Cablegate: Spain: Response to Request for Information On

This record is a partial extract of the original cable. The full text of the original cable is not available.

181459Z Nov 05

UNCLAS SECTION 01 OF 04 MADRID 004022

SIPDIS

SENSITIVE

STATE FOR OES/IHA (SINGER/DALEY), INR (LESTER), AND EUR/WE;
HHS FOR STEIGER/BUDASHEWITZ/GAY)

E.O. 12958: N/A
TAGS: TBIO SENV ECON EAGR EAID PREL SP
SUBJECT: SPAIN: RESPONSE TO REQUEST FOR INFORMATION ON
AVIAN AND PANDEMIC INFLUENZA

REF: A. SECSTATE 206992

B. MADRID 3635 AND PREVIOUS

Below are Post's responses to Ref A queries on Spain's
response to the Avian Influenza threat.

A) PREPAREDNESS/COMMUNICATION

-- DOES THE GOVERNMENT HAVE A PREPAREDNESS PLAN/STRATEGY
FOR PREVENTING AVIAN FLU FROM BECOMING A PANDEMIC AND
CONTAINING A PANDEMIC ONCE IT OCCURS?

Yes.

IF THE COUNTRY HAS A STRATEGY, HOW CAPABLE IS IT OF
IMPLEMENTING IT?

Spain has a capable national health care system that should
be able to implement this plan. Of course the plan's
effectiveness depends on the nature of any possible
pandemic.

PLEASE PROVIDE A COPY OF THE PLAN OR THE INTERNET ADDRESS
FOR THE PLAN.

The human plan is entitled National Influenza Preparedness
and Response Plan and is available in English at:
http://www.msc.es/enfermedadesLesiones/enfTra smisi/PlanPande
miaGripre/pdf/PlanGripeIngles.pdf.

The animal plan can be found at
http://www.mapya.es/ganaderia/pags/influenza_ aviar/plan_esta
tal.pdf.

-- HOW TRUTHFUL WILL THE GOVERNMENT BE IN REPORTING THE
SCOPE OF ANY DISEASE OUTBREAK AMONG PEOPLE?

As an EU Member state and OECD economy, we are confidant
that Spain will fully comply with national, EU and WHO
guidelines regarding the reporting of any disease outbreak
among people.

AMONG ANIMALS?

Ditto.

WHAT INCENTIVES COULD BE OFFERED THAT WOULD LIKELY RESULT
IN MORE TRANSPARENCY?

Transparency is not a likely concern vis-a-vis Spain.

-- WHERE DOES PREPARING FOR AN AVIAN FLU HUMAN PANDEMIC
RANK AMONG GOVERNMENT PRIORITIES?

This issue has been addressed by Prime Minister Zapatero
and the Spanish Council of Ministers and is a clear
government priority that has received continuous and
constant attention from both the Health and Agriculture
Ministries.

WHO AND WHAT WOULD MOST INFLUENCE THE COUNTRY TO GIVE THE
ISSUE A HIGHER PRIORITY?

The Health and Agriculture Ministers are on public record
saying that the immediate threat of a human Avian Influenza
pandemic has been exaggerated and that Spain has adequate
plans in place to deal with all eventualities. Absent a
sea change in the views of the Spanish scientific
community, which also believes the threat has been
exaggerated, influencing this policy line would likely
require an approach to Prime Minister Zapatero. However,
should Spanish expert analysis change (e.g., in the event
of a human pandemic gradually emerging), we would expect
the two Ministries to alter their policy lines in keeping
with widely held expert views. The bottom line is that
Spain has resisted what it believes to be the
"politicization" of the issue and wants policy based on
what it perceives to be a cold, hard assessment of the
scientific facts.

WHO IS THE KEY "GO-TO" PERSON, OFFICE OR DEPARTMENT (I.E.
MINISTER FOR HEALTH, PRIME MINISTER, ETC.) FOR USG
OFFICIALS TO ENGAGE ON THIS ISSUE?

The key GOS official on human Avian Influenza is Health
Ministry Director General for Public Health Manuel Onorbe.
Be aware that Onorbe firmly believes that the threat of a
human pandemic has been exaggerated.
-- HAVE NATIONAL LAWS BEEN REVIEWED TO ENSURE THAT THEY ARE
CONSISTENT WITH THE INTERNATIONAL HEALTH REGULATIONS AND DO
NOT POSE BARRIERS TO AVIAN INFLUENZA DETECTION, REPORTING,
CONTAINMENT, OR RESPONSE?
Embassy is not aware of any national laws that had to be
revised in connection with Spain meeting its detection,
reporting, containment, or response commitments under
either the national plans or international commitments.

-- IS THE HOST COUNTRY ALREADY WORKING WITH INTERNATIONAL
ORGANIZATIONS OR OTHER COUNTRIES ON THE AVIAN FLU ISSUE?

Spain addresses this issue as an active member of relevant
EU, WHO, and FAO bodies.

ARE GOVERNMENT LEADERS LIKELY TO ASK FOR ASSISTANCE FROM
THE US OR OTHER COUNTRIES?

Spain is a strong supporter of greater EU cooperation on
Avian Influenza, in particular urging the creation of an
EU-wide anti-viral/vaccine repository which could be
utilized for any potential outbreak inside EU borders.
Spain would likely seek EU, WHO, or FAO assistance before
requesting bilateral help from the U.S.

WOULD GOVERNMENT LEADERS BE RECEPTIVE TO MESSAGES FROM US
LEADERS THROUGH A BILATERAL APPROACH, AT A MULTILATERAL
FORUM SUCH AS THE UN (WHO,FAO,ETC.) OR APEC, OR THROUGH
BILATERAL CONTACTS BY A THIRD COUNTRY?

Spanish authorities would be receptive to bilateral
approaches from U.S. leaders. There would be no need to
deliver such messages via third countries.

WHAT WOULD THE COUNTRY WANT FROM THE US IN RETURN FOR ITS
EFFORTS?

Spain would not likely link greater Avian Influenza
cooperation to other issues.

-- DOES THE COUNTRY CURRENTLY ADMINISTER ANNUAL FLU SHOTS?

Yes

IF NOT, MIGHT IT CONSIDER DOING SO?

Not applicable.

WHAT IS THE PRODUCTION CAPABILITY (I.E. HOW MANY DOSES OF
THE ANNUAL TRIVALENT FLU VACCINE CAN THE COUNTRY MAKE) FOR
HUMAN INFLUENZA VACCINES IN THE COUNTRY?

To the best of our knowledge, Spain does not currently have
a flu vaccine production capability. It plans on opening
such a facility in 2006.

DOES THE COUNTRY PRODUCE INFLUENZA VACCINE FOR POULTRY AND
IF SO HOW MUCH?

Unknown.

IF THE COUNTRY IS DEVELOPING AN H5N1 VACCINE, WHERE IS IT
IN PRODUCTION AND TESTING?

Spain does not yet have a domestic human vaccine production
capability.

ANY LICENSING ISSUES?

Not applicable.

IS THERE A LIABILITY SHIELD FOR FOREIGN MAKERS/DONORS OF
VACCINES?

No. While this would not likely emerge as an issue, it
would be prudent for any U.S. government agency donating
vaccines to Spain to request such a liability shield.

IF NOT, ANY PROSPECTS OF ONE BEING ENACTED?

Not to our knowledge.

--HOW WELL INFORMED IS THE POPULATION ABOUT THE AVIAN FLU
THREAT AND ABOUT MEASURES THEY SHOULD TAKE TO MITIGATE THE
THREAT?

The population is well informed about the threat and of
general measures they should take to mitigate the threat.

WHAT MECHANISMS ARE AVAILABLE FOR PROVIDING ADDITIONAL
INFORMATION TO THE POPULATION, PARTICULARLY IN
RURAL AREAS AND HOW EFFECTIVE ARE THESE MEASURES?

Mechanisms exist to disseminate such information. The key
challenge is convincing Spanish officials that the threat
is currently serious enough to provide such information
now.

B) SURVEILLANCE/DETECTION

-- HOW CAPABLE ARE THE MEDICAL AND AGRICULTURE SECTORS OF
DETECTING A NEW STRAIN OF INFLUENZA AMONG PEOPLE OR ANIMALS
RESPECTIVELY?

Very capable. Appropriate detection equipment has been
widely deployed.

HOW LONG MIGHT IT TAKE FOR CASES TO BE PROPERLY DIAGNOSED,
GIVEN OTHER ENDEMIC DISEASES?

Humans: Same as in the U.S. Spanish surveillance systems
are similar to those in the U.S. Spanish hospital and
diagnostic skills and capabilities are comparable to those
found in the U.S.

Animals: Madrid's Alegete Central Veterinary Lab has
robotized diagnostic equipment than can analyze over 90
samples per hour. If a suspected case is reported, the
entire diagnostic process from reporting through testing
would likely take less than 24 hours.

CAN INFLUENZA VIRUSES BE SUBTYPED IN THE COUNTRY, IF SO BY
WHO, AND IF NOT WHERE ARE THEY SENT?

Humans: Yes. At the National Virus Center in a Madrid
suburb.

Animals: Yes. By the Alegete Lab.

DOES THE COUNTRY SEND SAMPLES TO A WHO/EU/US REFERENCE
LABORATORY?

Yes -- for confirmation of domestic results. The samples
are usually sent to the EU Lab in Weybridge, UK.

-- WHAT ARE THE CRITICAL GAPS THAT NEED TO BE FILLED IN
ORDER TO ENHANCE THE COUNTRY'S DISEASE DETECTION AND
OUTBREAK RESPONSE CAPABILITIES?

Detection: None.

Outbreak: Develop a domestic vaccine production capacity
and take delivery of anti-virals on back order (pending due
to Roche's inability to meet current "Tamiflu" demand).

WHAT IS THE COUNTRY'S GREATEST NEED IN THIS AREA FROM THE
US OR INTERNATIONAL ORGANIZATIONS?

More a question of time (build a vaccine production
facility and take delivery of backordered anti-virals) than
of assistance from the U.S. or an international
organization.

C) RESPONSE/CONTAINMENT

-- DOES THE COUNTRY HAVE A STOCKPILE OF MEDICATIONS,
PARTICULARLY OF ANTIVIRALS, AND IF SO HOW MUCH?

Since the summer, Spain has begun efforts to stockpile
anti-virals, in particular Roche's "Tamiflu."

IF SOME HAS BEEN ORDERED, HOW MUCH AND WHEN IS IT EXPECTED?

Spain has ordered anti-virals to cover approximately 25
percent of its population but has only received limited
deliveries from Roche. Delivery of the entire order is not
expected until late 2006.

--DOES THE COUNTRY HAVE A STOCKPILE OF PRE-POSITIONED
PERSONAL PROTECTIVE GEAR?
Yes. There are 48 centers located around the country (at
least one in each of Spain's 17 regions) that contain all
necessary quick response equipment, including personal
protective gear. In addition, some special police, health,
fire, and armed forces units control limited stockpiles of
such gear.

--WHAT IS THE RAPID RESPONSE CAPACITY FOR ANIMAL AND HUMAN
OUTBREAKS?

The rapid response capacity is delineated in the
afore-mentioned national human and animal plans.

ARE GUIDELINES IN PLACE FOR THE CULLING AND VACCINATION OF
BIRDS, DISINFECTION OF FACILITIES, AND LIMITATIONS ON
ANIMAL MOVEMENT?

Yes. They are being administered by the Agricultural
Ministry, which has already ordered 15 million animal H5N1
vaccines. The government has closed down all Spanish open
air poultry facilities near bird migratory routes. (Note:
less than 10 percent of Spanish poultry is raised in open
air facilities).

-- HOW WILLING AND CAPABLE IS THE GOVERNMENT OF IMPOSING
QUARANTINES AND SOCIAL DISTANCING MEASURES (CLOSING
SCHOOLS, PUBLIC GATHERINGS, MASS TRANSIT)?

Opposition political parties have said that such plans are
being developed but this has not been addressed publicly by
Spanish authorities, who have preferred to emphasize that
"everything is under control" vice increasing the general
alarm among the Spanish people.

WOULD ITS MILITARY ENFORCE QUARANTINES?

The military currently has no plans to enforce a possible
quarantine and has no ongoing staff study on this subject.
We believe any possible quarantine effort would be led by
local government assets, supported as necessary by the
National Police and Civil Guard.
AGUIRRE

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