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 JAKARTA 00011582 001.2 OF 004 ¶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 JAKARTA 00011582 002.2 OF 004 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 JAKARTA 00011582 003.2 OF 004 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. JAKARTA 00011582 004.2 OF 004 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