INDONESIA - SEPTEMBER 18 AVIAN INFLUENZA (AI)

UNCLAS SECTION 01 OF 04 JAKARTA 011582

SIPDIS

SIPDIS
SENSITIVE

DEPT FOR EAP/MLS, EAP/IET, A/MED AND S/ES-O
DEPT FOR G/AIAG/JLANGE AND RFENDRICK
DEPT FOR OES/FO, OES/EID, OES/PCI, OES/STC AND OES/IHA
DEPT PASS TO USDA/FAS/DLP/HWETZEL AND FAS/ICD/LAIDIG
DEPT ALSO PASS TO USDA/FAS/FAA/DYOUNG AND USDA/APHIS
DEPT ALSO PASS TO USAID/ANE/CLEMENTS AND GH/CARROLL
DEPT ALSO PASS TO HHS/WSTEIGER/ABHAT/MSTLOUIS AND HHS/NIH
PARIS FOR FAS/AG MINISTER COUNSELOR
CANBERRA FOR APHIS/DHANNAPEL
ROME FOR FAO
NSC FOR JMELINE
BANGKOK FOR RMO, CDC, USAID/RDM/A
USPACOM ALSO PASS TO J07

E.O. 12958: N/A
TAGS: TBIO AMED CASC EAGR PGOV ID KFLU
SUBJECT: INDONESIA - SEPTEMBER 18 AVIAN INFLUENZA (AI)
UPDATE

REF: A) Jakarta 11212 and previous

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1. (SBU) Summary. The National Committee for Avian
influenza and Pandemic Response (National AI Committee)
brought together on September 15 key representatives from
the government of Indonesia (GOI),donor agencies and
international organizations to coordinate funding and
implementation of intensified AI control in animals in
Indonesia. On September 11, National AI Committee Executive
Director Bayu Krisnamurthi described Indonesia's AI strategy
to the Ambassador and identified the need for the long-term
restructuring of the animal health system. We joined the
Singaporean Embassy in a September 13 meeting at the
Ministry of Health (MOH) to encourage progress on Tangerang
project implementation. As of September 15, NAMRU-2 reports
no new confirmed human AI cases since we transmitted Ref A.
Data from NAMRU-2 and the MOH show 65 human AI cases in
Indonesia with 49 fatalities. End Summary.

Successful Coordinating Meeting on AI Control
--------------


2. (U) The National AI Committee hosted a policy and
technical meeting in Jakarta on September 15. The meeting,
sponsored by USAID, brought together key representatives
from the GOI, donor agencies and international organizations
to coordinate funding and implementation of intensified AI
control in animals. Dr. Bayu opened the meeting, which also
included a speech from United Nations System Influenza
Coordinator Dr. David Nabarro and presentations from key
international partners, including USAID, the World Bank, the
Australian Agency for International Development (AusAID),
USDA, and the United Nations Food and Agriculture
Organization (FAO). Participants recognized Indonesia's
progress in controlling AI, particularly over the past 2-3
months. USAID and the World Bank (Avian and Human Influenza
Facility Trust Fund) presented an activity for intensified
and sustained implementation of the GOI animal response and
containment plan. The plan includes focal culling with
compensation, ring vaccination, district-level socialization
of animal control issues, and a validation exercise to
ensure the program is effective.


3. (U) Dr. Nabarro commended Indonesia for its "enormous"
progress in tackling AI over the past eight to twelve weeks
and its focus on animal health and behavior change
communications. He noted that the Participatory Disease
Surveillance and Response (PDS/R) program is making
significant progress at the local level in identifying and
controlling animal outbreaks. Through USAID and other donor
support, the PDS/R program has expanded from its initial 12
pilot districts to over 60 high-risk districts and will roll-
out to 159 districts by early 2007. Nabarro stressed,
however, that the GOI and the donor community must do
significant additional work to bring AI under control in
Indonesia. As a result, Nabarro said he would seek
additional funds for Indonesia from the international donor

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community.

Meeting with Coordinating Minister Bakrie
--------------


4. (SBU) Following the AI partners' meeting, Coordinating
Minister for Peoples' Welfare Aburizal Bakrie met with
Nabarro, World Bank Country Director Andrew Steer, visiting
Director of USAID's AI Unit Dennis Carroll and
representatives from the Mission and AusAID to discuss AI
control in Indonesia. A press conference followed the
meeting. For the first time, Bakrie recognized the $47
million in support international donors have provided
Indonesia to fight AI and publicly thanked the US, Japan,
and the World Bank for their assistance. He also announced
that the GOI budget for AI has not decreased, as was
previously reported. The GOI allocated some funds (such as
the budget for the National AI Committee) to sectors and
ministries that were not included in the earlier accounting,
Bakrie said.


5. (SBU) Minister Bakrie also announced two additional
sources of funds (exact amounts to be determined) for AI: a
$300 million reserve fund for disasters, much of which
remains unspent, and an $80 million fund for poverty
reduction, which the GOI may use to compensate farmers for
culled birds. In addition, the Minister stated that, to
date, the GOI has spent only 5 percent of the $1 million
earmarked in the current budget for culled bird
compensation, leaving considerable funds for future use.
Nabarro and others again acknowledged Indonesia's excellent
progress on animal health, but indicated they were
disappointed by the Ministry of Agriculture's (MOA) poor
representation at the morning meeting. Nabarro also pointed
out the lack of central leadership within the MOA on AI
control. The meeting ended with participants agreeing to
Bakrie's suggestion that the GOI and donors develop a "check
list" for priority AI control actions and budget lines
within the next two months.

Bayu's Views on GOI Efforts to Control AI
--------------


6. (SBU) During a September 11 meeting with the Ambassador,
Bayu described Indonesian efforts to refocus its AI control
campaign on three key strategies: risk communications,
information and public awareness; epidemiological
surveillance of animals and humans; and highly pathogenic
avian influenza control in animals. Bayu explained that
Indonesia has been making good progress on the human side of
AI partially due to stronger infrastructure and the presence
of puskesmas (provincial health centers),which are located
throughout Indonesia. Bayu noted that the animal side of AI
has no equivalent to puskesmas. He suggested that the GOI
must make a long-term commitment to restructure animal
health in Indonesia to include more infrastructure and
resources. AI is only one of many animal diseases prevalent

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in Indonesia; the county also struggles with anthrax,
rabies, hoof and mouth disease and other animal health
issues.


7. (SBU) Director Bayu stressed the need for an effective
public awareness campaign focused on villagers who own free
ranging chickens. He explained that the GOI had introduced
the concept of backyard chickens fifteen years ago in an
effort to promote more protein in Indonesian diets and that
chicken and eggs account for approximately 60 percent most
Indonesian's diet. The Ambassador offered to assist
Indonesia with additional proposals that may help GOI better
control AI.

Tangerang Trilateral Project Update
--------------


8. (SBU) On September 13, we joined Singaporean DCM Lim Hong
Huai in a meeting with Dr. Nyoman Kandun, current GOI head
for the Tangerang trilateral project, to summarize status of
actions taken since the August 18 trilateral planning
meeting in Singapore. Lim provided a Gant Chart listing
project implementation over a three-year span and requested
GOI and USG comments. He reported that the Singaporean
Ministry of Foreign Affairs has almost completed review of
the Singaporean-Indonesian Letter of Intent. Singapore is
interested in engaging in any Tangerang soft launch
activities. We reported USAID has initiated a "Knowledge,
Attitudes, and Practices" survey for Tangerang and were
ready to participate in planned working committees.


9. (SBU) The group reached consensus that the National AI
Committee should take a stronger role in coordinating the
Tangerang project. Dr. Nyoman agreed to convene a large
meeting on the Tangerang trilateral for the week of
September 18 including representatives from the Singaporean
and US Embassies, as well as the National AI Committee and
the Ministries of Health, Agriculture, Finance, and Foreign
Affairs.

NAMRU-2 Human AI Case Profile
--------------


10. (SBU) NAMRU-2 data indicates the following AI-related
case profile as of September 18:

-- Number of laboratory confirmed (positive PCR and/or
serology) human AI cases: 65, of which 49 have been fatal
(case fatality rate of 75 percent).

-- Number of probable AI cases 2, with 1 death (fatality
rate of 50 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.

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Note: NAMRU-2 data corresponds with MOH data but may vary at
times with AI case figures presented on the official World
Health Organization (WHO) website, which usually lags NAMRU-
2 data by one week. The WHO website, last updated on
September 8, notes 63 human AI cases in Indonesia with 48
deaths. WHO figures can be accessed at
www.who.int/csr/disease/avian_influenza.

PASCOE