the provincial Department of Agriculture 
to administer vaccines and issue vaccination records.  They also 
check vaccination records and monitor possible AI virus mutation 
precursors or outbreaks.  In addition, technicians collect both 
routine and unscheduled samples of poultry serum and swabs for 
testing.  The standard methods and reference reagents for performing 
the tests are provided by the National AI Reference Lab (Harbin 
Veterinary Research Institute).  Yu Yedong, Director of the 
Guangdong VCEPC, told us that these reagent standards and test 
methods comply with guidelines set by the International Organization 
for Animal Health (OIE). As of November, authorities tested 108,000 
poultry serum samples and 19,000 swab samples in 2007 alone.  In 
addition, 13 batches of 'surprise' poultry checks have been 
conducted to ensure that poultry producers are in compliance with 
vaccination regulations and that vaccination records are accurate. 
 
 
------------------------------------- 
Challenges - Vast Scale and Ducklings 
------------------------------------- 
 
9. (SBU) Guangdong has a large poultry industry and a high 
poultry-to-human density ratio of approximately 15:1.   Of the 1.35 
billion poultry produced in 2007, 30-35% of them were raised in 
rural and remote areas rather than on industrial poultry farms. 
 
GUANGZHOU 00000047  003 OF 003 
 
 
These small-scale farms pose a significant challenge to achieving 
the "100% vaccination" goal.  YU mentioned that an electronic 
information system similar to the framework of the U.S. National 
Animal Information System (NAIS) for animal premises registration, 
identification (including vaccination records), movement and disease 
tracing, is being considered for poultry.  A similar pilot program 
was just recently initiated for large farm animals, including 
cattle, pigs, sheep, and goats; it is unclear when the pilot program 
might be expanded to poultry. 
 
10. (U) Successful vaccination among ducks, the source of the 
September 2007 outbreak, remains a great concern (Ref A).  In 
general, ducks are farm-raised for 40 days before being sold on the 
market.  Sufficient protective antibodies can normally be attained 
20 days after vaccination with the current H5N1 vaccine.  Ducklings 
under 20 days of age do not respond with sufficient protective 
antibodies if given the vaccine too early.  Thus, vaccination in 
ducks remains the weakest link in this program unless an improved 
vaccine that could mount a much more efficient immune response in 
ducks can be deployed. 
 
GOLDBERG