INDONESIA - AVIAN INFLUENZA (AI) AND THE PRESIDENT"S

UNCLAS JAKARTA 013194

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DEPT FOR EAP/MLS, EAP/IET, MED/DASHO/EMR AND MED
DEPT FOR G/AIAG AND OES
DEPT PASS TO USDA/FAS/DLP/HWETZEL AND FAS/ICD/LAIDIG
DEPT ALSO PASS TO USDA/FAS/FAA/DYOUNG AND USDA/APHIS/ANNELLI
DEPT ALSO PASS TO USAID/ANE/CLEMENTS AND GH/CARROLL
DEPT ALSO PASS TO HHS/WSTEIGER/ABHAT/MSTLOUIS AND HHS/NIH
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E.O. 12958: N/A
TAGS: TBIO AMED CASC EAGR AMGT PGOV ID KFLU
SUBJECT: INDONESIA - AVIAN INFLUENZA (AI) AND THE PRESIDENT"S
VISIT

REF: A) Jakarta 13143 (NAMRU Negotiations)
B) Jakarta 12828 (AI Update)
C) Jakarta 12775 (GOI 2007 budget)
D) Jakarta 11379 (GOI Social Spending)


1. (SBU) Summary. Although the Government of Indonesia has not
yet finalized its FY 2007 allocations for AI control programs,
senior GOI officials including Coordinating Minister Bakrie and
Minister of Finance Sri Mulyani Indrawati have assured the
Embassy that total AI spending will match or exceed 2006 levels.
The Ambassador and Foreign Ministry Director General Eddi
Hariyadhi opened negotiations on a new Memorandum of
Understanding for the Naval Medical Research Unit (NAMRU-2) on
November 9. At that meeting, Dr. Triono Soendoro, the Director
of the Indonesian National Institutes of Health Research and
Development advocated strongly on NAMRU-2's behalf. On November
8, an Embassy interagency team conducted a site visit to Bogor to
see the Participatory Disease Surveillance (PDS) program in
action and better understand the Participatory Disease
Surveillance/Response program (PDS/PDR). With our AI agenda
moving forward on all fronts, we continue to urge Washington to
announce a bold deliverable of increased USG financial assistance
on AI during the President's November 20 visit. End Summary.

AI Budget Remains Unclear But Assurances Given
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2. (U) Despite our efforts to seek GOI clarification on AI
program spending, the GOI has not yet finalized this information.
Parliament passed a broad FY 2007 budget on October 17, but this
document does not contain program-by-program spending breakdowns.
The GOI will likely release more detailed program information o/a
November 30. However, Finance Minister Sri Mulyani Indrawati,
in a meeting with the Ambassador on October 30, reiterated that
the GOI would increase its AI spending in 2007, not decrease it.
This statement is similar to Coordinating Minister for People's
Welfare Aburizal Bakrie's announcement to the press on September

15.


3. (SBU) On November 7, Executive Secretary for the National
Committee for AI Control and Pandemic Prevention Bayu
Krisnamurthi told us that he will not know final AI numbers
until November 15 at the earliest. However, Bayu assured us that
total AI spending would not be lower than 2006 levels. He
further explained that last year, GOI treated AI spending similar
to "disaster management" spending. However, this year, senior
officials have recognized AI as a long term problem that must be
budgeted and organized accordingly. Bayu noted therefore that
analysts' efforts to compare AI spending relative to last year
may not result in a simple apples-to-apples comparison. Pots of
money may be different.

NAMRU Negotiations Underway
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4. (SBU) Ambassador Pascoe and Deplu Director General [xxxxx]
opened negotiations on a new NAMRU-2 MOU on November 9. The
negotiations lasted for several hours. During the negotiation
session, Dr. Triono Soendoro, the Director of the Indonesian
National Institutes of Health Research and Development strongly
advocated on NAMRU-2's behalf. Both sides agreed to stress the
importance of NAMRU-2 in the visit communiqu and resume
discussions after the President's visit.

PDS/PDR Program Observations
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5. (U) On November 8, representatives from NAMRU-2, APHIS, FAS,
USAID and the Economics Section visited Bogor for a field site
visit to better understand the Food and Agricultural Organization
(FAO) PDS/PDR program. Two veterinarians, including one poultry
specialist from APHIS and one veterinarian from NAMRU-2
participated in the site visit. The field trip included a
presentation given by FAO representatives, followed by a brief
visit to the Local Disease Control Center and observation of PDS
team interviews in the field. Throughout the trip, the group
discussed the issues of vaccination, culling, compensation,
program staffing, and PDS/PDR strengths and limitations.

Usefulness and Availability of Vaccine
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6. (U) The team discussed with FAO presenters vaccine policy,
supply and effectiveness. The GOI blanket vaccination policy
suffers from limitations including the potential for vaccinators
to spread the disease and insufficient vaccine supply. There is
some evidence of chickens dying with AI symptoms soon after
vaccination. There may be two reasons for this: vaccinators may
be vaccinating already infected chickens or vaccinators may
unwittingly carry the virus from farm to farm. The PDR team
trains poultry owners to vaccinate poultry at their own farms to
avoid spreading the virus.


7. (U) FAO raised the issue of limited vaccine supply. Currently
the Government of Indonesia (GOI) has only 45 million doses of
vaccine against an estimated need of 1.2 billion. However, the
Minster of Agriculture announced last week that the GOI would
make available 450 million doses in the 2007 budget cycle. The
World Bank and USAID will also provide additional vaccine in
early 2007 and USAID will pilot social marketing of the vaccine
as a more sustainable long-term community financed approach.
However, additional resources will be necessary to meet the
vaccine need.

Culling, Compensation, and PDS/PDR Staffing
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8. (U) FAO recommends focal culling when teams identify AI
infected chickens. The GOI has a compensation program of Rps
12,500 per culled bird (about US$1.35) that is rarely applied.
FAO noted that decentralization and fear of anti-corruption laws
play a significant role in hampering timely compensation to
affected farmers. Decentralization impedes the speed of funds
flowing from national to local levels. Given limited
compensation, poultry owners are often reluctant to cull and PDR
teams must persuade local communities that culling is in their
best long-term interests. FAO reported at present, approximately
50% of focal culling was taking place through PDR. In other
areas not covered by PDR, culling is rare. In collaboration with
the FAO and USG, the World Bank has earmarked funds for
developing a more effective compensation system.


9. (U) FAO stated that training was ongoing. By May 2007, FAO
will have trained 1240 Ministry of Agriculture staff members (650
teams) and approximately 200 trainers in PDS/PDR.

PDS/PDR Successes and Challenges
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10. (U) The visiting embassy team noted that the primary strength
of the PDS/PDR program is that FAO teams are on the ground,
highly focused on the issue, and gain significant insights about
the prevalence, nature and spread of AI among poultry
populations. Teams interview numerous farmers, local village
leaders and owners in the informal poultry sector (sector 3-4).
By speaking to this largely informal sector, PDS/PDR officials
are able to gain valuable information and educate the population
on preventative measures and dealing rapidly with outbreaks.


11. (U) FAO representatives acknowledged that the PDS/PDR program
alone will not contain AI given compensation and culling
challenges, ineffective poultry transportation regulations,
insufficient vaccination programs, and the absence of full
implementation of the GOI national strategic plan. FAO stressed
that the effort to contain the disease will require additional
inputs from GOI, FAO, and the international donor community. The
U.S. Department of Agriculture representative also cited the lack
of a comprehensive policy to control the virus in larger
industrial farms (sector 1-2) as a significant weakness in the
effort to control the disease in Indonesia, although this lies
outside the scope of the PDS/PDR program. Observers noted the
need for PDS/PDR teams to provide local communities with
handouts, flyers and other ancillary items to ensure better
knowledge of safe poultry rearing and handling practices and to
provide ongoing references on poultry and human health risks.
FAO officials stress that they welcome opportunities to improve
the program and will conduct an external evaluation of all
Southeast Asia FAO AI programs in January 2007.


Comment: POTUS Visit: Important Opportunity on AI
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13. (SBU) We share the view of other donors that the GOI has made
significant progress in the past year in managing the AI threat.
But even under the best case budget scenario, GOI will not be
able to meet the requirements for an effective revised AI control
program without increased contributions from donors, including
the U.S. Perhaps more importantly, announcing a major increase
of USG assistance for AI control programs will give us strong
leverage to seek a stronger private and public commitment from
President Yudhoyono to increase the GOI's AI control programs.
The Indonesian press has already reported that Presidents Bush
and Yudhoyono will discuss AI control during President Bush's
visit, and announcing an increase in assistance would enable us
to show that we are ready to back up our concern with concrete
assistance. In this context, we continue to urge Washington to
announce a bold deliverable of increased AI financial assistance
during the President's November 20 visit.

PASCOE