INDONESIA - SEPTEMBER 1 AVIAN INFLUENZA (AI) UPDATE

UNCLAS SECTION 01 OF 03 JAKARTA 010923

SIPDIS

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DEPT FOR EAP/MLS, EAP/IET, A/MED AND S/ES-O
DEPT FOR G/AIAG/JLANGE AND RFENDRICK
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DEPT ALSO PASS TO USAID/ANE/CLEMENTS AND GH/CARROLL
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BANGKOK FOR RMO, CDC, USAID/RDM/A
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E.O. 12958: N/A
TAGS: TBIO AMED CASC EAGR AMGT PGOV ID KFLU
SUBJECT: INDONESIA - SEPTEMBER 1 AVIAN INFLUENZA (AI) UPDATE

REF: A) Jakarta 10492 B) Jakarta 10140 and previous

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1. (SBU) Summary. The Government of Indonesia (GOI) announced
refocused priorities for controlling avian influenza (AI) at a
successful international donor meeting on August 23-24. Donor
representatives were pleased with the coordination of the meeting
and refocused GOI priorities but concerned by proposed GOI budget
cuts in 2007 for AI activities. The GOI will convene a policy
and technical meeting on AI control in Animals on September 15
sponsored by USAID. On September 1, the GOI launched the National
Committee for Avian Influenza Control and Pandemic Influenza
Preparedness (National AI Committee) Secretariat and an AI public
awareness campaign. A local newspaper reported on August 25 that
Indonesia has suffered up to $170 million in damages to its
poultry industry as a result of AI. On August 29, the World
Health Organization released new case definitions for suspected,
probable and confirmed human cases of H5N1 infection, and as a
result, NAMRU-2 identified one additional subject as "confirmed".
Using the new WHO case definitions, as of September 1, data from
NAMRU-2 and the Ministry of Health show 63 human AI cases in
Indonesia with 48 fatalities. End Summary.

International Donor's Meeting
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2. (U) On August 23-24, 2006, Indonesia's National AI Committee
hosted a meeting to map donor and GOI resources committed to AI
control and to identify gaps in funding. During his opening
remarks, Dr. Bayu Krisnamurthi, Executive Secretary for the
National AI Committee announced that the GOI is narrowing its
priorities to three key components of its national strategy: risk
communications, information and public awareness; epidemiological
surveillance of animals and humans; and highly pathogenic avian
influenza control in animals. Donors concurred with this
refocus, recognizing that human cases will continue until the
disease is controlled at the poultry source.


3. (U) The mapping exercise revealed that the GOI and donors have
budgeted approximately $93 million for AI control in 2006, about
60% of which has come from the GOI budget and 40% from donor
support. Approximately 60-70% of total funds have been directed
to human health. Meeting attendees agreed that funding needs to
shift to focus on the new strategic priorities through increased
funding for AI control in animals, including vaccination, culling
and compensation. The GOI estimated that comprehensive
implementation of the refocused strategy would cost approximately
$250 million per year.


4. (U) While the announcements, findings, and tone of the meeting
were positive, the National AI Committee also announced that the
draft 2007 budget reduces funds for AI control to $46.5 million
from US $57.4 million in 2006. This includes reductions in the
Ministry of Agriculture budget for animal health. Donors reacted
negatively and suggested that the GOI remedy this funding cut.
World Bank Country Representative Andrew Steer noted that donors
would not be willing to support increased funding for Indonesia
for new priorities if the GOI was decreasing its own AI budget.
In the wake of the donors meeting, the local press reported on

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August 31 that Vice President Kalla had assured Steer that the AI
budget will not be cut.

Proposed Policy and Technical Meeting for AI Control in Animals

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5. (U) The National AI Committee will host a policy and technical
meeting on September 15 to bring together key representatives
from the GOI, donors and international organizations to
coordinate on AI Control in animals. Coordinating Minister for
People's Welfare Aburizal Bakrie will open the event, which USAID
is sponsoring. The meeting's objectives include: A) developing a
realistic and effective AI animal control program; B) obtaining
key stakeholder agreement on the animal control program; and C)
gaining consensus on a plan for rolling-out the animal control
program at all levels of government. The agenda includes a
presentation of the GOI's refocused program for AI control in
animals; a presentation and discussion with U.N. AI Coordinator
David Nabarro and other potential high-level participants; and
formulation of an implementation plan.

Launch of National AI Committee and AI Public Awareness Campaign
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6. (U) The GOI officially launched the National AI Committee
Secretariat at a September 1 reception. Established earlier in

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the year by presidential decree, the National AI Committee is a
minister-level committee that coordinates Indonesian actions at
controlling bird flu. A staff of 15 carries out day-to-day
operations. At the reception, Dr. Bayu inaugurated an AI Public
Awareness Campaign "Tanggap Flu Burung!" (Pay Attention to Bird
Flu!) that is aimed at all Indonesians, including the millions of
small-scale, backyard poultry owners across the country. The
campaign uses television and radio public service announcements
(PSAs) and an emergency PSA featuring Indonesian celebrities in
local languages and dialects. A PSA aimed at children features
action star Jackie Chan, and has already started airing on
Indonesian TV stations. The campaign also uses billboards,
magazine articles, comic books, informational leaflets and
signage that are distributed throughout the country.

Indonesia Loses Rp. 1.3 Trillion Due to Bird Flu
-------------- ---


7. (U) A local newspaper reported on August 25th that Indonesia
has suffered a loss of up to US$ 170 million, or Rp. 1.53
trillion, since the start of bird flu. According to Dian
Triansyah Djani, the ASEAN Cooperation Director General of the
Foreign Ministry, the loss is based on deaths and destroyed
poultry only and is less than the losses calculated for Thailand
and Vietnam.

WHO New Definitions and Human AI Case Profile
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8. (SBU) With the August 29 announcement by the WHO to revise
WHO AI Case Definitions, NAMRU-2 has retrospectively made changes

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to the number of confirmed cases of H5N1 infection in humans in
Indonesia to match new WHO definitions. The proposed WHO
definitions will have the greatest impact on the number of cases
listed as probable. These definitions can be found on the
official World Health Organization (WHO) website which can be
accessed at www.who.int/csr/disease/avian_influenza. Researchers
anticipate additional modifications to definitions.


9. (SBU) Currently both NAMRU-2 and the Indonesian Ministry of
Health have the same number of confirmed cases. NAMRU-2 data
indicates the following AI-related case profile as of September
1:

-- Number of laboratory confirmed (positive PCR and/or serology)
human AI cases: 63, of which 48 have been fatal (case fatality
rate of 76 percent).

-- Number of probable AI cases 1, with 1 death (fatality rate of
100 percent).

-- Number of cases awaiting sequencing at the U.S. CDC: 0.

-- Number of possible untested AI cases under investigation (last
30 days): approximately 30.

Note: NAMRU-2 statistics differ from statistics on the official
World Health Organization (WHO) website, which usually lags NAMRU-
2 data by one week. The WHO website, last updated on August 23,
notes 60 human AI cases in Indonesia with 46 deaths.

PASCOE